Substance Abuse – Lysergic acid diethylamide (LSD)

Anesthesia Implications

Anesthesia Implications

Succinylcholine – Effects of succinylcholine can be prolonged due to anticholinesterases inhibition.

Detection window – 36–96 h

False positives – Amitriptyline, sumatriptan

Substance abuse (general considerations) – If necessary, get your urine/blood screen early. The urine screen will take 30 minutes and a serum screen will be closer to an hour. Almost all drug screens will return results for marijuana, amphetamines/methamphetamines, phencyclidine (PCP), cocaine, opioids, barbiturates, and benzodiazepines. Generally speaking, if the patient is acutely intoxicated, the case should be cancelled/delayed. Refer to your facility to get policies on cancellations/delays.

Pathophysiology

Other names – Acid A, Strawberry, and Microdots

Symptoms – Low doses increase light and sound sensitivity. High doses cause visual and emotional disturbances. General symptoms may also include mydriasis, increased wakefulness, and reduced appetite

Mechanism – unknown. LSD has anticholinesterase properties. Inhibits monoamine oxidase (MAO), which potentiates endogenous seratonin and histamine effects.

Toxicity symptoms – can include hallucinations, frothing, dilated pupils, synesthesia, tachycardia, tachypnea, hyperthermia/hypothermia, hypertonia, and hyperglycemia.

Drug duration – last from 6 to 10 hours

References

Moran. Perioperative management in the patient with substance abuse. 2015.. web link
Haldar. Rave drugs and anesthesiology practice: A pharmacoclinical review. 2015.. web link