Melbourne:
Except for Fentanyl, which is also being discussed here, and is an opioid, and causes confusion and constipation.
Personally, I just use versed (midazolam) for cataracts, if the surgeon is using topical anesthetic. Also, fentanyl causes much less “confusion” than midazolam, and I would be interested in a source showing significant constipation as a common side effect of fentanyl at the doses used in cataract surgery (say, 50 - 100 mcg).
It may not be a common side effect, but different people vary in how they react to most drugs.
Of course they do, but to simply state that it causes confusion and constipation is inaccurate.
Okay, fair. Versed is much more likely to cause confusion, and the one time I had the combination I certainly wasn’t constipated.
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June 17, 2019, 7:16pm
45
ThelmaLou:
Yes.
With my first cataract surgery in January the anesthesiologist gave me Versed and Fentanyl. That was standard.
Right before my second surgery about two months ago, the anesthesiologist came to talk to me and I told him how sick I had been after the first one. He said, “Do you think it was the Fentanyl that made you sick?” I said I didn’t know, but let’s skip it all the same. So he did. After the (second) surgery, my eyeball hurt, but I asked the nurse for a bag of ice, and after an hour the pain was much relieved. But I still felt that it was at least three days before the anesthesia (Versed) was out of my system. It might have been longer, but by three days I was feeling more or less like myself.
After the first surgery (with Fentanyl), major constipation. After the second one (without Fentanyl), no.
That’s pretty much in line with my experiences too; general anesthetic makes you groggy, nauseated and generally feel like crap for a couple of days afterward. The sedatives I’ve had and my friends/family have had didn’t have any significant side-effects, unless you count that amnesia.
Fentanyl isn’t general anesthesia (unless you have a massive dose). It’s an opiate, mostly it interferes with feeling pain.
I’m pretty sure my problem was with the versed.
Well, actually Fentanyl does cause confusion and constipation, so I think that calling that inaccurate it inaccurate. What we all mean here is that when used in small enough doses so that it doesn’t cause confusion and constipation, it doesn’t cause confusion and constipation. On the other hand, when it’s abused, it does cause confusion and constipation, so it’s not like those aren’t known characteristics of the drug.
in context, it was being compared to Versed, which causes a lot more confusion. So it was at best misleading.
FWIW. I came across something really interesting this morning, apropos of my Adventures with Anesthesia. Might help someone out.
Source: The People’s Pharmacy
Will Potatoes Slow Your Recovery from Surgery? Eggplants, peppers, potatoes and tomatoes all can block acetylcholinesterase. This might slow recovery from surgery in which muscle relaxants are used.
Q: When I had surgery, the head of anesthesiology came by and talked with me beforehand, and I mentioned an article I had read. It advised avoiding potatoes, tomatoes and eggplant several days before surgery. These foods cause problems clearing the effects of the anesthesia. She responded that in 22 years in the field, she’d never heard that.
After my surgery, the anesthesiologist came back to see me and was impressed with my recovery. That inspired her to search the article I’d mentioned, and she found a study from the University of Chicago around 1998.
The surgeon also was impressed by how well I was doing after anesthesia. Others might appreciate knowing this, since it can be difficult to clear anesthesia from our systems.
A: We too were unaware of the impact of solanaceous vegetables, such as potatoes, eggplant and tomatoes. These foods impact an enzyme called acetylcholinesterase, which is important in clearing muscle relaxants similar to curare (Anesthesiology, August 2000). Such medications are often used during surgery, especially abdominal surgery…
We found only a few research articles related to this topic, so it is not surprising that your anesthesiologist was unaware of this potential reaction. Tobacco is also a member of this nightshade family, although you should avoid tobacco for lots of reasons, not just recovery from surgery. Some botanicals from other plant families also inhibit cholinesterase (Pharmacognosy Reviews, July 2013). In theory, they too could interfere with quick recovery from muscle relaxants.