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Q. Is it mandatory to stop MAO inhibitor before spine surgery?

Answered by
Dr. Arul Amuthan
and medically reviewed by Dr.Nithila A
This is a premium question & answer published on May 07, 2019

Hello doctor,

I am 79 years old. I am having spinal surgery on L4 and L3 next month. I have been on 90 mg of Nardil,an MAOI, for the last 32 years. Is there any general anesthesia that can be used so that I do not have to come off this medication, or do I have to be off it two weeks before surgery?

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Hello,

Welcome to icliniq.com.

The anesthetic drugs and their dose are carefully chosen after considering patients age, general health, condition of vital organs, previous history of diseases, concomitant medications, and duration of surgical procedure, etc. Hence, before any elective surgery, the anesthesia specialist will do a thorough examination and necessary investigations to fix the anesthetic drugs. Rarely in some case, it becomes very difficult to fix safe anesthetic drugs. Only in such cases, the anesthetist may deny the surgery.

In your case, many good safe anesthetic drugs will not interact with your MAOI (monoamine oxidase inhibitor) drugs so that you can continue the current medication. If your anesthetist feels that those safe anesthetic drugs are not suitable for you (based on your body condition and duration of surgery), then he may use anesthetic drugs that may interact with MAOI.

In such a case, alternative to MAOI will be started with the help of a psychiatrist. The anesthesiologist will coordinate all these. Hence, you do not worry about this part. With the current details given by you and without doing a personal examination, I am not in a position to discuss further drug details. But, I can assure you that your concern will be solved when an anesthetist examines you.


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