SUFENTANIL ISOFLURANE NITROUS-OXIDE ANESTHESIA FOR A PATIENT TREATED WITH MONOAMINE-OXIDASE INHIBITOR AND TRICYCLIC ANTIDEPRESSANT

We report a case in which sufentanil was given to a patient who was al ready taking both a monoamine oxidase (MAO) inhibitor and a tricyclic antidepressant. Anecdotal reports have recommended discontinuing MAO i nhibitors 2 to 3 weeks prior to elective surgery. However, current ane sthesia literature suggests this practice may be unnecessary. This cas e report involved a patient who refused to stop her antidepressant med ications. She was given art uneventful elective anesthetic with measur es to minimize the risk of an adverse drug reaction involving the anti depressants she was taking. Our experience suggests that the use of an opioid other than meperidine may allow the anesthetist to proceed cau tiously to provide an anesthetic for an elective surgery patient who i s also currently receiving MAO inhibitor therapy.