Perioperative considerations for patients exposed to hallucinogens.
Trent Emerick, Tetyana Marshall, Thomas Jeff Martin, Doug Ririe
Reg Anesth Pain Med December 2, 2024 DOI: 10.1136/rapm-2023-104851 (opens in new tab)
Study at a glance
AI-extracted from the abstract| Characteristics | Narrative review Peer reviewed |
|---|---|
| Keywords | Anesthesiology Psychedelic medicine Surgical safety Drug interactions Perioperative care |
| Citations | 1 |
| Key findings | Hallucinogens and psychedelics have varied mechanisms of action that present diverse perioperative implications and considerations for patient management. |
Abstract
Hallucinogen exposure in patients in the perioperative period presents challenges for anesthesiologists and other anesthesia providers. Acute and chronic exposure to these substances can cause physiological impacts that can affect the function of anesthetic and analgesic medications used during perioperative care. The objective of this narrative review is to educate readers on the wide array of hallucinogens and psychedelics that may influence the perioperative management of patients exposed to these substances. A narrative review of the literature surrounding hallucinogens and psychedelics was completed. Hallucinogens and psychedelics are quite varied in their mechanisms of action and therefore present a variety of perioperative implications and perioperative considerations. Many of these substances increase serotonin levels or act directly at serotonergic receptors. However, there are other relevant actions that may include varied mechanisms from N-methyl-D-aspartate receptor antagonism to stimulation of muscarinic receptors. With hallucinogen exposure rates on the rise, understanding the effects of hallucinogens is important for optimizing management and reducing risks perioperatively for patients with acute or chronic exposure.