Study: Women not being told common anesthetic may lead to contraceptive failure

By Stephen Beech via SWNS

Women are not being routinely told that a common anesthetic may make their contraception less effective, warns a new report.

The drug may reduce effectiveness of hormonal contraceptives - including the Pill and mini-pill, say doctors.

Researchers found that women undergoing surgery in a London hospital were not being routinely informed that sugammadex , widely used in anesthesia, may put them at risk of an unplanned pregnancy.

Administered towards the end of an operation, ahead of waking the patient, sugammadex reverses the action of drugs given earlier in the procedure to relax the patient’s muscles.

Scientists say that sugammadex is known to interact with the hormone progesterone and so may reduce the effectiveness of hormonal contraceptives, including the progesterone-only pill (mini-pill), combined pill, vaginal rings, implants and intra-uterine devices (IUDs).

Current guidance is to inform women of child-bearing age (WCBA) that they have received the drug and, due to increased risk of contraceptive failure, advise those taking oral hormonal contraceptives to follow the missed pill advice in the leaflet that comes with their contraceptives and advise those using other types of hormonal contraceptive to use an additional non-hormonal means of contraception for seven days.

However, doctors say that robust methods for identifying at-risk patients and informing them of the associated risk of contraceptive failures is "not common practice" across anesthetic departments in the UK.

To find out more, Dr. Neha Passi, Dr. Matt Oliver and colleagues at the Department of Anesthesiology, University College London Hospitals NHS Foundation Trust, surveyed anesthetists at their hospital on their use of sugammadex and carried out a retrospective audit of sugammadex use.

A seven-question survey was sent to all anesthetists at the Trust including consultants, junior doctors and physician assistants, totaling almost 150 professionals.

The findings showed that 94 percent of the 82 anesthetists who responded said they were aware of the risk of contraceptive failure.

However, 70 percent said they do not routinely discuss sugammadex with the patients who have received the drug.

More than 230 patients were administered sugammadex during the six weeks covered by the audit.

A total of 65 of the patients (28 percent) given sugammadex were WCBA, and 48 of these should have received advice on the risks of contraceptive failure.

However, there was no record of it, in the medical notes of any of the 48 women.

Dr. Passi said: “It is concerning that we are so seldom informing patients of the risk of contraceptive failure following sugammadex use.

“Use of sugammadex is expected to rise as it becomes cheaper in the future and ensuring that women this receiving medicine are aware it may increase their risk of unwanted pregnancy must be a priority.”

Dr. Oliver added: “We only studied one hospital trust, but we expect the results to be similar in elsewhere in the UK.”

Dr. Passi added: “It is important to note, however, that most patients receiving an anesthetic do not need a muscle relaxant and that sugammadex is one several drugs available to reverse muscle relaxation.”

Following their findings, the the research team have created patient information leaflets and letters and programmed the Trust’s electronic patient record system to identify ‘at-risk’ patients and deliver electronic prompts to the anesthetists caring for them b before they undergo surgery.

The researchers said that sugammadex is the only anaesthetic drug known to have the effect.

The findings are due to be presented at Euroanaesthesia, the annual meeting of the European Society of Anesthesiology and Intensive Care (ESAIC) in Milan, Italy.