Do I Have to Go off of my Anti-Seizure Medication for the Surgery?

Question

I am looking at having a tummy tuck, breast reduction and lipo. I am concerned that I might have to go off of my anit-seizure medication (Gabapnetin). Since it is the only thing keeping me from having seizures, what are my options for these types of surgery and meds?

Leila Kasrai, MD, FRCSC · Answer

The only medications that we stop around surgery is blood thinner and some immune modulating agents. Otherwise it is very important that medications that are controlling body systems issues (e.g., high blood pressure, diabetes, seizures, depression) be continued.

Vincent N. Zubowicz, MD · Answer

It would be unwise to comment specifically on your medication. This is a decision that will be made by the surgeon and anesthesiologist. On balance, most patients continue to take their usual medications throughout the operation and convalescence.

Kenneth Hughes, MD · Answer

Your seizures should be controlled prior to surgery, and gabapentin is generally not contraindicated prior to surgery. You should confer with your plastic surgeon and anesthesiologist prior to surgery. Find a plastic surgeon with ELITE credentials who performs hundreds of tummy tucks each year. Then look at the plastic surgeon's website before and after photo galleries to get a sense of who can deliver the results. Kenneth Hughes, MD Los Angeles, CA

Pablo Prichard, MD · Answer

Dear LFL, Thank you for your post.  There is nothing contra-indicated about having breast surgery or TT when one has epilepsy.  It sounds like your epilepsy is well controlled.  Notify your physician of your intentions, and ask for advice on modulation of epilepsy meds during the post-operative period.  I do not think you need to come off of the meds however.Best wishes, Pablo Prichard, MD

Michael D. Cohen, MD · Answer

Generally, you should be able to continue taking your medication as long as they pose no risk during surgery. In some cases, certain medications need to maintain a steady state level within your body. By interrupting their use, it may throw these levels off. Therefore, it is advised that the patient check with the providing physician and the anesthesiologist regarding the advisability regarding your specific health condition. All the best –Dr. Cohen

Stephen Salerno, MBBS, FRACS · Answer

Hello

	I would not see the need for you to come off your medication prior to having you surgery.  These types of decisions need to be made wth your anaesthetist, surgeon and probably your Neurologist.  As far as I am aware there is no contraindication to Gabapentim and body contouring surgery.

	Regards

	Stephen Salerno

Victoria Yongsook Suh, MD · Answer

Preventing seizures during general anesthesia is very important. Most seizure medications should be continued during surgical procedures. However, to prevent drug interactions and any potential complications, the Plastic Surgeon, the Anesthesiologist, and your Neurologist and/or Primary Care Physician should all work together prior to the surgery. I highly recommend pre-operative consultation with your physician with direct request to address the seizure medication manangement before, during, and after the surgery. Coordinated medical teamwork is the best way to ensure safe outcome from the surgical procedure. Best Wishes!

Jeffrey Zwiren, MD · Answer

With any medications that are medically necessary you should work with your plastic surgeon and primary physician.

William B. Rosenblatt, MD · Answer

Sounds like you need to see your internist and perhaps neurologist and be cleared before the surgery. Ask them these questions, although in my experience the usual answer is no, you can continue to take them.

Jourdan Gottlieb, MD · Answer

As with all medicines, your surgeon and anesthetist should be aware of  what you are taking to avoid reactions with other drugs that may be given during your surgery. That said, gabapentin is frequently used for pre-op anxiety, and to reduce pain med usage after surgery. 

	I see know reason why you couldn't proceed as planned with your surgery while continuing to take your gabapentin.

	All the best.

Do I Have to Go off of my Anti-Seizure Medication for the Surgery?

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