Phencyclidine (PCP) and elective surgeries

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

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  1. sigrhoillusion

    sigrhoillusion ASA Member 2+ Year Member

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    Thoughts?
    Go ahead? Postpone?
    Are you ok with any drugs outside of prescribed pain meds and methadone for elective cases?
     
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  3. linkin06

    linkin06 We are all witnesses. 7+ Year Member

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    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.
     
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  4. SaltyDog

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

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    Generally I try not to have any before elective cases.
     
  5. pgg

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

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    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
     
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  6. sigrhoillusion

    sigrhoillusion ASA Member 2+ Year Member

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  7. sigrhoillusion

    sigrhoillusion ASA Member 2+ Year Member

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    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

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    add 200mg ketamine and you're good to go ...
     
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