Monoamine Oxidase Inhibitors and Anaesthesia

Stack, C.G.; Rogers, P.; Linter, S.P.K.

doi:10.1093/bja/60.2.222

Cited by 104 publications

(44 citation statements)

References 23 publications

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“…83 What is the evidence linking MAOI to serotonergic crises? Serotonergic reactions to meperidine have been described for all MAOI, 80,84,85 including moclobemide 81,82 and selegiline. 83 Meperidine blocks neuronal serotonin reuptake, resulting in serotonergic overactivity, agitation, hyper/hypotension, convulsions, hyperthermia, and coma.…”

Section: Is Postoperative Fever An Indication For Hospital Admission?mentioning

confidence: 99%

“…In fact, direct-acting sympathomimetics such as epinephrine are the recommended pressor agents for patients on MAOI. 80,84 Patients on MAOI/RIMA do not have clinically significant potentiation of cardiovascular effects of iv infusions of norepinephrine or epinephrine. 82,88 Vasopressors at concentrations contained in local anesthetics are not likely to be significantly potentiated in otherwise healthy patients on MAOI.…”

Section: Are Maoi Associated With Atypical Responses To All Catecholamentioning

confidence: 99%

“…80 Three cases of excessive barbiturate/opioid effects were reported from 1960 to 1970. 80,84 Since then, numerous reports have described uneventful anesthetics using barbiturates and various opioids: remifentanil, 89 alfentanil, 89,90 sufentanil, 91 fentanyl, 80,81 hydromorphone 91 and morphine 80,81,81,85,89 for patients continuing to take MAOI. Other agents including propofol, 90,92 ketamine, 93 midazolam, 92 ketorolac, 92 vecuronium, 92 and atracurium 92 have also been used safely.…”

Section: Do Maoi Interact With Anesthetic Drugs?mentioning

confidence: 99%

“…80,84,95 Withdrawal of MAOI is not without risks. Many patients have severe depression refractory to other treatment and are at risk for life-threatening psychiatric illness.…”

Section: Is the Continuation Of Maoi Associated With Adverse Outcomes?mentioning

confidence: 99%

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Patient selection in ambulatory anesthesia — An evidence-based review: part II

et al. 2004

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P Pu ur rp po os se e: : This is the second of two reviews evaluating the management of patients with selected medical conditions undergoing ambulatory anesthesia and surgery. Conditions highlighted in this review include: diabetes mellitus; morbid obesity; the ex-premature infant; the child with an upper respiratory infection; malignant hyperthermia; and the use of monoamine oxidase inhibitors.S So ou ur rc ce e: : Medline search strategies and the framework for the evaluation of clinical evidence are presented in Part I. P Pr ri in nc ci ip pa al l f fi in nd di in ng gs s: : Diabetes mellitus has not been linked with adverse events following ambulatory surgery. The morbidly obese patient is at an increased risk for minor respiratory complications in the perioperative period but these events do not increase unanticipated admissions. The ex-premature infant may be considered for ambulatory surgery if post-conceptual age is > 60 weeks and hematocrit is > 30%. The child with a recent upper respiratory tract infection is at an increased risk for perioperative respiratory complications, particularly if endotracheal intubation is required. Patients with malignant hyperthermia may undergo outpatient surgery but require four hours of postoperative temperature monitoring. Sporadic cases of drug interactions have been reported when meperidine and indirectacting catecholamines are administered in the presence of monamine oxidase inhibitors. Ambulatory anesthesia and surgery is safe if these combinations of drugs are avoided.C Co on nc cl lu us si io on n: : Ambulatory anesthesia can be performed in, and is being offered to, a variety of patients with significant coexistent disease. In many cases there is little evidence documenting the outcomes expected in such patients. Prospective observational and interventional trials are required to better define perioperative management. Objectif : C'est la seconde revue qui évalue la prise en charge de patients, dont les pathologies médicales ont été ciblées, qui doivent subir une anesthésie en chirurgie ambulatoire. Les situations choisies comprennent : le diabète, l'obésité morbide, l'enfant né prématurément, l'enfant atteint d'infection des voies respiratoires supérieures, l'hyperthermie maligne et l'usage d'inhibiteurs de la monoamine-oxydase. Source : Les stratégies de recherche dans Medline et le cadre de l'é-valuation de la preuve clinique sont présentés dans la partie I. Constatations principales : Le diabète n'a pas été relié à des événements indésirables à la suite d'une opération ambulatoire. Le patient très obèse est plus à risque de complications respiratoires péri-opératoires mineures, ce qui n'augmente pas les admissions hospitalières imprévues. L'enfant prématuré est admis en chirurgie ambulatoire si l'âge post-conception est > 60 semaines et si l'hématocrite est > 30 %. L'enfant qui a une infection récente des voies respiratoires supérieures

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Section: Is Postoperative Fever An Indication For Hospital Admission?mentioning

confidence: 99%

Section: Are Maoi Associated With Atypical Responses To All Catecholamentioning

confidence: 99%

Section: Do Maoi Interact With Anesthetic Drugs?mentioning

confidence: 99%

“…80,84,95 Withdrawal of MAOI is not without risks. Many patients have severe depression refractory to other treatment and are at risk for life-threatening psychiatric illness.…”

Section: Is the Continuation Of Maoi Associated With Adverse Outcomes?mentioning

confidence: 99%

See 2 more Smart Citations

Patient selection in ambulatory anesthesia — An evidence-based review: part II

et al. 2004

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show abstract

“…Besides the well-described problems of occasionally lethal excitatory or depressive interactions with meperidine, l,2 severe hypertension may be encountered if indirect-acting pressor agents are used to manage hypotension following establishment of a regional block. 3 There is little known about the effects of MAOIs on the fetus and the neonate. The literature contains no information on analgesia for labour or Caesarean delivery.…”

Section: La Bupivacaine Sans Dpindphrine Ni Morphinique a Did Raise Ementioning

confidence: 99%