Scared of pre-surgery meds (lorazepam & tramadol), am I going to be super messed up?

Question

Hello I’m scheduled to get chin Lipo with local anesthesia next week and I’m to take two 2mg lorazepam and one 50mg tramadol two hours prior and then another of each one hour prior. I’m not familiar with these drugs and online says mixing them can be fatal. Am I gonna be super messed up? Will I be able to walk? Is it dangerous?

Eric M. Joseph, MD · Answer

Your surgeon should be able to monitor you both before during and after your procedure to make sure that you are stable. And you would certainly benefit from having an adult stay with you for the first 24 hours after your procedure. If you have any doubts any doubts, go with your gut. I hope this helps. Sincerely, Dr Joseph

Anna Chacon, MD, FAAD · Answer

It's completely normal to feel anxious about taking medications before a procedure, especially if you're not familiar with them. Here's a breakdown of what you can expect and some important points to consider:

### Lorazepam
- **Purpose**: Lorazepam is a benzodiazepine used to reduce anxiety and help you relax before surgery.
- **Dosage**: 2mg is a standard dose for preoperative anxiety. Taking two doses (total 4mg) over a period of time is intended to ensure you are calm and relaxed.

### Tramadol
- **Purpose**: Tramadol is an opioid pain medication used to manage moderate to moderately severe pain.
- **Dosage**: 50mg is a typical starting dose for pain relief. Taking two doses (total 100mg) is meant to cover pain management during and after the procedure.

### Combination Concerns
- **Sedation**: Both lorazepam and tramadol can cause drowsiness and sedation. When taken together, these effects can be enhanced.
- **Respiratory Depression**: There is a risk of respiratory depression (slowed breathing) when combining these medications, but this is usually more of a concern at higher doses or in individuals with certain health conditions.
- **Walking and Coordination**: You may feel very drowsy and uncoordinated. It's likely that you will need assistance walking and should not drive or operate heavy machinery.

### Safety Measures
1. **Medical Supervision**: Your surgeon and anesthesiologist are aware of the medications you're taking and the dosages. They have prescribed these specific amounts to ensure your safety and comfort during the procedure.
2. **Monitoring**: During the procedure, you will be monitored closely. Any signs of excessive sedation or respiratory issues will be addressed immediately.
3. **Preoperative Consultation**: If you have any health conditions (e.g., respiratory issues, liver or kidney problems) or are taking other medications, discuss these with your doctor. They can adjust dosages if necessary.
4. **Postoperative Care**: Arrange for someone to accompany you to and from the procedure, as you will not be in a condition to drive or navigate on your own.

### What to Do
- **Contact Your Doctor**: If you have concerns or are feeling very anxious, reach out to your surgeon or the anesthesiologist. They can provide reassurance or adjust the medication plan if needed.
- **Follow Instructions**: Take the medications exactly as prescribed, and do not alter the doses on your own.
- **Stay Hydrated and Rested**: Ensure you are well-hydrated and have had a good night's sleep before the surgery.

While it's understandable to be concerned, the dosages prescribed are intended to manage your anxiety and pain effectively and safely. Your medical team has considered the potential risks and will monitor you closely. If you have any lingering worries, don't hesitate to discuss them with your healthcare provider for additional reassurance.

Mats Hagstrom, MD (license on probation) · Answer

We use similar combinations to do our procedures.
We use opiates instead of tramadol.
Our patients are observed the entire time so if they become over sedated, we are there to assist the patient.
We have reversal drugs for benzodiazepines and opiates in case of an emergency.
I don’t know if there are reversal drugs for tramadol.
If your procedure is in an accredited facility, then most likely they will have a similar set up. 
I’m not sure if it’s necessary to give medication two hours before the procedure but each provider will do things differently.
The drugs and doses do not seem inappropriate, but it does seem like you should be monitored while being sedated. 
If you have questions about your upcoming procedure, then you should bring them up with your provider.
There are plenty of things to be anxious about before surgery.
In my opinion, the one single most important variable I think patients should be most concerned about is understanding their own candidacy and confirming that you’ve done a thorough job in provider selection.
 in the end results are usually based on candidacy and provider selection and those are the two variables that in the end dictate whether someone is going to have an overall positive or negative experience.
A lot of anxiety before surgery is fear of the unknown.
What you describe does not seem inappropriate.
Best,
Mats Hagstrom MD

Scared of pre-surgery meds (lorazepam & tramadol), am I going to be super messed up?

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Scared of pre-surgery meds (lorazepam & tramadol), am I going to be super messed up?

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