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Lithium Perioperative Management — FRCA Final MCQ

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ModeratePerioperative MedicineLithium Perioperative ManagementFRCA Final

A patient taking lithium for bipolar disorder requires elective surgery. How should lithium be managed?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Stop lithium 48 hours before and restart when eating and drinking

Lithium has a narrow therapeutic index and is renally excreted. Perioperative dehydration, NSAIDs, and renal impairment risk toxicity. Standard practice: withhold lithium 24-48h before surgery, monitor levels, ensure adequate hydration perioperatively, restart when eating/drinking normally and renal function is stable. Avoid NSAIDs. Monitor renal function.

Reference: RCOA – 2023 – Perioperative management of psychotropic medications