Is it safe for a woman to use Adderall before hip surgery?

Question

Hi doctor,

My 28-year-old female friend is on Adderall for ADD and is scheduled for hip surgery. She had a long-term (eight months) adverse reaction to general anesthesia after surgery on the other hip last year. It appeared to be post-anesthetic cognitive dysfunction. Only recently, she has been able to function more normally. She is concerned about both these issues and did not get a real answer from her surgeon.

Should she stop Adderall before surgery?
Is there an adverse interaction between anesthesia and Adderall?
Is there any research to help her?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

Your friend need not stop Adderall (a combination of Amphetamine and Dextroamphetamine) to get anesthesia. Secondly, the only side effect that may happen is resistant hypotension due to catecholamine depletion. That can be taken care of by the anesthetist.

Postoperative cognitive dysfunction (a decline in cognitive ability from a patient's baseline that starts in the days after surgery) does not present eight months late. It presents immediately within a week or so after anesthesia.

Earlier dysfunction might be misdiagnosed, or wrongly attributed to the anesthesia. Even if you want to avoid general anesthesia, the safest method for hip surgery is local anesthesia with a spinal epidural, which we routinely do.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.