Highlights the clinical challenges of managing narcotic-addicted patients during anesthesia and warns anesthesiologists about the addictive potential of anesthetic drugs.
Requires heightened perioperative vigilance in narcotic-addicted patients; leaves open addiction risks of specific anesthetics for prospective study.
Patients who are addicted to narcotics pose a special problem to the anesthesiologist because they sometimes require unusually large doses of premedicants and anesthetics, manifest withdrawal symptoms while in the hospital, develop complications (e. g., tetanus and hepatitis) from previous infections, or act in devious ways to conceal or satisfy their need for narcotics. Any drug with analgesic, relaxant, or euphoric properties is potentially addicting. This applies to meprobamate as well as to meperidine. It also applies to volatile anesthetics like nitrous oxide and fluothane. Anesthesiologists are advised to refrain from sampling anesthetic drugs for any reason. When a physician uses potentially addicting drugs to relieve pain he exercises a sacred right, but he also assumes tremendous responsibilities.
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Edward R. Bloomquist (1959) studied this question.
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