SDN members see fewer ads and full resolution images. Join our non-profit community!

Phencyclidine (PCP) and elective surgeries

Discussion in 'Anesthesiology' started by sigrhoillusion, Oct 11, 2017.

  1. SDN is made possible through member donations, sponsorships, and our volunteers. Learn about SDN's nonprofit mission.
  1. sigrhoillusion

    sigrhoillusion ASA Member 2+ Year Member

    Feb 22, 2014
    Go ahead? Postpone?
    Are you ok with any drugs outside of prescribed pain meds and methadone for elective cases?
  2. SDN Members don't see this ad. About the ads.
  3. linkin06

    linkin06 We are all witnesses. 7+ Year Member

    Dec 20, 2008
    If truly elective, then I would question them being able to consent for the surgery. If emergency, then proceed. I'm imagining PCP can make you quite altered, almost to a psychotic state. Perhaps it would be similar to ketamine in its hemodynamic effects? Lots of versed, etomidate vs propofol to go to sleep. I don't think I would extubate without knowing mental status is normal.
    FFP likes this.
  4. SaltyDog

    SaltyDog Keeping the Forces of Entropy at Bay 10+ Year Member

    Aug 10, 2007
    Closer to Mexico
    Generally I try not to have any before elective cases.
  5. pgg

    pgg Laugh at me, will they? Moderator 10+ Year Member

    Dec 14, 2005
    Home Again
    Acute intoxication of anything is always a hard stop for elective surgery.

    The gray area in my mind is the positive tox screen for _____ in a patient who is not presently intoxicated, presenting for elective surgery. For those cases, I’ll proceed unless it’s cocaine or meth. Reasonable people can disagree that I’m either too conservative or too cowboyish but that’s where my line is.

    My concerns with a PCP user are
    - acute intoxication (consent)
    - proven bad judgment and likelihood that the patient will be noncompliant with treatment / postop instructions resulting in an avoidable poor outcome
    - not so much the physiologic issues
    FFP likes this.
  6. sigrhoillusion

    sigrhoillusion ASA Member 2+ Year Member

    Feb 22, 2014
  7. sigrhoillusion

    sigrhoillusion ASA Member 2+ Year Member

    Feb 22, 2014
    That's usually my approach. I always repeat day of to ensure it's negative or nothing new is present. I was more conservative cause I knew colleague was going to be taking room and didn't want something to happen and have blame go around.
  8. JobsFan

    JobsFan 10+ Year Member

    Jan 19, 2005
    add 200mg ketamine and you're good to go ...
    dhb likes this.

Share This Page