Prevalence of drug abusers in patients undergoing elective surgeries at the Cairo University Teaching Hospital; Prospective cohort study

Background and Aim : Drug abusers are presenting a challenge to the anaesthetist because of the added potential risks involved in the administration of anaesthesia to this subset of patients. In this study, we aimed at screening all patients scheduled for elective orthopaedic, general, vascular, and plastic at the Cairo University Teaching Hospital during a set period of time for the most commonly abused drugs in Egypt. Methods : All patients included in the study were consented for taking part in this study. Each patient was asked to answer a form and submit a urine sample in order to be screened for the most commonly abused drugs in Egypt (hashish, tramadol, benzodiazepine, and morphine). Patients were then followed up both intra and post-operatively. Incidence of drug abuse among those patients was set as primary outcome, intraoperative hemodynamic, Richmond Agitation-Sedation Scale (RASS) scores as well as clinical recovery scores (CRS) were set as secondary outcomes. Results : Out of a total of 1106 patients screened during the study period, only 500 met inclusion criteria and consented to be part of the study. Results showed evidence of drug abuse among 14.4% of study patients, with frequencies of drugs abused as follows: hashish (11.4%); tramadol (5%); benzodiazepines (1.6%); and morphine (0.4%). Most patients that showed evidence of drug abuse were among those scheduled for orthopaedic surgeries, and a higher percentage of them were males. Conclusions : Within the study group, cannabinoids were the most frequent substance of abuse, followed by tramadol and then other opioids.