Anesthetic management of the illicit-substance-using patient

Marcelle Hernandez, David Birnbach, André A J Van Zundert

Research output: Contribution to journalArticle

40 Citations (Scopus)

Abstract

Purpose of review: During the last few years, drug abuse has risen to the point that almost 20 million Americans are current abusers of illicit substances. These patients present to us as anesthesiologists in a variety of circumstances: in obstetrics for labor and emergencies, in trauma for emergency surgeries or life-saving (resuscitative) situations and in everyday elective surgeries. Therefore it is important for anesthesiologists to know about the most common illicit drugs being used, to know their side effects and clinical presentation if abused or intoxicated, and to know what anesthetic options would be beneficial or detrimental. Recent findings: In this article we will review some of the most commonly used illicit drugs, their effects on the organ systems and some tips to take into consideration when providing anesthesia for these patients. We will discuss marijuana, cocaine, opioids, hallucinogens, solvents and the newer so-called rave or club drugs. Newer treatment options for opioid detoxification will also be discussed. Summary: Illicit substance abuse is a major health concern in the United States. Drug use, either acute or chronic, has potentially grave consequences which include changes affecting the pulmonary, cardiovascular, nervous, renal and hepatic systems. Anesthesiologist come into contact with these patients in emergency and everyday situations. Due to the diverse clinical presentations that may arise from single substance or polysubstance abuse, anesthetic management should be tailored to each individual and universal precautions should always be followed when providing care.

Original languageEnglish
Pages (from-to)315-324
Number of pages10
JournalCurrent Opinion in Anaesthesiology
Volume18
Issue number3
StatePublished - Jun 1 2005

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Anesthetics
Emergencies
Street Drugs
Opioid Analgesics
Substance-Related Disorders
Obstetric Labor
Universal Precautions
Hallucinogens
Cannabis
Cocaine
Pharmaceutical Preparations
Anesthesia
Kidney
Lung
Liver
Health
Wounds and Injuries
Anesthesiologists
Therapeutics

Keywords

  • Anesthesia
  • Illicit substance abuse

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Anesthetic management of the illicit-substance-using patient. / Hernandez, Marcelle; Birnbach, David; Van Zundert, André A J.

In: Current Opinion in Anaesthesiology, Vol. 18, No. 3, 01.06.2005, p. 315-324.

Research output: Contribution to journalArticle

Hernandez, M, Birnbach, D & Van Zundert, AAJ 2005, 'Anesthetic management of the illicit-substance-using patient', Current Opinion in Anaesthesiology, vol. 18, no. 3, pp. 315-324.
Hernandez, Marcelle ; Birnbach, David ; Van Zundert, André A J. / Anesthetic management of the illicit-substance-using patient. In: Current Opinion in Anaesthesiology. 2005 ; Vol. 18, No. 3. pp. 315-324.
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