What drugs are used in general anesthesia? Is it safe?

Hello and thank you for your question regarding drugs used in general anesthesia for gynecomastia and tummy tuck surgery. There are several drugs used for general anesthesia. Each drug has a particular role. Each anesthesiologist also has a particular recipe with which they are comfortable. The following list is the drugs most commonly used to achieve comfortable and safe general anesthesia.
Propofol is medication given at the beginning of the procedure to make you sleepy. This is an induction agent.
Cis-atracurium (Nimbex), Vecuronium, Rocuronium, Succinyl choline are paralytic agents. These allow your entire body to relax. This also allows placement of the breathing tube between your vocal chords. Sevo-flurane is a hypnotic medication and allows for deep sleep during surgery.  Nitrous oxide, Fentanyl, and Dilaudid are analgesic medications. These medications minimize the pain during surgery.  Glycopyrolate and Atropine are medications given to decrease oral secretions and to protect your airway. Oral secretion can block your airway and restrict breathing.  Versed is a medication to help you relax and forget some of the procedure.  Neostigmine is a reversal agent. This medication is given at the end of the case to fully awaken you. If you are in good health with normal blood test, EKG, and chest x-ray, general anesthesia is relatively safe. If you are healthy, it is safe to have multiple surgeries in a single day. Most plastic surgeons try to limit the hours under anesthesia. In general I believe it is safe to do male breast reduction and full tummy tuck on the same day. I believe it is probably less risky to perform these procedures on a single day as opposed to separating the procedures on different days. Performing the procedures on different days may increase anesthetic risks.
To a certain extent, general anesthesia does affect the liver, kidneys, and heart. Some medications are processed by the liver, while others are processed by the kidneys. However, most general anesthetics are extremely short acting and pass through your system very quickly. The general anesthetics used today have minimal temporary effect on the kidneys and liver.
Good luck. If you have any questions regarding male breast reduction and full tummy tuck, please contact my office. Sincerely, Dr. Katzen.

Your concern is correct and I hope you will find my answer useful.GA drugs can be toxic for patients' with liver, kidney and heart problems, otherwise it is very unlikely - but not impossible. Cocktails usually include at least 3-4 drugs plus antibiotics, anticoagulants etc.The length of the surgery is certainly another critical factor.Healthy patients can have multiple procedures at the same time and I perform very often combined procedures within a single session of general anaesthesia: breast&abdo is certainly amongst the most common combinations.

There are many different agents that can be used.  I like to have my anesthesiologist review these agents with patients. This is their expertise.  Good luck.  I often perform multiple procedures at the same time on healthy patients.

Dear musa1992,

Thank you for your clinical
post. Your concern is appropriate as
general anesthesia uses certain medications that come with risk. They are generally considered quite safe, but
there is always a rare risk of drug reactions both anaphylactic shock, allergic
potential or toxic effects of the drugs on the kidney, the liver or other organ
functions. In general, these risks are
very rare and prior to the surgery you would meet with the anesthesiologist to
discuss your concerns with them. The
most common kinds of anesthetics used depending on the surgery performed are
Propofol, narcotics such as Fentanyl and relaxation or Benzodiazepine
called Midazolam. Some inhalational
agents and gases may be also mixed and a paralytic agent is often used to relax
muscles.

All of these comes with risk, but are
very safe and have been used millions of times over the past decade and a half
of anesthetic procedures.

Many procedures I do such as
facelift, liposuction, blepharoplasty, neck surgery, skin only tummy tucks and
others can be done under local anesthesia with no general anesthetic
risks. Generally, things that do work
are anesthesia should be done with an anesthetist with extensive experience and
close hospital privileges to the surgical facility in case there’s an
anesthetic mishap.

I’ve been performing aesthetic
plastic surgery for over 20 years in my private Yorkville facility and use the
anesthetic groups in the Toronto General Hospital and other hospitals, that
they are excellent well-trained and are able to transfer patients if there’s an
anesthetic mishap. A thorough workup using a
cardiologist, blood test are all an important part of screening patients prior
to surgery.

I hope this information is of some
assistance and best of luck.

R. Stephen Mulholland, M.D.

Certified Plastic Surgeon

Yorkville, Toronto