Perioperative Management in the Patient with Substance Abuse

Are Intoxicated Trauma Patients at an Increased Risk for Intraoperative Anesthetic Complications? A Retrospective Study

“…ese substances, whether ingested acutely or chronically, alter ordinary physiology, increasing the risk for adverse effects and complications during the patient's hospital stay [6,7]. Surgery must often be postponed for acutely intoxicated patients because of the potential anesthetic risks [10,11]. However, many trauma patients require urgent treatment forcing anesthesiologists to manage the acutely intoxicated patient.…”

“…Anesthesiologists are frequently responsible for the urgent management of trauma patients at all levels of intoxication. Delaying treatment is a common practice for patients who test positive for an intoxicant, but do not require urgent care [11]. e purpose of this study was to compare the association of U-TOX screening results with intraoperative anesthetic complications of trauma patients.…”

Anesthetic implications of recreational drug use

“…Accordingly, it is important for anesthesiologists to know about the most common illicit drugs being used, their clinical presentation and side effects, and the anesthetic options that are beneficial or detrimental to these patients. [1][2][3][4] In this article, we discuss some of the most frequently used illicit substances, including their effects and importance for anesthesiologists. We discuss how to manage addicted patients prior to administering anesthesia or providing analgesia, how to anticipate drug interactions and predict tolerance to some anesthetic agents, and how to recognize signs and symptoms of drug withdrawal.…”

“…Although alcohol and tobacco are the most common substances abused by patients, they are outside the scope of this article and have been reviewed elswhere. [4][5][6][7][8] Drug abuse is associated with altering a person's thinking and judgement, leading to health problems, including addiction and reckless behaviour. Addiction has been defined as a form of maladaptive memory.…”

“…The Table provides a summary of the main recreational drugs, with specific considerations for each of them. [1][2][3][4][47][48][49] Specifically, it is important to know the time of the last dose and the typical amount of a patient's illicit or prescribed (e.g., in the case of long-term opioid therapy) medication or if and when they have taken other recreational drugs (e.g., cannabis, cocaine, ecstasy, etc.). Specific screening tests, if applicable, can be performed.…”