Display options
Cite
Edwards AM, Johnson EG, Bernard AC. Intraoperative vasopressor use during emergency surgery on injured meth users. Trauma Surg Acute Care Open. 2020;5(1):e000553doi: 10.1136/tsaco-2020-000553.
Edwards, A. M., Johnson, E. G., & Bernard, A. C. (2020). Intraoperative vasopressor use during emergency surgery on injured meth users. Trauma surgery & acute care open, 5(1), e000553. https://doi.org/10.1136/tsaco-2020-000553
Edwards, Alexandra Marie, et al. "Intraoperative vasopressor use during emergency surgery on injured meth users." Trauma surgery & acute care open vol. 5,1 (2020): e000553. doi: https://doi.org/10.1136/tsaco-2020-000553
Edwards AM, Johnson EG, Bernard AC. Intraoperative vasopressor use during emergency surgery on injured meth users. Trauma Surg Acute Care Open. 2020 Nov 11;5(1):e000553. doi: 10.1136/tsaco-2020-000553. eCollection 2020. PMID: 33225071; PMCID: PMC7661360.
Copy Download .nbib Format: NLM
Share it on

Trauma Surg Acute Care Open. 2020 Nov 11;5(1):e000553. doi: 10.1136/tsaco-2020-000553. eCollection 2020.

Intraoperative vasopressor use during emergency surgery on injured meth users.

Trauma surgery & acute care open

Alexandra Marie Edwards, Eric Gregory Johnson, Andrew C Bernard

Affiliations

  1. Department of Obstetrics, Gynecology and Womens's Health, St. Louis University, St. Louis, Missouri, USA.
  2. Department of Pharmacy, University of Kentucky, Lexington, Kentucky, USA.
  3. Department of Pharmacy Practice, University of Kentucky College of Pharmacy, Lexington, Kentucky, USA.
  4. Department of Surgery, University of Kentucky Medical Center, Lexington, Kentucky, USA.

PMID: 33225071 PMCID: PMC7661360 DOI: 10.1136/tsaco-2020-000553

Abstract

BACKGROUND: Methamphetamine is a growing drug of abuse in America. Patients with recent methamphetamine use pose potential complications to general anesthesia due to changes in hemodynamics and arrhythmias. Limited data exists on the incidence of intraoperative complications on methamphetamine-intoxicated patients requiring urgent or emergent trauma surgery. This study aims to describe intraoperative complications observed in methamphetamine and amphetamine-intoxicated patients requiring emergent surgery.

METHODS: Using the Trauma Registry at our ACS-verified level I trauma center, we completed a single-center, descriptive, retrospective cohort review between July 1, 2012 and June 30, 2016, of adult patients requiring emergent surgery with a positive urine-drug screen for methamphetamines or amphetamines. The objective was to evaluate vasopressor utilization during surgical operation.

RESULTS: A total of 92 patients were identified with a positive UDS for amphetamine and/or methamphetamine who went to the operating room within 24 hours of admission. Thirty-two (34%) patients received one or more (≥1) doses of vasopressor, while 60 patients (66%) received no vasopressor. Changes in mean arterial pressure (MAP) were noted in 64%, while only 3% experienced an EKG change. A binomial logistic regression showed age, base deficit and change in MAP to be predictive of vasopressor use (p<0.002). No intraoperative cardiac events or anesthetic complications were seen.

DISCUSSION: Hemodynamic instability in the amphetamine and methamphetamine-intoxicated population may be more directly related to degree of resuscitation required, than the presence of a positive UDS.

LEVEL OF EVIDENCE: IV.

© Author(s) (or their employer(s)) 2020. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.

Keywords: anesthesia; hypotension; methamphetamine; vasopressins

Conflict of interest statement

Competing interests: None declared.

References

  1. J Trauma. 2009 Mar;66(3):895-8 - PubMed
  2. Eur Heart J. 2000 Aug;21(15):1216-31 - PubMed
  3. Anesth Analg. 2006 Jul;103(1):203-6, table of contents - PubMed
  4. J Am Coll Surg. 1999 Nov;189(5):442-9 - PubMed
  5. Anesthesiology. 1992 Jan;76(1):3-15 - PubMed
  6. Heart Rhythm. 2014 Oct;11(10):1836-8 - PubMed

Publication Types