Have you ever wondered what medications are used during surgery? How do surgeons and anesthesiologists know which medications to use, and does everyone get the same medications? There are a variety of medications that may be used before, during and after surgical procedures. It can be confusing trying to remember them all, but hopefully this blog post will help you understand some common medications used during surgeries. These medications can differ from patient to patient because of medical history, the type of surgery you will have, whether or not anesthesia will be given, and any type of health problems you might be dealing with. The 8 most common types of medications used before, during, and after surgeries include anesthesia, paralytics, benzodiazepines, antibiotics, analgesics, anticoagulants, antiemetics, and stool softeners.
Before Surgery Questionnaire and Medications:
Before undergoing surgery, you’ll most likely meet with your surgeon/anesthesiologist, or nurse to review and gather lots of information from you. Health care providers and workers will ask you the same questions more than once not because we forget your answers or want to make you upset, but because want to add lots of layers of security throughout the process. Different healthcare providers asking the same questions can help reduce the risk of a mistake occurring. Medical mistakes are a huge issue, and so remember when we ask you for the same information over and over, we really care about you! Some information that we gather before surgery includes the following:
- Medical record like past surgeries and current health conditions
- Allergy history such as latex or iodine
- Current medications you’re taking or recently took like insulin
- OTC (Over the counter) medications like aspirin or melatonin
- Herbal supplements or vitamins like fish oil, or turmeric
One super important question you will be asked is whether you’ve ever had any issues with anesthesia during a previous surgery; the surgeon might even ask you whether there’s a family member who’s ever had a history of getting bad reactions from medications during surgery because this helps give the doctor a good idea on whether to hold off any specific medications or to use different medications in order to avoid complications. If you’ve ever had surgery and was sent home with any type of pain medications that did not work well, or you had a reaction to, this is a great time to inform your provider. Letting the provider or nursing staff know before hand will help them examine medications they might send you home with.
During intake, the provider may also obtain information about whether you drink alcohol or not, if you smoke, or take any illegal drugs because these substances may impact the efficacy of not only the anesthesia that may be given, but they can also negatively affect your recovery and incision or wound healing. For example, smoking can increase the risk of developing pneumonia after surgery and it can also slow wound healing.
Although these questions are extremely personal, the providers, nurses, and staff obtaining this information are not there to judge you or to expose your privacy – information is kept confidential due to HIPPA laws, and we’re there to make sure you have the best outcome from your surgery, which involves getting as much information as possible to help us get you there safely.
Medications Given During surgery:
Most major surgeries require general anesthesia, but the 3 different types of anesthesia are:
- General anesthesia
- Regional anesthesia
- Local anesthesia
General anesthesia are medications given to make patients fall asleep and to prevent pain from being felt anywhere around the body. Most major surgical procedures require general anesthesia, like appendectomies or breast augmentation. During general anesthesia, a medication known as an anesthetic is used to induce amnesia and analgesia, which means to make the patient fall asleep and not feel pain. It can either be administered through the veins in an IV, or as a gas through a mask or tube.
Sometimes, during the surgery, a breathing tube is placed in a patient’s airway to monitor a patient more closely and to provide oxygen; this is done in order to make sure the patient is able to breathe safely and easily during the procedure. An example of an anesthetic that is mostly used to induce anesthesia is known as propofol.
Additionally, a medication class known as paralytic can be used alongside an anesthetic to help relax the muscles of the patient’s body during surgery; anesthetics help patients fall asleep, whereas paralytics help prevent movement when the patient is asleep.
Another class of medications that may be given before surgery are benzodiazepines. This class of medication is used to depress the central nervous system. Sometimes, they are used alongside anesthesia to calm a patient down or to induce relaxation. The 3 most well known benzodiazepines include:
If you’ve ever gone to the dentist to get a tooth extraction or a root canalm, the dentist might have used local anesthesia; local anesthesia means when an area of your body is numbed by medications, but you are completely awake and aware of what’s going on around you. In medicine, a time when local anesthesia is used is when stitches on a minor wound, or mole removal is done. Most times, local anesthesia may be injected onto the area that will be worked on.
Regional anesthesia is a little more extensive than local anesthesia; a targeted area of nerve bundles in a larger portion of the body is injected with regional anesthesia, but the patient is still awake. A well-known regional anesthesia is an epidural anesthetic given during labor. The other type of regional anesthesia is a spinal anesthetic.
Although anesthesia is one of the most well known medication classes given during surgery, there are other medications that you may not be familiar with that may still be given. One class of medications surgeons might use are antibiotics.
Depending on the facility or the type of surgery the patient is undergoing, one or more doses of antibiotic may be given before or during the surgery to prevent surgical site infections. Antibiotics are a category of medications that are used to combat bacteria, and they are mostly given either orally in pill form, or intravenously, through an IV. The type of surgery a patient will undergo determines the choice of antibiotic to be used; for example, a patient undergoing spinal surgery may receive:
- Cefazolin (Ancef
Whereas a patient undergoing colorectal surgery may receive the following suppository several hours up to 2 days before surgery:
- Metronidazole (Flagyl)
Medications Given After Surgery or Post-Operatively
After successful surgery, you may be transferred to the recovery room where nurses and techs will closely monitor your vitals such as heart rate, blood pressure, oxygen saturation, and respirations as you recover and begin to wake up fully from the anesthesia. If staying overnight or for more than one day, you will still recover then be transferred to a hospital room for further and proper rest, recovery, and pain management.
Analgesics are also known as pain medications, and are used for controlling pain post surgery. Analgesics are available in a wide assortment of forms and can be administered in many ways such as pill form, through an IV, liquid, suppository, and even as a patch, where the medication is absorbed through the skin. The strength of pain medications vary widely, just as the dose of drugs prescribed by a physician also differ from one patient to another. Most post-operative analgesics are opioids, either purely or in combination with acetaminophen (Tylenol). Commonly prescribed pain-relief medications given in the hospital after surgery through a patient’s vein includes the following:
- Ofirmiv (IV Tylenol )
- Tordol (IV Ibuprofen)
Pills or tablet forms of analgesics may include:
- Lortab (Vicodin)
Upon discharge from surgery, the provider may write a script for the medications to help with pain management as you heal:
- Opioids like Oxycodone, Hydrocodone, & Lortab
- Non-Opiods like Ultram (tramadol)
- NSAIDS (like ibuprofen)
- Tylenol (acetaminophen)
Some surgeons may or may not allow NSAIDs to be given post surgery or even after discharge because of the increase of risk of bleeding, but this is something to be discussed you’re your surgeon or nurse. Another important tip to remember is to make sure you don’t take more than 4 g of Tylenol in a 24 hour period, this may cause GI upset or cause liver problems. As a nurse, I find that creating a schedule for your pain medications, and to stay on top of your schedule allows the medications to build up in your system and to provide adequate pain relief. When your body is in pain, it’s difficult for it to focus on healing.
- Oral antibiotics
- Bacitracin (Neosporin): topical ointment for wounds or incision
Another very important after surgery medication often used is an anticoagulant, which is a medication that reduces the rate of clotting of the blood. This is a critical situation as one of the risks of surgery is blood clots, most notably deep vein thrombosis, which often transpires in the legs. To prevent the formation of blood clots and complications such as a stroke or a clot in the lung (a pulmonary embolus), anticoagulants are administered through an injection, an IV, or in a pill form. Examples of anticoagulants include:
- Coumadin (Warfarin)
- Lovenox (Enoxaparin)
Finally, the doctor might prescribe other symptom-reducing medications in order to ease any form of discomforts that may be associated with having the surgery or with unfavorable symptoms that arise from pain-relief medication administration; some of these medications include:
- Pepcid/Protonix: Acid reducers and ulcer prevention
- Colace/Senna/Miralax: Stool softeners and stimulant laxative
- Anti-emetics such as Zofran: Anti-nausea medications
If you’re having major surgery, it might be advisable to discuss with your surgeon to take stool softeners or Miralax a day or 2 before surgery, to prevent constipation from opioid usage. Depending on the surgeon or team, patients’ discharge may be delayed due to lack of bowel movement during hospitalization after surgery.
There might be some medications your surgeon may use that are not listed on this post. It is important to touch base with your surgeon, anesthesiologist, or nurse if you have questions regarding any of these medications, what the surgeon may or may not use specifically, and what would be the best plan for you as a patient. During recovery, it’s important to combine the correct medications, in conjunction with activity and increased protein intake to improve healing. Always discuss appropriate activity level with your surgeon and physical therapist before starting a regimen. Lastly, it’s so important to follow the discharge instructions your nurse goes over with you, and to call your doctor if your pain is not being adequately managed or you have other questions. Be diligent about calling 911 regarding life threatening symptoms such as post operative chest pain or new onset numbness or tingling, and other signs and symptoms of listed on your discharge instructions.
Disclaimer: This content or any other content found on this site is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this Website.