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. This blog will help you understand some common medications used during the time during and after surgery.
Medications differ from patient to patient because of:
- Your unique medical history
- The type of surgery you are going to experience
- The surgeon and anesthesia team preferences
The 8 most common types of medications used before, during, and after surgeries include: anesthesia, paralytics, benzodiazepines, antibiotics, analgesics, anticoagulants, antiemetics, and stool softeners.
Pre-Surgical Meeting
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 people asking the same questions can help reduce the risk of a mistake occurring. Some information that we gather before surgery includes the following:
- Medical record (this includes past surgeries and current/previous health conditions)
- Allergy history (food environmental, and medication wise)
- Current prescription medications (they will want to know the name, dose, frequency, and when you last took them)
- OTC (Over the counter) medications like aspirin or melatonin
- Herbal supplements or vitamins like fish oil, or turmeric
Prior Medication Issues
An important question you will be asked is whether you’ve had any issues with anesthesia in the past. This will help ensure that the right anesthesia is selected. This is also 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 medical 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 impair wound healing. If you do have a history of drinking frequently, please share with your medical team. Withdrawing from alcohol prior to surgery can be dangerous and can impact whether or not the surgery happens as scheduled.
Although some of these questions are personal, just know that no one is judging you or trying to expose your privacy. Personal health information is kept confidential by federal HIPPA laws. Our goal is to ensure you have the best outcome.
Medications Given for Surgery:
There are 3 different types of anesthesia:
- General anesthesia
- Regional anesthesia
- Local anesthesia
General Anesthesia
General anesthesia medications are given to make patients fall asleep so that you are unconscious and have no awareness. Most major surgical procedures require general anesthesia, like appendectomies or breast augmentation. It can either be given through an IV (in your vein) or as a gas that you breath in.
When general anesthesia is used, a breathing tube (intubation) is placed to keep the airway open for breathing. A medication class known as paralytic is used with an anesthetic to help relax the muscles of the patient’s body during surgery. This helps prevent movement starting from the time of intubation.
Side effects of general anesthesia include: drowsiness afterwards, a sore throat from being intubated, and nausea.
Local Anesthesia:
If you’ve ever gone to the dentist to have a tooth removed or a root canal, the dentist more than likely used local anesthesia to keep you from feeling the pain. Local anesthesia is used to numb a specific area of your body. With local anesthesia, you are completely awake and aware of what’s going on around you. Local anesthesia is used when stitches are placed or a mole is removed. A very common type of medication used is called Lidocaine. It is typically injected into the skin with a needle, or applied as a cream. Sometimes, lidocaine is available as an oral solutions to swirl around in your mouth. It can be used in combination with sedation during minor outpatient surgeries.
Regional Anesthesia
Regional anesthesia numbs a larger area than local anesthesia. It targets specific bundles of nerves that clock sensation to the area of the body that will be undergoing surgery. While a patient is awake with regional anesthesia they may be given other medications to relieve anxiety. Two types of regional anesthesia include: “epidurals” and “spinals” which are commonly given during childbirth or orthopedic procedures. Nerve blocks are another type of regional anesthesia that can block specific smaller areas such as an arm or a leg. These medications can often time reduce the need of opioid pain medications after surgery.
Although anesthesia is one of the most well known medication given during surgery, there are other medications that are used that are involved during the peri-operative period.
Antibiotics:
Depending on the type of surgery a patient is undergoing, one or more doses of an antibiotic are given before, during, and/or after the surgery to prevent infections. 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. The timing of when the antibiotic is given may vary, but the goal is to ensure that the concentration of the antibiotics is highest at the start of surgery and during surgery. This often times means at least 30 minutes, but not greater than 60 minutes before the initial incision is made. This can help prevent surgical site infections which can negatively impact healing and recovery.
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
- incision sites
Once you are fully awake and meet safe criteria, you will be discharged home or assigned a bed in the hospital to recover.
Analgesics
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:
- Morphine
- Dilaudid ©
- Fentanyl
- Ofirmiv ©
- Tordol ©
Pills or tablet forms of pain medications can include:
- Oxycodone
- Hydrocodone
- Lortab
- Non-Opioids like Ultram© (tramadol)
If using IV pain medications, it is important to start weaning from using IV medications to pill form as soon as possible. As you will not be taking IV medications at home, your medical staff needs to understand what pill combination and doses are helpful at managing your pain effectively and safely.
Some surgeons may not allow nonsteroidal anti-inflammatories (NSAIDS) to be given because of the increase of risk of bleeding, or as they may impair the healing process. 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 cause liver problems.
One of the best ways to manage different types of medications with different functions is to create a schedule. This will help you stay on top of your schedule while also helping you set goals for weaning off medications like opioids. When your body is in pain, it’s difficult for it to focus on healing so it is important to manage. However, a goal to try to minimize reliance on them is important as pain medications also have side effects.
Anticoagulants
Another very important after surgery medication is an anticoagulant. Anticoagulants are a medication that reduces the bodies ability to clot blood, which is important for specific types of surgeries, or those that limit movement. To prevent the formation of blood clots anticoagulants are administered through an injection under the skin, through an IV, or in a pill form. They are typically given in the belly, just around the belly button. They do cause bruising to the skin, and it is important not to rub the area after administration. Examples of common anticoagulants include:
- Heparin
- Lovenox © (Enoxaparin)
Symptom-Reducing Medications
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 laxatives
- Anti-nausea such as Zofran©
Your doctor may advise you to take stool softeners or a laxative a day or two before surgery to help ensure your bowels are moving prior to surgery. Constipation from pain medication usage is a problem, and it can delay your discharge.
Conclusion
There are other medications your medical team may use. It is important to touch base with your surgeon, anesthesiologist, and nurse if you have questions regarding any medications. Your surgeon has medications they prefer to use, and will tailor specifically for your needs. 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 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 chest pain or difficulty breathing.
Love and Best of Health
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.
