Conclusions
In the majority of cases, patients should continue their usual medications preoperatively. Exceptions to this have been alluded to. Of greater importance is the recognition of potential adverse interactions with anaesthesia and the modification of the anaesthetic technique to reflect this. When it is necessary to withhold a drug preoperatively, knowledge of the T1/2β and the behaviour of any metabolites is required to ensure the expected decline in drug activity. Whenever drug levels are allowed to decrease preoperatively, a resurgence of symptoms of the underlying pathology must be anticipated. Communication with the prescribing physician and surgeon may be appropriate.
Conclusions
Dans la majorité des cas, les patients devraient continuer de prendre leur médication habituelle. Des exceptions ont été formulées. Il est encore plus important de reconnaître les interactions défavorables avec l’anesthésie qui peuvent survenir et de modifier les techniques anesthésiques en conséquence. Quand il devient nécessaire de cesser l’administration d’un médicament avant l’intervention, pour prévoir la décroissance de son activité, il faut connaître la T1/2β et le comportement des métabolites. Quand on permet aux concentrations des médicaments de diminuer avant une intervention, il faut anticiper une recrudescence des symptômes. Il semble pertinent de communiquer avec le chirurgien et le médecin traitant.
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Doak, G.J. Discontinuing drugs before surgery. Can J Anaesth 44 (Suppl 1), R112–R123 (1997). https://doi.org/10.1007/BF03022270
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DOI: https://doi.org/10.1007/BF03022270