Posted by Caleb462 on August 16, 2003, at 13:58:12
In reply to Re: Parnate and Anaesthesia, posted by Ame Sans Vie on August 15, 2003, at 11:29:24
> From what I understand, there *are* some *relatively* safe methods of inducing general anesthesia in a patient on MAOIs, but only, like you said, in an emergency. Phencyclidine (PCP) and ketamine can be used, along with other anesthetics, though the whole waking up tripping thing is pretty much a turn-off when considering these options.
>
> Most commonly employed is a combination of an opioid anesthetic (i.e. Alfenta, Sufenta, Ultiva) with a barbiturate (i.e. thiopental, methohexital) or Versed, along with oxygen, nitrous oxide, and monitored anesthesia care. Even this is risky though, as opioids are very much cautioned against while on MAOI therapy. The key for the anesthetist is to start low and go slow.Why *is* anesthesia + MAOI risky? I don't understand the mechanisms behind this - care to enlighten me?
Also - you say opiods are cautioned against while on MAOI therapy, but it was my understanding that only those which also block monoanime reuptake (Demerol, Ultram, etc) need to be avoided. For instance, I see no reason why MAOI + hydrocodone would be a problem.
poster:Caleb462
thread:250988
URL: http://www.dr-bob.org/babble/20030812/msgs/251337.html