Perioperative management of patients with depression

Abstract

One of the most common mental illnesses, occurring in more than 5 % of the adult population, is depression. In the management of patients with this concomitant pathology in the perioperative period, the anesthesiologist must take into account a number of characteristics. These may be possible difficulties in communication due to patient closure, the risk of developing a “withdrawal syndrome” of antidepressants, side effects, as well as undesirable interactions of these drugs with anesthetics. The article reviews the publications of Russian and foreign articles and manuals on the perioperative management of patients with depression. The characteristics of the main groups of modern drugs for the treatment of depression, the tactics of their withdrawal or continuation of admission before the operation, the features of anesthesia against the background of long-term intake of various groups of antidepressants are presented. The problem of such complication of therapy with these drugs, such as serotonin syndrome, its differential diagnosis is considered. The review also includes non-pharmacological treatments for depression, their complications and anesthesia in electroconvulsive therapy.