Perioperative care in a patient with acute psychosis: Challenges and management

Providing perioperative care for patients with acute psychosis poses a unique challenge to the anesthesiologist. These patients are usually uncooperative, difficult to communicate with, and present with aggressive behavior. Such patients often have a history of substance abuse or chronic psychiatric illness and are on antipsychotic drugs. We report the successful perioperative management of a patient with acute psychosis, scheduled for open reduction and internal fixation of right humerus and clavicle fractures under regional anesthesia and conscious sedation.