• Anesthesia and analgesia · Dec 2022

    Review

    Narrative Review of Kratom, an Emerging Psychoactive Substance With Perianesthetic Implications.

    • Emily H Garmon and Kandice Olson.
    • From the Baylor Scott and White Temple Department of Anesthesiology, Texas A&M Health Science Center College of Medicine, Temple, Texas.
    • Anesth. Analg. 2022 Dec 1; 135 (6): 118011881180-1188.

    AbstractOpioid overprescribing, with resultant overdose and death, has led to a national focus on alternative treatments for pain. With the decline in legal access to opioids, kratom has gained popularity as a legal, "natural," and easily accessible nonprescription analgesic for consumers wishing to self-medicate for pain, opioid use disorder, and other mental health conditions. While implications of kratom use in patients with chronic pain and/or opioid use disorder have been published, information on perianesthetic implications is lacking. Anesthesiologists should be informed about kratom, including the potential for unexpected physiologic derangements and adverse drug interactions resulting from complex pharmacologic activity, cytochrome P450 interactions, and common adulterations of the drug that may result in unpredictable clinical effects. This article explores the relevance of kratom to perioperative anesthetic care, including suggestions for anesthesiologists extrapolated from published information in nonoperative settings that may improve patient safety in individuals using kratom.Copyright © 2022 International Anesthesia Research Society.

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