Key result
Continuing tranylcypromine during anesthesia is linked to ~37% less hypotension without increasing severe hemodynamic events.
Why the study?
The safety of continuing antidepressive treatment with monoamine oxidase inhibitors during anesthesia regarding intraoperative hemodynamic events was uncertain.
Does continuation of MAOIs (tranylcypromine or moclobemide) increase intraoperative hemodynamic events in patients undergoing elective surgery requiring anesthesia?
Comparison
Current use of irreversible or reversible MAOIs continued during anesthesia vs nonusers
Design
Retrospective observational cohort study
Follow-up
Intraoperative
Authors
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MAOI continuation was not associated with more events in this cohort; leaves open whether discontinuation guidelines need revision pending randomized data.
Cohort (n=200)
Yes
Does continuation of MAOIs (tranylcypromine or moclobemide) increase intraoperative hemodynamic events in patients undergoing elective surgery requiring anesthesia?
Absolute Event Rate: 46% vs 73%
p-value: p=0.01
Continuation of MAOIs during elective surgery does not increase the risk of severe adverse intraoperative hemodynamic events compared to nonusers, suggesting routine discontinuation may be unnecessary.
Haelst et al. (2012) conducted a cohort in Elective surgery requiring anesthesia (n=200). Monoamine oxidase inhibitors (MAOIs) vs. Nonusers was evaluated on Intraoperative hypotension (p=0.01). Continuation of MAOIs during anesthesia did not increase severe adverse hemodynamic events; intraoperative hypotension was less frequent in tranylcypromine users (46%) than nonusers (73%, P=0.01).
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