Have you ever wondered what medications are given for 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. Hopefully this blog will help you understand some common medications used during surgery.
Medications differ from patient to patient because of:
- Medical history
- Type of surgery each person is having
- Whether or not anesthesia will be given
- Any additional health problems you have
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 undergoing surgery, you will meet with your surgeon, anesthesiologist, and nurse to review and gather lots of information from you. Health care providers will ask you the same questions more than once. They don’t ask because they forget your answers or want to make you upset, but because they want to make sure the information is correct. Different providers asking the same questions can help reduce the risk of a mistake occurring. Medical mistakes are a huge issue, so remember when we ask you for the same information over and over it shows 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
Prior Medication Issues
One super important question you will be asked is whether you’ve ever had any issues with anesthesia during a previous surgery. The surgeon will want know if there are other family members who have a history of bad reactions to medications used during surgery. This information helps the doctor to know which medications to avoid. This is a great time to tell them if you’ve ever had surgery and was sent home with any type of pain medications that did not work well. Letting the provider or nursing staff know before hand will help them choose the right medications to send you home with.
Before surgery you will be asked whether you drink alcohol, smoke, or take any illegal drugs. These questions are asked because these substances change how well surgical medications work. They can also negatively affect your recovery and ability to heal. For example, smoking can increase the risk of developing pneumonia after surgery and it can slow wound healing.
Although these questions are extremely personal no one is judging you or trying to expose your privacy. Personal health information is kept confidential by federal HIPPA laws. We are there to make sure you have the best outcome.
Medications Given for Surgery:
There are 3 different types of anesthesia:
- General anesthesia
- Regional anesthesia
- Local anesthesia
General anesthesia medications are given to make patients fall asleep, prevent pain from being felt, and prevent movement during surgery. Most major surgical procedures require general anesthesia, like appendectomies or breast augmentation. During general anesthesia, a medication is used to cause amnesia and prevent pain. It can either be given through an IV or as a gas.
When general anesthesia is used a breathing tube is placed in the patient’s airway to help them breath.
Benzodiazepines are a drug commonly used in surgery. This class of medication is used to make patients sleepy, reduce anxiety, and causes amnesia. They are used alongside other types of anesthesia that help patients relax. The 3 most well known benzodiazepines are:
- Valium© (diazepam)
- Ativan© (lorazepam)
- Versed© (midazolam)
Additionally, a medication class known as paralytic is used with an anesthetic to help relax the muscles of the patient’s body during surgery. Anesthetics help patients fall asleep, whereas paralytics help prevent movement.
If you’ve ever gone to the dentist to get a tooth removed or a root canal, the dentist used local anesthesia to keep you from feeling the pain. Local anesthesia is used numb a specific area of your body. You are completely awake and aware of what’s going on around you with local anesthesia. Local anesthesia is used when stitches are placed or a mole is removed.
Regional anesthesia numbs a larger area than local anesthesia. It targets specific bundles of nerves. While a patient is awake with regional anesthesia they may be given other medications to relieve anxiety. Two types of regional anesthesia are “epidurals”, given during labor, and “spinals”.
Although anesthesia is one of the most well known medication given during surgery, there are other medications that are used. Another type of medication used are antibiotics.
Depending on the your of surgery a patient is undergoing, one or more doses of an antibiotic are given before or during the surgery to prevent infections. Antibiotics are medications that kill bacteria. They are given either in a pill form or through an IV. The type of surgery a patient is having determines the choice of antibiotics 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 Flagyl © (Metronidazole).
Medications Given After Surgery or Post-Operatively
After successful surgery you will be transferred to the recovery room where you will be closely monitored. The nurse will watch your
- Heart rate
- Blood pressure
- Oxygen saturation
- Rate of breathing
Once you are fully awake you will be discharged home. If you are staying overnight you will go to the recovery room, then transfer to a hospital room to rest and receive pain management.
Analgesics are also known as pain medications. They are used for controlling pain after surgery. Analgesics are available in many different forms such as a pill, IV, liquid, suppository, and even as a patch. The strength of pain medications varies and are adjusted for each individual patient. Powerful pain medications are opioids. Commonly prescribed pain-relief medications given in the hospital after surgery through a patient’s vein includes the following:
- Dilaudid ©
- Ofirmiv ©(IV Tylenol )
- Tordol ©(IV Ibuprofen)
Pills or tablet forms of pain medications are either pure opioids or combined with acetaminophen (Tylenol©) including:
- Non-Opioids like Ultram© (tramadol)
Upon discharge from surgery, the provider may write a prescription for the medications to help with pain management as you heal.
Some surgeons may not allow nonsteroidal anti-inflammatories (NSAIDS) to be given because of the increase of risk of bleeding. This is something to be discussed with your surgeon or nurse. Another important tip to remember is to make sure you don’t take more than 4 grams of Tylenol in a 24 hour period, this may cause GI upset or cause liver problems. 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 is an anticoagulant. Anticoagulants are a medication that reduces the bodies ability to clot blood. This is a critical medication because one of the risks of surgery is blood clots, most notably deep vein thrombosis, which usually occurs in the legs. To prevent the formation of blood clots anticoagulants are administered through an injection under the skin, through an IV, or in a pill form. Examples of anticoagulants include:
- Coumadin© (Warfarin)
- Lovenox © (Enoxaparin)
Finally, the doctor might prescribe other symptom-reducing medications. These medications are used to ease other discomforts associated with having surgery or side effects from pain medication. For example:
- Pepcid ©/ Protonix © : Acid reducers and ulcer prevention
- Colace© /Senna ©/ Miralax ©: Stool softeners and stimulant laxative
- Anti-nausea such as Zofran©
Your doctor may advise you to take stool softeners or a laxative a day or 2 before surgery to prevent constipation from pain medication usage. Discharge from the hospital can be delayed due to lack of a bowel movement after surgery. Make sure to talk to your doctor about it.
There are other medications your surgeon will use that are not listed in this post. It is important to touch base with your surgeon, anesthesiologist, and nurse if you have questions regarding any medications. Your surgeon has medications they use specifically and they have a plan for you. During recovery, it’s important to combine the correct medications with activity and increased protein intake to help healing. Always discuss appropriate activity level with your surgeon and physical therapist before starting.
Lastly, it’s so important to follow the discharge instructions your nurse goes over with you. Call your doctor if your pain is not under control 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.
Love and Best of Health,
Ayan S. MSN, RN, Co-founder, Operations
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.