title: [Lithium use and perioperative management].
abstract: A 62-year-old man presented with diminished consciousness, hypotension, hypoglycaemia and agitation. He had undergone heart surgery 1.5 weeks earlier. Due to a stroke as a postoperative complication, antihypertensive medication had been added. His lithium medication had been interrupted only on the first postoperative day. The presenting complaints were due to delirium as a result of lithium intoxication. The delirium faded away after interruption of the lithium medication and treatment with haloperidol and oxazepam. The patient and his family were informed as to the nature of the delirium and the precautions to be taken in case of any future disease or operation. Lithium should be discontinued preoperatively in all patients. If necessary, alternative psychiatric medication must be prescribed. After restarting lithium, the serum levels of lithium must be monitored.
authors.affiliation: Universitair Medisch Centrum Groningen, afd. Inwendige Geneeskunde, Postbus 30o.oo, 9700 RB Groningen. k.meijer@int.umcg.nl
authors.forename: K
authors.initials: K
authors.lastname: Meijer
authors.forename: J P J
authors.initials: JP
authors.lastname: Slaets
authors.forename: F J
authors.initials: FJ
authors.lastname: Huyse
mesh_terms: D014150:Antipsychotic Agents / Q000009:adverse effects* / Q000627:therapeutic use*; D003693:Delirium / Q000139:chemically induced; D006220:Haloperidol / Q000627:therapeutic use; D006801:Humans; D008094:Lithium / Q000009:adverse effects* / Q000097:blood / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010076:Oxazepam / Q000627:therapeutic use; D019990:Perioperative Care
chemical_list: D014150:Antipsychotic Agents; D010076:Oxazepam; D008094:Lithium; D006220:Haloperidol