women not being told common anesthetic interferes with birth control: study
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sugammadex, a drug widely used in anesthesia, is typically administered to patients toward the end of a medical procedure to reverse the effects of muscle relaxants delivered prior to surgery. getty
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women who require surgery are not being properly informed that a commonly used anesthetic may reduce the effectiveness of their birth control, according to a new study that warns the omission may result in unwanted pregnancies.
the research, which was presented at the annual meeting of the european society of anaesthesiology and intensive care (esaic) in italy, found that robust methods for identifying women of child-bearing age and informing them of these risks was not common in the u.k. and, likely, elsewhere.
sugammadex, a drug widely used in anesthesia, is typically administered to patients toward the end of a medical procedure to reverse the effects of muscle relaxants delivered prior to surgery. according to the study, this drug is known to interact with the hormone progesterone in a way that can reduce the effectiveness of hormonal contraceptives, including the progesterone-only pill (mini-pill), combined pill, implants, vaginal rings and intra-uterine devices.
women of child-bearing age should be warned of anesthetic risk
current guidance requires women of child-bearing age to be informed of the risks that accompany sugammadex and for them to be advised to follow the missed-pill advice included in the information that comes with hormonal contraceptives. they are also encouraged to use a non-hormonal method of contraception, if required, for the next seven days.
to see if this was happening, the team conducted a retrospective audit at their trust (a hospital that provides secondary health services within the u.k.), which included a seven-question survey that was sent to all anesthetists and completed by almost 150 professionals. of the 82 anesthetists that completed the survey, 94 per cent said they were aware of the contraceptive risks of sugammadex but 70 per cent said they did not routinely discuss this with patients receiving the drug.
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during the six-week audit, 234 patients were administered sugammadex, 48 of whom were of child-bearing age (and considered to be at risk of pregnancy) and should have been informed of the dangers the drug posed to the effectiveness of hormonal contraceptives. there was no mention of the advice being offered in the medical notes of any of the 48 women.
“it is concerning that we are so seldom informing patients of the risk of contraceptive failure following sugammadex use,” said neha passi, a researcher in the department of anaesthesiology, university college london hospitals nhs foundation trust in the u.k. “use of sugammadex is expected to rise as it becomes cheaper in the future and ensuring that women receiving medicine are aware it may increase their risk of unwanted pregnancy must be a priority.”
the study’s findings prompted the team to create information pamphlets and program the trust’s computers to issue electronic prompts to anesthetists for patients who need to be informed of the potential risks to contraception.
although the study was limited to one institution, the team said it is confident the lax practice is common in other hospitals, both in the u.k. and further afield. they stressed, however, that the drug in question is the only one known to have this anesthetic effect. “it is important to note that most patients receiving an anesthetic do not need a muscle relaxant and that sugammadex is one several drugs available to reverse muscle relaxation.”
dave yasvinski is a writer with healthing.ca
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