Propofol for benzodiazepine-refractory alcohol withdrawal in a non-mechanically ventilated patient

Am J Emerg Med. 2014 Jan;32(1):112.e3-4. doi: 10.1016/j.ajem.2013.08.044. Epub 2013 Sep 26.

Abstract

Long-term alcohol use confers neurochemical changes in response to alcohol's exogenous inhibitory effects. Downregulation and decreased sensitivity of γ-aminobutyric acid receptors render benzodiazepines less effective at controlling psychomotor agitation. Propofol has been reported to have successfully relieved alcohol withdrawal syndrome (AWS) symptoms in part because of activation of γ-aminobutyric acid channels in combination with antagonism of excitatory amino acids such as N-methyl-D-aspartate. Successful use of propofol in refractory AWS in patients with endotracheal intubation and mechanical ventilation has been reported. We present a case of resolution of AWS symptoms in a benzodiazepine-refractory, nonintubated, non-mechanically ventilated alcohol withdrawal patient with low-dose, continuous-infusion propofol.

Publication types

  • Case Reports

MeSH terms

  • Adult
  • Alcohol Withdrawal Delirium / diagnosis
  • Alcohol Withdrawal Delirium / drug therapy*
  • Diazepam / therapeutic use
  • Emergency Service, Hospital
  • Haloperidol / therapeutic use
  • Humans
  • Hypnotics and Sedatives / therapeutic use*
  • Lorazepam / therapeutic use
  • Male
  • Propofol / therapeutic use*
  • Treatment Failure

Substances

  • Hypnotics and Sedatives
  • Haloperidol
  • Lorazepam
  • Diazepam
  • Propofol