UFH: unfractionated heparin.

resulted from administration of pethidine to patients treated with MAOI. Hypertensive crises may occur when vasopressors are administered to patients on MAOIs. If surgery in patients on ongoing MAOI therapy is necessary or for emergency surgery, the following guidelines should be employed: Preoperative consultation with the treating psychiatrist. Benzodiazepine premedication. Avoid halothane, pethidine.

If vasopressors are necessary, avoid indirect-acting pressors (metaraminol) and use fluids and posture wherever possible. Carefully titrate small doses of direct-acting vasoconstrictors (methoxamine or phenylephrine) if necessary. Suxamethonium effect may be prolonged due to decreased cholinesterase levels.

Oral contraceptives

The use of the progesterone-only pill poses no documented problems during surgery. However, the combination oestrogen-progesterone pill should be discontinued 6 weeks prior to elective surgery because of the increased risk of DVT, especially in women who smoke. When emergency surgery is necessary, additional thomboembolism prophylaxis is required. In all cases, the patient must be advised to use alternate forms of contraception as the reliability of oral absorption is affected by fasting, perioperative nausea and vomiting and any antibiotic-induced diarrhoea (Table 1.8).

Was this article helpful?

0 0
How To Win Your War Against Anxiety Disorders

How To Win Your War Against Anxiety Disorders

Tips And Tricks For Relieving Anxiety... Fast Everyone feels anxious sometimes. Whether work is getting to us or we're simply having hard time managing all that we have to do, we can feel overwhelmed and worried that we might not be able to manage it all. When these feelings hit, we don't have to suffer. By taking some simple steps, you can begin to create a calmer attitude, one that not only helps you feel better, but one that allows you the chance to make better decisions about what you need to do next.

Get My Free Ebook

Post a comment