General Anesthesia and Chronic Amphetamine Use: Should the Drug Be Stopped Preoperatively?

In Brief Prescription amphetamines are being used more often for several medical conditions. Anesthesia concerns focus on the cardiovascular stability of patients who may be catecholamine-depleted and thus have a blunted response to intraoperative hypotension. Previously we reported one case of a patient receiving chronic amphetamine therapy who had a stable intraoperative course. We now report eight additional patients taking chronic prescription amphetamines who underwent a safe general anesthesia and outcome. Predominately prescribed for narcolepsy and attention deficit hyperactivity disorder, amphetamine drugs had been given to these 8 patients for 2 to 10 yr. Ages ranged from 22 to 77 yr and genders were equally divided. All required general anesthesia for their surgical procedures and 6 of the 8 patients were tracheally intubated. Anesthesia operating room times ranged from 30 min to 4.25 h. The authors conclude that amphetamine use need not be stopped before surgery and anesthesia. IMPLICATIONS: Amphetamine therapy is prescribed for patients with narcolepsy, exogenous obesity, Parkinson’s disease, attention deficit disorder, and other psychiatric diagnoses. The significant effects of these potent sympathomimetic amines can potentially affect a patient’s hemodynamic stability during anesthesia. We report eight cases of patients receiving chronic amphetamine therapy who underwent general anesthesia without adverse events or outcomes.