title: Sufentanil-isoflurane-nitrous oxide anesthesia for a patient treated with monoamine oxidase inhibitor and tricyclic antidepressant.
abstract: We report a case in which sufentanil was given to a patient who was already taking both a monoamine oxidase (MAO) inhibitor and a tricyclic antidepressant. Anecdotal reports have recommended discontinuing MAO inhibitors 2 to 3 weeks prior to elective surgery. However, current anesthesia literature suggests this practice may be unnecessary. This case report involved a patient who refused to stop her antidepressant medications. She was given an uneventful elective anesthetic with measures to minimize the risk of an adverse drug reaction involving the antidepressants she was taking. Our experience suggests that the use of an opioid other than meperidine may allow the anesthetist to proceed cautiously to provide an anesthetic for an elective surgery patient who is also currently receiving MAO inhibitor therapy.
authors.affiliation: Department of General Anesthesiology, Cleveland Clinic Foundation, OH 44195-5154, USA.
authors.forename: J F
authors.initials: JF
authors.lastname: O'Hara
authors.forename: W G
authors.initials: WG
authors.lastname: Maurer
authors.forename: M P
authors.initials: MP
authors.lastname: Smith
mesh_terms: D000328:Adult; D000758:Anesthesia; D000929:Antidepressive Agents, Tricyclic / Q000009:adverse effects* / Q000627:therapeutic use; D003866:Depressive Disorder / Q000150:complications / Q000188:drug therapy; D005260:Female; D006801:Humans; D007530:Isoflurane; D008996:Monoamine Oxidase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D009609:Nitrous Oxide; D011229:Preanesthetic Medication; D013270:Stomach / Q000601:surgery*; D017409:Sufentanil; D017792:Surgical Stapling
chemical_list: D000929:Antidepressive Agents, Tricyclic; D008996:Monoamine Oxidase Inhibitors; D017409:Sufentanil; D007530:Isoflurane; D009609:Nitrous Oxide