[The surgeon and therapeutic drugs]

The surgeon uses the scalpel rather than the prescription pad, but this fact is deceptive. Analysis of the development of surgical history yields an impressive insight into the interaction between medication and operative treatment. The impact of drugs can mean that some operative interventions do not need to be performed so often or even become totally unnecessary (ulcer or reflux surgery), while others are only made feasible at all by the availability of medical drugs (transplant surgery). The pathophysiology of a surgical intervention and perioperative intensive care medicine require that surgeons have detailed clinical and pharmacological knowledge relating to the operative procedure and the handling of technical devices. With regard to drugs, intensive care medicine confronts the surgeon with an inconceivable complex of interactions, side effects and dose adaptations. In addition, human suggestibility influences the outcome of operative interventions no less than medical drugs.