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Psychiatric medications and surgical bleeding in cosmetic surgery patients
Harvey, DJ; Punjabi, AA; Guyuron, B.
Case Western Reserve University , University Hospitals Case Medical Center
2016-01-31
Presenter: Ayesha Punjabi
Affidavit:
Ayesha Punjabi
Director Name: Hooman Soltanian
Author Category: Resident Plastic Surgery
Presentation Category: Clinical
Abstract Category: Aesthetics
Background: Psychiatric medications, particularly the selective serotonin reuptake inhibitors, have been associated with increased surgical bleeding. The mechanism for this is thought to be inhibition of the transporter that drives serotonin, a platelet activator, into platelets. This study aims to compare surgical bleeding between cosmetic surgery patients taking psychiatric medications versus not.
Methods: The charts of 392 patients receiving surgery at the senior author's practice from 2007-2013 were reviewed. Independent variables included self-reported psychiatric history, psychiatric diagnoses, and psychiatric medications as documented in the pre-operative history and physical. The primary endpoint was administration of DDAVP, our proxy for surgical bleeding. Significant predictors of DDAVP administration were determined via chi-squared testing.
Results: 72 patients received DDAVP. 117 patients had a psychiatric diagnosis; a psychiatric diagnosis did not predict DDAVP administration (14.3% for patients with a psychiatric diagnosis versus 20.88% for those without, p=0.14). 129 patients were on psychiatric medications; the use of a psychiatric medication was not associated with DDAVP administration. (14.7 v. 21%, p=0.14).
Conclusions: The use of psychiatric medications does not predict surgical bleeding. This is useful given the prevalence of psychiatric medication use amongst this patient population. This study suggests that patients need not be counseled to discontinue their psychiatric medications prior to surgery.
