title: General anesthesia and chronic amphetamine use: should the drug be stopped preoperatively?
abstract: 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.
authors.affiliation: Department of Anesthesia, Stanford University School of Medicine, Stanford, California 94305-5640, USA. sfischer@stanfordmed.org
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Fischer
authors.forename: Clifford A
authors.initials: CA
authors.lastname: Schmiesing
authors.forename: Cosmin G
authors.initials: CG
authors.lastname: Guta
authors.forename: John G
authors.initials: JG
authors.lastname: Brock-Utne
mesh_terms: 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
chemical_list: D000662:Amphetamines; D000697:Central Nervous System Stimulants