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Abrupt withdrawal of drugs to prepare for surgery can be dangerous
September 19, 2000(Editorial: The risks of interrupting drug treatment before surgery)
Abruptly stopping drug treatments before surgery can be dangerous and increase the risk of postoperative complications, suggests an editorial in this week?s
BMJ.
routine.
Noble and Kehlet cite research showing a significantly increased risk of adverse outcomes among patients whose drug regimens had been stopped before surgery. Patients taking therapeutic drugs that were unrelated to their surgery were three times as likely to have complications as those not taking medicines. And the longer the duration of abstinence, the higher was the complication rate.
Doctors need to ensure that drug treatments are resumed as soon as possible, write the authors, by providing alternative routes, medicines, and by reducing the need for opioid anaesthesia. But the pharmaceutical industry also needs to do more, they say. Guidance should be included in drug information leaftlets and in national drug formularies to help doctors provide alternative medicines and be aware of the symptoms associated with sudden withdrawal from treatment.
Such is the scale of the problem that failing to prevent the consequences of drug withdrawal in the postoperative period should possibly be considered equivalent to those medication errors that have been called worse than a crime, conclude the authors.
Psychotherapy and Psychosomatics, Journal of
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