Open AccessImplications of Perioperative Polypharmacy in Adolescents Undergoing Bariatric Surgery: a Single-Center Experience
Author(s) -
Elaine F. Williams,
Janelle D. Vaughns,
Eleanor Mackey,
Jane Muret,
Evan P. Nadler,
Johannes N. van den Anker
Publication year - 2020
Publication title -
obesity surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.474
H-Index - 138
eISSN - 1708-0428
pISSN - 0960-8923
DOI - 10.1007/s11695-020-04456-w
Subject(s) - medicine , polypharmacy , perioperative , center (category theory) , single center , general surgery , surgery , intensive care medicine , chemistry , crystallography
Adolescents seeking bariatric surgery may present with pre-existing psychiatric diagnoses for which they use chronic medications. To heighten awareness concerning perioperative polypharmacy in adolescents with extreme obesity, we conducted a retrospective review of patients undergoing laparoscopic sleeve gastrectomy between February 2010 and May 2017 at Children's National Health System (CNHS). A total of 167 adolescent patients had pre-existing psychiatric diagnoses which included depression (50%), anxiety (23%), ADHD (23%), and binge eating disorder (11%). Medications prescribed to treat these diagnoses included selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs). Additionally, all patients were given fentanyl, ondansetron, morphine, and acetaminophen perioperatively. Although no life threatening symptoms of drug-drug interactions (DDIs) were appreciated, the combined use of many different potent drugs in these patients warrants attention.