Are there low‑interaction sedative options for my surgery?

Question

Hi doctor,

I am going to undergo a laparoscopic fundoplication surgery after a week for severe GERD. For the past two months, I have been taking Valium 5 mg for severe anxiety (mainly related to my health) three times daily. I have also been taking Omeprazole 80 mg daily for several months.

I recently came across a study that stated the AUC and half-life of Valium are increased by 130 percent with a dose of 40 mg Omeprazole. As I am taking double the dose of Omeprazole, I am afraid that it has raised my plasma level. I am concerned about the concurrent use of other drugs (opioids) that can help me.

This is my first major surgery, and I am terrified. I am taking Aspirin 81 mg and Crestor 10 mg. My past medications are Lorazepam, Citalopram, Escitalopram, Zoloft, Propranolol, Esomeprazole, and Ranitidine.

I need to talk to an anesthesiologist before my surgery.

Is this dangerous, or are there any other alternative sedatives to opiates that would interact less with my Valium dose?
Is there any increased concentration in my body?

Please help.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

I read your query and understand your concern.

Please convey your medical history to the anesthetist when you have a pre-anesthetic consultation. I am sure that they will be using Remifentanil (an opioid analgesic) infusion for the surgery.

This drug is short-acting and is considered a low-interaction sedative option that can be used alongside diazepam (anxiolytic).

I suggest you consult an anesthetist before surgery and stop taking Valium (Diazepam). There are better medications for controlling anxiety. I recommend a psychiatrist referral after the surgery. This will cure your stress and anxiety-related gastritis.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.