Abstract
The selective serotonin reuptake inhibitor (SSRI) is a newer antidepressant in Japan, since its introduction in May 1999. We gave general anesthesia for teeth extraction to a 72-year-old woman having a depression, who was taking the SSRI (fluvoxamine). In this case, we directed the patient to suspend takirug the SSRI for two days preoperatively, and general anesthesia was given with nitrous oxide, oxygen, and sevoflurane. As a result of our management, no remarkable complications were seen throughout the perioperative period. For the general anesthetic management of patients taking the SSRI, it is thought to be important as follows; we should try to reduce the effects of the SSRI on the general anesthesia depending on withdrawal in the light of its half-life, and manage general anesthesia to cope with the inhibition of cytochrome P450 in the SSRI. The SSRI has less severe side effects, such as the anticholinergic effects reported in the tricyclic antidepressants. But the anesthetic implications of the SSRI particularly involve hyponatremia, platelet aggregation, and developing the serotonin syndrome associated with the serotomimetic drugs. Therefore, these drug interactions and altered physiological states should be cared.
