Valium, Demerol and Xanax: Too Much Medication for Blepharoplasty Surgery?

The combo of Valium and Xanax seems a bit weird and heavy-handed since they're both benzodiazepines. I've gotten away from prescribing Valium for in-office procedures mainly because of its long elimination half-life (20-80 hours, given its multiple metabolites). Valium has become kinda of "old school," if you will.
Ativan is a reasonable choice and I like it for longer procedures (e.g., 2-ish hours), since it's got a shorter half-life than Valium and is well tolerated.
Lately, I've been keen on Halcion (triazolam), especially for short procedures such as a bleph. It's got *no* active metabolites, works quickly, and is gone quickly (half-life of about 2-5 hours).
The Demerol is probably way over the top for this procedure given the typically trivial pain involved.
Best of luck,
--DCP

Hi Helen,
This sounds like a lot of medication.  Valium and Xanax are both benzodiazepines and will potentiate each other's affects - you're better off choosing just one of those medications.  With this cocktail of medications, it's important that your physician's office monitor your vital signs during the procedure to ensure that you're not oversedated.
Hope this helps.  Best of luck.

Dear Helen
Valium and Xanax have similar effects. Demerol, although still commonly used, can cause hypotension and respiratory arrest especially in combination with other drugs. If the doses are relatively small, the combination may be safe. However, this type of cocktail is often used in office based surgery because it avoids a general anesthesia or deep iv sedation which in many states necessitates an accredited surgery center or hospital based operating room. Upper eyelid and lower eyelid surgery is generally comfortable enough that a valium and local anesthestic is generally all that is needed.
To be quite honest, I do many of my eyelid surgeries in an accredited operating room so my patients can have IV sedation. This is a good choice so that patients can be less aware of what is going on during surgery. The drugs used are very short acting so that there is almost no hang over. Comfort level is very good after these types of surgeries.