Medications can have an impact on the anesthesia that will be used for your surgery and even on your recovery, says Ram Roth, MD, board certified anesthesiologist at Mount Sinai Queens. That is why it is very important to talk with your surgeon and anesthesiologist about all the medications you are currently taking or have recently taken. Even though someone may have asked you and written down your medications, I usually will ask you again. Whether you have a surgery scheduled or not, it is good practice to have a ready list of medications you are taking, and to make your health care professionals aware of them, especially when you receive care. Your list should include:
- Drug name and dosage
- How often you take the medication
- How long you have been taking the medication
Be sure to include over-the-counter medications; vitamins, herbs, and supplements; and even recreational drugs. Remember to update the list when changes are made by your doctor. In addition, you should keep, and share with all healthcare professionals, a list of any medications that have caused an allergic reaction.
Some routine and maintenance medications merit special consideration prior to your procedure. A good example is insulin. Insulin-dependent diabetics need to continue their medication to maintain normal blood sugar. Prior to surgery, patients are asked to fast after midnight, which may affect the way insulin needs to be taken. If this situation applies to you, discuss it with your endocrinologist or ask your surgeon for his or her recommendations.
Anticoagulants, or blood thinners, are another type of medication that requires special consideration. This includes medications like ibuprofen and vitamin E, which thin the blood even though that is not their express purpose. Based on your medical history, your cardiologist, surgeon and/or anesthesiologist will determine the optimal timing for discontinuing some or all of your blood thinners. In some situations, you will be told that continuing your medication is important even prior to surgery. Decisions like these are based on the risk of bleeding related to surgery versus the risks of stopping the medication. The primary care or specialty physician who knows your medical history is the best person to help you and the surgical team decide. I include you, because as a participant in your healthcare, you should be informed and understand how the decision is made.
Patients should not discontinue medications that control high blood pressure or anti-seizure medications. While patients must avoid food and drink starting at midnight on the night before the scheduled surgery, it is permissible to have a small sip of water with your medication.
Click here for a comprehensive list of medications to avoid prior to surgery. Remember, this information is not a substitute for direct medical advice.
Ram Roth, MD
Assistant Professor, Anesthesiology, Perioperative & Pain Medicine, Mount Sinai Queens
