General Anaesthetic & Recreational Drugs
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fairnymph
Bluelighter
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Another reason that you wouldn't want to take stimulants prior to an operation -- stimulants take a toll on the immune system, as can surgery, and the combined effect would impair/delay healing and recovery. Thus, even if you did tweak/roll the night before, and had your surgery and whatnot problem-free, the extra time it would take you to recover (and how shitty you would feel combining a drug hangover with the post-op yucky feeling) would simply NOT be worth getting high in the first place.
Btw, doesn't this type of question belong in the Health forum?
Btw, doesn't this type of question belong in the Health forum?
There are a lot of interesting comments here regarding rec drugs and anaesthesia. Some of them are valid, some are over-theoretical and many are way off the track, particularly pertaining to speed and E.
Being an anaesthetist, here is the bottom line on speed and E with respect to GA
1. Increased risk of awareness, (decrease MAC for volatile agents and similar effects with TIVA), this is only really relevant it u are Speeding and E'ing at the time of your anaesthetic.
2. Increased risk of peri-operative central serotonin syndrome (with concomitant use of other drugs working on the serotonin axis given as part of your anaesthetic).
3. Increased risk of Post-operative nausea and vomiting (serotonin receptors in chemoreceptor trigger zone and also peripherally causing emesis).
4. Lack of effect of indirect acting sympathomimetics. You wont find this in many text books except some older ones, but in practice it is very true. Need to resort to direct acting agents (like adrenaline, noradrenaline). By the time your anaesthetist figures out that you are insensitive to indirect acting agents - it may be too late !
Out of these 4, Points 1 and points 4 are the most serious and a failure to disclose your drug habbit to your anaesthetist is potentially life threatening or at the very least, you put yourself at risk of awareness. There are things we can do if we know you are using these agents to prevent all of them ! The more remote your drug taking from your GA, the less the risk. People who are speeding/E'ing at the time of their surgery are very high risk (have seen this many times in emergency surgery).
We are not here to police drugs by any means - hell, no anaesthetist is going to report you to the cops, we have better things to do. AS for me, I love the occasional E (or four) at a rave !
As for discontinuing drug use prior to anaesthesia, it depends on your useage. Chronic long term users require a longer period of abstinence to avoid these complications (if undisclosed), for occasional binge users, then 3 - 4 days usually sees a return to normal of the serotonin axis.
While the CYP2D6 comments are true in theory, the argument is floored in practice
1. Unless you are having cardiac surgery where it is sometimes the practice to use ultra large doses of fentanyl, then the standard 100 mcg pharmacodynamics is not going to be affected. Anyone with any knowlegde on anaesthetic drug action knows that the offset of action of typical doses of fentanyl is due to redistribution of the drug - not metabolism !
2. Codeine is not a serious option for post-operative analgesia - find another anaesthetist !
3. Of more relevance is tramadol - which is becoming more frequently used for intra op and post op analgesia.
3. Occasional users have no measureable effects detected in their CYP2D6 activity, chronic users do.
Hope that clarifies a few things. Don't mean to get on a soap box - just sometimes when there is so much dribble being written, it is quite therapeutic to respond !
Rave on ! C u on the dance floor.
(ps. I will be the one with the pupils the size of dinner plates !)
[ 13 May 2002: Message edited by: gasbo ]
Being an anaesthetist, here is the bottom line on speed and E with respect to GA
1. Increased risk of awareness, (decrease MAC for volatile agents and similar effects with TIVA), this is only really relevant it u are Speeding and E'ing at the time of your anaesthetic.
2. Increased risk of peri-operative central serotonin syndrome (with concomitant use of other drugs working on the serotonin axis given as part of your anaesthetic).
3. Increased risk of Post-operative nausea and vomiting (serotonin receptors in chemoreceptor trigger zone and also peripherally causing emesis).
4. Lack of effect of indirect acting sympathomimetics. You wont find this in many text books except some older ones, but in practice it is very true. Need to resort to direct acting agents (like adrenaline, noradrenaline). By the time your anaesthetist figures out that you are insensitive to indirect acting agents - it may be too late !
Out of these 4, Points 1 and points 4 are the most serious and a failure to disclose your drug habbit to your anaesthetist is potentially life threatening or at the very least, you put yourself at risk of awareness. There are things we can do if we know you are using these agents to prevent all of them ! The more remote your drug taking from your GA, the less the risk. People who are speeding/E'ing at the time of their surgery are very high risk (have seen this many times in emergency surgery).
We are not here to police drugs by any means - hell, no anaesthetist is going to report you to the cops, we have better things to do. AS for me, I love the occasional E (or four) at a rave !
As for discontinuing drug use prior to anaesthesia, it depends on your useage. Chronic long term users require a longer period of abstinence to avoid these complications (if undisclosed), for occasional binge users, then 3 - 4 days usually sees a return to normal of the serotonin axis.
While the CYP2D6 comments are true in theory, the argument is floored in practice
1. Unless you are having cardiac surgery where it is sometimes the practice to use ultra large doses of fentanyl, then the standard 100 mcg pharmacodynamics is not going to be affected. Anyone with any knowlegde on anaesthetic drug action knows that the offset of action of typical doses of fentanyl is due to redistribution of the drug - not metabolism !
2. Codeine is not a serious option for post-operative analgesia - find another anaesthetist !
3. Of more relevance is tramadol - which is becoming more frequently used for intra op and post op analgesia.
3. Occasional users have no measureable effects detected in their CYP2D6 activity, chronic users do.
Hope that clarifies a few things. Don't mean to get on a soap box - just sometimes when there is so much dribble being written, it is quite therapeutic to respond !
Rave on ! C u on the dance floor.
(ps. I will be the one with the pupils the size of dinner plates !)
[ 13 May 2002: Message edited by: gasbo ]
phase_dancer
Bluelight Crew
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Welecome to Bluelight gasbo.... great post. More of the same pleez