Периоперационное ведение пациентов с шизофренией
#2018-2
PDF_2018-2_24-30

Ключевые слова

шизофрения
периоперационное ведение
антипсихотические препараты
нейролептический злокачественный синдром

Как цитировать

Мясникова В.В., Муронов А.Е. Периоперационное ведение пациентов с шизофренией. Вестник интенсивной терапии имени А.И. Салтанова. 2018;(2):24–30. doi:10.21320/1818-474X-2018-2-24-30.

Статистика

Просмотров аннотации: 134
PDF_2018-2_24-30 загрузок: 22
Статистика с 21.01.2023

Аннотация

Настоящая статья является обзором публикаций, посвященных клиническим исследованиям и рекомендациям по ведению больных шизофренией в периоперационном периоде при хирургических вмешательствах, не связанных с психопатологией. Анестезиолог может столкнуться с поведенческими, когнитивными и эмоциональными проблемами у пациентов с шизофренией на всех этапах периоперационного периода. При проведении анестезии таким пациентам необходимо учитывать нежелательные побочные эффекты антипсихотических препаратов, а также риск их взаимодействия с анестетиками. Известно также, что шизофрения часто сочетается с сердечно-сосудистыми и эндокринными заболеваниями, что дополнительно увеличивает риск анестезии. В статье дана характеристика основных групп препаратов для лечения шизофрении — типичных и атипичных антипсихотиков, представлена тактика отмены или продолжения их приема в периоперационном периоде. Рассмотрена проблема нейролептического злокачественного синдрома — потенциально летального осложнения терапии этими препаратами.
https://doi.org/10.21320/1818-474X-2018-2-24-30
PDF_2018-2_24-30

Библиографические ссылки

  1. Kaye A.D., Liu H., Fox C. et al. Psychiatric and Behavioral Disorders. In: Anesthesia and Uncommon diseases. 6th ed. Fliesher L.A., ed. Philadelphia: Saunders Elsevier, 2012: 444–469.
  2. Федеральные клинические рекомендации по диагностике и лечению шизофрении [проект]. Московский НИИпсихиатрии. 2013. Обсуждение на сайте Российского общества психиатров: psychiatr.ru. [Federal clinical guidelines for diagnosis and treatment of schizophrenia (draft). Moscow Research Institute of Psychiatry. 2013. Discussion on the site of the Russian Society of Psychiatrists — psychiatr.ru. (In Russ)]
  3. Remington G., Fervaha G., Foussias G. et al. Antipsychotic dosing: found in translation. J. Psychiatry Neurosci. 2014; 39(4): 223–231.
  4. Zolezzi M. Medication management during electroconvulsant therapy. Neuropsychiatr. Dis. Treat. 2016; 12: 931–939.
  5. Attri J.P., Bala N., Chatrath V. Psychiatric patient and anaesthesia. Indian J. Anaesth. 2012; 56(1): 8–13.
  6. Huyse F.J., Touw D.J., Strack van Schijndel R.J., et al. Measures for patients taking psychotropic drugs who undergo elective surgery. [Article in Dutch] Ned. Tijdschr. Geneeskd. 2007; 151(6): 353–357.
  7. Desai N., Venkatesh C.R., Kumar S.S. QT prolongation and torsades de pointes with psychotropic agents. Indian J. Psychiatry. 2015; 57(3): 305–308.
  8. Mailman R.B., Murthy V. Third generation antipsychotic drugs: partial agonism or receptor functional selectivity? Curr. Pharm. Des. 2010; 16(5): 488–501.
  9. Glassman A.H., Bigger J.T., Jr. Antipsychotic drugs: Prolonged QTc interval, torsade de pointes, and sudden death. Am. J. Psychiatry. 2001; 158: 1774–1782.
  10. Smith F.A., Wittmann C.W., Stern T.A. Medical complications of psychiatric treatment. Crit. Care Clin. 2008; 24: 635–656.
  11. Kailasam V.K., Chima V., Nnamdi U., et al. Risperidone-induced reversible neutropenia. Neuropsychiatr. Dis. Treat. 2017; 13: 1975–1977.
  12. Lim M.H., Park J., Park T.W. A Case with Neutropenia Related with the Use of Various Atypical Antipsychotics. Psychiatry Investig. 2013; 10(4): 428–431.
  13. Kawachi I. Physical and psychological consequence of weight gain. J. Clin. Psychiatry. 1999; 60(Suppl. 21): 5–9.
  14. Baptista T. Body weight gain induced by antipsychotic drugs: Mechanisms and management. Acta Psychiatr. Scand. 1999; 100: 3–16.
  15. Singh M.K., Giles L.L., Nasrallah H.A. Pain insensitivity in schizophrenia: Trait or state marker? J. Psychiatr. Pract. 2006: 90–102.
  16. Gugger J.J. Antipsychotic pharmacotherapy and orthostatic hypotension: identification and management.CNS Drugs. 2011; 25(8): 659–671.
  17. Bymaster F.P., Felder C.C., Tzavara E., et al. Muscarinic mechanisms of antipsychotic atypicality. Prog. Neuropsychopharmacol. Biol. Psychiatry. 2003; 27(7): 1125–1143.
  18. Shapiro D.A., Renock S., Arrington E., et al. Aripiprazole, a novel atypical antipsychotic drug with a unique and robust pharmacology. Neuropsychopharmacology. 2003. 28(8): 1400–1411.
  19. OʼKeane V., Meaney A.M. Antipsychotic drugs: a new risk factor for osteoporosis in young women with schizophrenia? J. Clin. Psychopharmacol. 2005; 25(1): 26–31.
  20. Katta N., Balla S., Aggarwala K. Clozapine-induced hypersensitivity myocarditis presenting as sudden cardiac death. Autops. Case Rep. 2016; 6(4): 9–13.
  21. Chou P.H., Chu C.S., Lin C.H., et al. Use of atypical antipsychotics and risks of cataract development in patients with schizophrenia: A population-based, nested case-control study. Schizophr. Res. 2016; 174(1–3): 137–143.
  22. Khasawneh F.T., Shankar G.S. Minimizing cardiovascular adverse effects of atypical antipsychotic drugs in patients with schizophrenia. Cardiol. Res. Pract. 2014; 2014: 273060.
  23. Sawada N., Higashi K., Yanagi F., et al. Sudden onset of bronchospasm and persistent hypotension during spinal anesthesia in a patient on long-term psychotropic therapy. Masui. 1997; 46: 1225–1229.
  24. Lanctot K.L., Best T.S., Mittman N., et al. Efficacy and safety of neuroleptics in behavioral disorders associated with dementia. J. Clin. Psychiatry. 1998; 59: 550–561.
  25. Hines R.L., Marschall K.E. Psychiatric disease/substance abuse/drug overdose Stoeltingʼs: Anaesthesia and co-existing diseases. 7thed. ELSEVIER, 2017: 611–633.
  26. Kudoh A., Katagai H., Takazawa T. Effect of preoperative discontinuation of antipsychotics in schizophrenic patients on outcome during and after anesthesia. Eur. J. Anaesth. 2004; 21: 414–416.
  27. Kudoh A. Perioperative management of chronic schizophrenic patients. Anesth. Analg. 2005; 101: 1867–1872.
  28. Kudoh A. Preoperative assessment, preparation and prospect of prognosis in schizophrenic patients. Masui. 2010; 59: 1105–1115.
  29. Руководство по клинической анестезиологии: Пер. с англ. / Под ред. Б.Дж. Полларда. Под общ. ред. Л.В. Колотилова, В.В. Мальцева. М.: МЕДпресс-информ, 2006. [Rukovodstvo po klinicheskoy anesteziologii / Pod red. B.Dzh.Pollarda. Pod obshch. red. L.V. Kolotilova, V.V. Malʼtseva. M.: MEDpress-inform, 2006. (In Russ)]
  30. Amstrong S.C., Cozza K.L. Med-psych drug-drug interactions update. Psychosomatics. 2001; 42: 435–437.
  31. Constance L.S.L., Lansing M.G., Khor F.K., Muniandy R.K. Schizophrenia and anaesthesia. BMJ Case Rep. 2017; pii: bcr-2017-221659.
  32. Morgan G.E., Mikhail M.S., Murray M.J. Anesthesia for patients with neurologic and psychiatric diseases. In: Clinical anaesthesiology. 4th ed. G. Morgan, M.S. Mikhail, M.J. Murray, eds. USA: LANGE International edition, 2008: 647–661.
  33. Katz E., Kluger Y., Ravinovici R., et al. Acute surgical abdominal disease in chronic schizophrenic patients: a unique clinical problem. Isr. J. Med. Sci. 1990; 26: 275–277.
  34. Javitt D.C., Zukin S.R. Recent advances in the phencyclidine model of schizophrenia. Am. J. Psychiatry. 1991; 148: 1301–1308.
  35. Buckley N.A., Sanders P. Cardiovascular adverse effects of antipsychotic drugs. Drug Saf. 2000; 23: 215–228.
  36. Naudin J., Capo C., Giusano B., et al. A differential role for interleukin-6 and tumor necrosis factor in schizophrenia? Schizophr. Res. 1997; 26: 227–233.
  37. Kudoh A., Kudo T., Ishihara H., Matsuki A. Depressed pituitary-adrenal response to surgical stress in chronic schizophrenic patients. Neuropsychobiol. 1997; 36: 112–116.
  38. Donnely J.G., MacLeod A.D. Hypotension associated with clozapine after pulmonary bypass. J. Cardiothorac. Vasc. Anesth. 1999; 13: 597–599.
  39. Boakes A.J., Laurence D.R., Lovel K.W., et al. Adverse reactions to local anaesthetic/vasoconstrictor preparations. Br. Dent. J. 1972; 133: 137–140.
  40. Kudoh A., Ishihara H., Matsuki A. Pituitary-adrenal and parasympathetic function of chronic schizophrenic patients with postoperative ileus or hypotension. Neuropsychobiol. 1999; 39: 125–130.
  41. Kudoh A., Katagai H., Takazawa T. Effect of epidural analgesia on postoperative paralytic ileus in chronic schizophrenia. Reg. Anesth. Pain Med. 2001; 26(5): 456–460.
  42. Molnar G., Fava G.A. Intercurrent medical illness in the schizophrenic patients. In: Principles of medical psychiatry. Stoudemire A., Fogel B.S., eds. Orland: Grune & Stratton Inc, 1987: 451.
  43. O’Keeffe S.T., Devlin J.G. Delirium and the dexamethasone suppression test in the elderly. Neuropsychobiol. 1994; 30: 153–156.
  44. Van der Mast R.C. Pathophysiology of delirium. J. Geriatr. Psychiatry Neurol. 1998; 11: 138–145.
  45. Kudoh A., Takahira Y., Katagai H., et al. Schizophrenic patients who develop postoperative confusion have an increased norepinephrine and cortisol response to surgery, Neuropsychobiology. 2002; 46: 7–12.
  46. Kudoh A., Takahira Y., Katagai H., Takazawa T. Cortisol response to surgery and postoperative confusion in depressed patients under general anesthesia with fentanyl. Neuropsychobiology. 2002; 46(1): 22–26.
  47. Goldman M.B., Robertson G.L., Luchins D.J., et al. Psychotic exacerbations and enhanced vasopressin secretion in schizophrenic patients with hyponatremia and polydipsia. Arch. Gen. Psychiatry. 1997; 54: 443–449.
  48. Kramer M.R., Vandijik J., Rosin A.J. Mortality in elderly patients with thermoregulatory failure, Arch. Intern. Med. 1989; 149: 1521–1523.
  49. Young D.M. Risk factors for hypothermia in psychiatric patients. Ann. Clin. Psychiatry. 1996; 8: 93–97.
  50. Kudoh A., Takase H., Takazawa T. Chronic treatment with antipsychotics enhances intraoperative core hypothermia, Anesth. Analg. 2004; 98: 111–115.
  51. Vohra S.B. Convulsions after enfluranein a schizophrenic patients receiving neuroleptics. Can. J. Anaesth. 1994; 41: 420–422.
  52. Kudoh A., Katagai H., Takazawa T. Anesthesia with ketamine, propofol, and fentanyl decreases the frequency of postoperative psychosis emergence and confusion in schizophrenic patients. J.Clin. Anesth. 2002; 14(2): 107–110.
  53. Периоперационное ведение пациентов с сопутствующими заболеваниями: Руководство для врачей: B3 т. / Под ред. И.Б. Заболотских. Т. 3. 2-е изд., перераб. и доп. М.: Практическая медицина, 2018. [Perioperative management of patients with co-existing diseases. Guidelines for doctors in 3 vol., Ed.: I.B. Zabolotskikh. Vol. 3, 2nd ed. M.: Prakticheskaya meditsina, 2016. (In Russ)]
  54. Ishihara H., Satoh Y., Kudo H., et al. No psychological emergence reactions in schizophrenic surgical patients immediately after propofol, fentanyl, and ketamine intravenous anesthesia. J. Anesth. 1999; 13(1): 17–22.
  55. Bajwa S.J., Jindal R., Kaur J., Singh A. Psychiatric diseases: Need for an increased awareness among the anesthesiologists. J. Anaesthesiol. Clin. Pharmacol. 2011; 27(4): 440–446.
  56. Kaye A.D., Liu H., Fox C. et al. Psychiatric and Behavioral Disorders. In: Fliesher L.A., ed. Anesthesia and Uncommon diseases. 6thed. Philadelphia: Saunders Elsevier, 2012: 444–469.
  57. Shaw A., Matthews E.E. Postoperative neuroleptic malignant syndrome. Anaesthesia. 1995; 50: 246–247.
  58. So P.C. Neuroleptic malignant syndrome induced by droperidol. Hong Kong Med. J. 2001; 7: 101–103.
  59. Gillman P.K. Neuroleptic malignant syndrome: mechanisms, interactions, and causality. Mov. Disord. 2010; 25: 1780–1790.
  60. Bhalla T., Maxey D., Sawardekar A., Tobias J.D. Anesthetic management of a pediatric patient with neuroleptic malignant syndrome. J. Anesth. 2012; 26: 250–253.
  61. Kishimoto S., Nakamura K., Arai T., et al. Postoperative neuroleptic malignant syndrome-like symptoms improved with intravenous diazepam: a case report. J. Anesth. 2013; 27: 768–770.
  62. Ramamoorthy K.G., Downey H., Hawthorne P. Rocuronium and sugammadex: An alternative to succinylcholine for electro convulsive therapy in patients with suspected neuroleptic malignant syndrome. J. Anaesthesiol. Clin. Pharmacol. 2011; 27(3): 380–382.
  63. Agrawal P., Agrawal A., Singh I. Neuroleptic malignant syndrome and anaesthesia: A case report. The Indian Anaesthetists Forum. 2010. Jan. http://www.theiaforum.org.
  64. Периоперационное ведение пациентов с сопутствующими заболеваниями: Руководство для врачей: В 3 т. / Под ред. И.Б. Заболотских. Т. 1. 2-еизд. перераб. и доп. М.: Практическая медицина, 2016. [Perioperative management of patients with co-existing diseases. Guidelines for doctors in 3 vol. Ed.: I.B. Zabolotskikh. Vol. 1. 2nd ed. M.: Prakticheskaya meditsina, 2016. (In Russ)]
  65. Периоперационное ведение пациентов с сопутствующими заболеваниями: Руководство для врачей: В 3 т. / Под ред. И.Б.Заболотских. Т. 2. 2-е изд. перераб. и доп. М.: Практическая медицина, 2016. [Perioperative management of patients with co-existing diseases. Guidelines for doctors in 3 vol. Ed.: I.B. Zabolotskikh. Vol. 2. 2nd ed. M.: Prakticheskaya meditsina, 2016. (In Russ)]
  66. Анестезиология-реаниматология: Клинические рекомендации. Под ред. И.Б. Заболотских, Е.М. Шифмана. М.: ГЭОТАР-Медиа, 2016. [Anesthesiology-reanimatology. Clinical guidelines. Eds.: I.B. Zabloltskikh, E.M. Shifman. M. GEOTAR-Media, 2016. (In Russ)]
Лицензия Creative Commons

Это произведение доступно по лицензии Creative Commons «Attribution-NonCommercial-ShareAlike» («Атрибуция — Некоммерческое использование — На тех же условиях») 4.0 Всемирная.

Copyright (c) 2018 ВЕСТНИК ИНТЕНСИВНОЙ ТЕРАПИИ имени А.И. САЛТАНОВА