[Anesthesia in the schizophrenic]

The preanaesthetic interview and examination is difficult in case of schizophrenia. The lack of communication can be responsible for late recognition of surgical diseases. The treatment by neuroleptic drugs should not be interrupted. It can interfere with anaesthesia, yet all anaesthetic methods can be safely used including local and regional anaesthesia to be performed under sedation. Postoperative care requires psychiatric nursing staff and is often rendered difficult by the patients agitated behaviour. In catatonic schizophrenia it can be difficult to diagnose a malignant syndrome of neuroleptics. Peristaltis is slowed by neuroleptic and antiparkinson drugs and pseudoileus may occur. Appropriate medical treatment to evacuate the bowels is needed.