General anesthesia and chronic amphetamine use: should the drug be stopped preoperatively?
Prescription amphetamines are being used more often for several medical conditions. Anesthesia concerns focus on the cardiovascular stability of patients who may be catecholamine-depleted and thus have a blunted response to intraoperative hypotension. Previously we reported one case of a patient receiving chronic amphetamine therapy who had a stable intraoperative course. We now report eight additional patients taking chronic prescription amphetamines who underwent a safe general anesthesia and outcome. Predominantly prescribed for narcolepsy and attention deficit hyperactivity disorder, amphetamine drugs had been given to these 8 patients for 2 to 10 yr. Ages ranged from 22 to 77 yr and genders were equally divided. All required general anesthesia for their surgical procedures and 6 of the 8 patients were tracheally intubated. Anesthesia operating room times ranged from 30 min to 4.25 h. The authors conclude that amphetamine use need not be stopped before surgery and anesthesia.
Fischer
Stephen P
SP
Department of Anesthesia, Stanford University School of Medicine, Stanford, California 94305-5640, USA. sfischer@stanfordmed.org
Schmiesing
Clifford A
CA
Guta
Cosmin G
CG
Brock-Utne
John G
JG
D000328:Adult; D000368:Aged; D000662:Amphetamines / Q000009:adverse effects / Q000627:therapeutic use*; D000768:Anesthesia, General; D000697:Central Nervous System Stimulants / Q000009:adverse effects / Q000627:therapeutic use*; D005260:Female; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011300:Preoperative Care
D000662:Amphetamines; D000697:Central Nervous System Stimulants