Women in UK ‘rarely’ told drugs used in surgery can interfere with birth control | women’s health

Women undergoing NHS operations are not routinely told that a drug commonly used in anesthesia may make their birth control less effective, putting them at risk of an unplanned pregnancy, doctors have warned.

Given at the end of surgery before patients wake up, sugammadex reverses the action of drugs given earlier in the procedure to relax the patient’s muscles. The drug is known to interact with the hormone progesterone and may reduce the effectiveness of hormonal contraceptives, including the progesterone-only pill, the combined pill, vaginal rings, implants, and intrauterine devices.

However, new research suggests that robust methods of identifying at-risk patients and informing them of the associated risk of contraceptive failures are not standard practice in anesthesia departments in the UK.

The results are being presented this weekend at Euroanaesthesia in Milan, the annual meeting of the European Society for Anaesthesiology and Intensive Care.

Current guidelines require physicians to inform women of childbearing potential about the drug. Women taking oral hormonal contraceptives should be instructed to follow the missed pill advice in the package leaflet that comes with their contraceptives, and those using other types of hormonal contraceptives should be instructed to use additional non-hormonal contraception for seven days.

But doctors at a major London hospital found no record in the medical notes of affected patients that they had been counseled about the risks of contraceptive failure from sugammadex.

Doctors from the Department of Anaesthesiology at University College London (UCL) Hospitals NHS Foundation Trust asked anesthesiologists at their hospital about their use of sugammadex.

Of the 48 women of childbearing age who they believe should have received risk counseling, none recorded such a conversation in their medical notes, the researchers said. Additionally, 70% of 82 anesthesiologists surveyed said they did not routinely discuss sugammadex with patients receiving the drug.

“We only looked at one hospital, but we expect the results to be similar elsewhere in the UK,” said Dr Matt Oliver, one of the study leaders.

Another of the researchers, Dr Neha Passi, added: “It is worrying that we so rarely inform patients of the risk of contraceptive failure following the use of sugammadex. The use of sugammadex should increase as it becomes cheaper in the future and ensuring that women receiving this drug are aware that it may increase their risk of unintended pregnancy should be a priority.

The researchers said sugammadex was the only drug known to have such an effect. UCL doctors have now compiled leaflets and patient information letters and have also programmed their trust’s electronic patient record system to identify patients at risk and provide electronic prompts to anesthesiologists treating them. .

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Meanwhile, new research also presented at the Euroanaesthesia conference reveals that preoperative body mass index (BMI) and weight play an important role in outcomes after bariatric surgery.

The study by Dr Michael Margarson of St Richard’s Hospital in Chichester confirms the long-suspected view that admission to intensive care or death after bariatric surgery is much more likely in patients with the weight and BMI the highest.

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