Mentally ill and mentally retarded patients present special problems as surgical patients because of their mental and physical status and the use of tranquilizers and other drugs. About half of the patients have some serious complicating condition before surgery, mainly related to inadequate coughing, tendency to aspirate secretions and foods, tenacious constipation, and urinary tract infections. Early diagnosis in acute surgical diseases is made difficult by the lack of symptoms and some physical signs. An intensive preoperative and postoperative program, including frequent laryngotracheal suctioning and administration of cathartics, has been effective in preventing complications in a series of 76 consecutive operations in these patients.
Kuster G, Kralemann H, Pluth JR. Mentally Ill and Mentally Retarded PatientsSpecial Considerations in Preoperative and Postoperative Care. Arch Surg. 1971;102(3):175-177. doi:10.1001/archsurg.1971.01350030013003