Postoperative adverse effects after recent or remote lithium therapy

Area of Science:

• Anesthesiology
• Pharmacology
• Psychiatry

Background:

• Lithium is a common treatment for bipolar disorder.
• Its narrow therapeutic index requires careful management, especially in vulnerable patient populations.

Observation:

• Two critically ill patients on preoperative lithium therapy developed adverse reactions.
• These reactions occurred during the perioperative period, a critical phase for managing lithium levels.

Findings:

• The cases highlight the risk of lithium toxicity in critically ill patients.
• Perioperative physiological changes can exacerbate lithium's narrow therapeutic index, leading to adverse events.

Implications:

• Anesthesiologists and critical care physicians must be vigilant for lithium toxicity in patients undergoing surgery.
• Close monitoring and proactive management are crucial to prevent severe adverse reactions in this patient group.