[An emergency tracheotomy in case of airway compromise after post-operative bleeding associated with the use of an antidepressant].
Selective serotonin reuptake inhibitors block the uptake ofserotonin into thrombocytes. One of the functions of serotonin in thrombocytes is to promote platelet aggregation. When serotonin levels are depleted after several weeks of treatment, the altered platelet function leads to increased risk of abnormal bleeding. In patients taking a combination of a selective serotonin reuptake inhibitor and a non-steroidal anti-inflammatory drug, the risk ofabnormal bleeding is thought to be even higher. A case is reported of abnormal bleeding after treatment in the oral cavity, associated with simultaneous use of a selective serotonin reuptake inhibitor and a non-steroidal anti-inflammatory drug. A large haematoma in the floor of mouth caused airway compromise which necessitated an emergency tracheotomy. Until greater insight is achieved by means of additional research, increased attentiveness for these patients seems to be called for and extra care should be employed. Additional haemostatic measures could be considered.
Van Cann
E M
EM
Uit de afdeling Mondziekten, Kaak- en Aangezichtschirurgie en Bijzondere Tandheelkunde van bet Universitair Medisch Centrum Utrecht te Utrecht. e.m.vancann@umcutrecht.nl
Koole
R
R
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000627:therapeutic use; D018687:Antidepressive Agents, Second-Generation / Q000009:adverse effects* / Q000627:therapeutic use; D004347:Drug Interactions; D006406:Hematoma / Q000150:complications / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D019106:Postoperative Hemorrhage / Q000139:chemically induced* / Q000150:complications / Q000601:surgery; D017367:Selective Serotonin Reuptake Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D014140:Tracheotomy
D000894:Anti-Inflammatory Agents, Non-Steroidal; D018687:Antidepressive Agents, Second-Generation; D017367:Selective Serotonin Reuptake Inhibitors