Expert: Ronald Levy, M.D. - 12/9/2007

Question
QUESTION: I have read numerous places that a spinal administered to a patient on mardil will increase the possibility of hypotension.  I have not been able to find a reference to a medication that safely corrects the problem.  Also is there a safe seditive to releive tension without putting a patient to sleep with nardil.  Stopping the nardil in advance is not an option.

ANSWER: There is no medication that corrects the problem per se but if we are aware that the patient is on MAOIs, we can treat any hypotension that occurs with a variety of medications. The key is to let the anesthesiologist know that the patient is on these meds and to definitely not stop the medications before surgery because that can lead to a potentially serious rebound hypertension.

Hope this helps,

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMb-Galveston

---------- FOLLOW-UP ----------

QUESTION: Thank you for the information.  The second part about safe sedative to relieve tension without putting the patient to sleep is of equal importance.  Could you respond? Thank you

Answer
Yes, we can certainly sedate the patient. In general this is not as big an issue as general anesthesia. There are several drugs we can use to sedate patients on MAOI's.

Hope this helps,

Ronald Levy, MD
Associate Professor of Anesthesiology
UTMb-Galveston