Benzos Something of a Curious Question about Benzo's and Anesthesia...

[Cone]

I know there are a lot of BL'ers out there with a great wealth of knowledge about the interactions of GABAnergenics in all sorts of ways...

I've recently been on somewhat of a rollercoaster ride with phenazepam, and I'm due in for surgery in a month's time.

If my "maintenance" dose could somehow be brought down to 4-5mg's from, say, 6-8mg's as a constant plasma level, would anesthesia still work on me as it would a normal person?

Last time I had propofol it took them 2x the normal dose to fully put me into twilight, I know because I sat awake and watched them put them in and talk about why 1x wasn't doing the trick. I wasn't even addicted to GABA drugs at the time.

Say I don't mention the phenazepam usage... would they just keep feeding me Versed (Midazolam) until I knocked out (assuming I was a naturally tolerant patient)?

Orrrr.... should this be something I could discreetly slip to my anesthesiologist before the surgery?

Either way, the surgery has gotta go down at this date. No delays possible unless I wanna miss school in the fall.

Also, as a side note - I didn't elaborate on my dosing schedule for a reason as its mostly random. I only begin to notice w/d type effects at 5-6mg's (calculated) plasma levels right now. However, as it may not be related... I can ingest 50mg's of zolpidem and not notice the slightest change in demeanor. I don't even get high off nitrous any more for some reason (strange... I know).

This might give you an Idea of what my overall "GABAnergenic" tolerance is.

 

[T. Calderone]

Say I don't mention the phenazepam usage... would they just keep feeding me Versed (Midazolam) until I knocked out

You really should mention it because your tolerance seems real high. Since they had to use extra propofol last time, you may not be properly sedated by the versed come surgery time. If you don't feel comfortable talking to your surgeon, definitely have a word with the anesthesiologist so he won't be so shocked if it doesn't work.

 

[Cone]

definitely have a word with the anesthesiologist so he won't be so shocked if it doesn't work.

Yeah. That's my plan so far.

Only problem is, I'd rather tell him in person face-to-face rather than sending a letter or some other BS. That way I can communicate what my tolerance *really* is and judge his reaction. I just don't know how the fuck to get face time with the guy beforehand since they work shifts, I could pick any one off a list.
My whole family will be surrounding me the second I enter the hospital.

"quick... lemme go tell the anesthesiologist that his shit's weak"

I mean, is there a chance that they might cancel it altogether in light of these facts?

I don't know if doctor-patient confidentiality applies to anesthesiologists. And he may not feel comfortable injecting me with 5x the normal dose just in case I'm lying.

PLUS they (the docs, not my family) already know I'm an ex-user because of my tracks. Cubital median, both sides. No denying that shit.

Fortunately I've been clean from opes long enough that 20mg of hydro still gets me buzzed.

A curious situation indeed.

 

[Chauncey_GARDENer]

I dont think you are allowed to, but try ask for ketamine... Works on a different receptor and is much safer in the first place/

 

[xxxyyy]

i, like you, have a naturally high tolerance to pretty much all gabaergics. the first time in my life i had a major surgery (to fix a cut tendon in my left ringfinger) they locally anesthesized my left arm and then shot me up with what the anesthesiologist called a 'benzo cocktail'. back in those days my knowledge of drugs was rather limited, and while i was prescribed diazepam i took it rarely and back then 20mgs had the effect on me that, say, 60mgs have now. anyway, instead of knocking me out, whatever he injected me with just made me feel really, really great. he wanted to give me another shot but i refused, because i was enjoying the feeling so much. an hour later or so they redosed me and i was promptly knocked out, but to this day it makes me smile that the guy respected my wishes and didn't put me under.
on an unrelated note, has anyone ever heard of multiple benzos being used at once in a hospital setting? because 'benzo cocktail' sounds to me very much like it was more than just midazolam.

 

[Jktm]

I'm pretty sure they'll dose you accordingly. They don't just use a set amount and say fuck it if you aren't put under. I was given 3x the normal amount of an anesthetic for my wisdom teeth extraction, but I had informed him of my opioid tolerance.

 

[Cone]

I guess my biggest fear is that they'll give me an "in-between" dose which will keep me in the twilight, unable to speak but still conscious and able to understand whats going on.


They're going to be replacing the head of my humerus with a steel cap. It's kinda akin to getting hip replacement. AKA major surgery which requires nasty deep cuts through muscle, in addition to "popping" the bone out of place to fit a cap to it and make sure it won't move by using bone drilling equipment.

3-4 hour procedure.

Not something I wanna be "awake enough" to feel/know.

 

[weekend addiction]

Well I'm not going to read everybody's post but I got to make something clear. I had my wisdom teeth taken out. I was given ativan and diluadid IV. The rush is breathtaking. Better than any sex you can have. But I woke up 45 minutes later angry and in excruciating pain. Fuck that. At the time I had been decently behaved for about a year. If there was no pain those doses probably would have knocked me out. But they didn't and now I wish I would haver stood up for myself. Oh well. No problems sp far.

 

[bingey]

^
APAp when taken correctly should take care of all kinds of dental pain (except abscesses/rotting roots) once the initial anesthesia wears off. Use it to your advantage.

 

[xxxyyy]

i am lucky that i still have all four of my wisdom teeth. maybe give diclofenac a try, of the OTC NSAIDs it's the most effective in my opinion.

 

[Captain.Heroin]

Personally, I wouldn't mention it. The anesthesiologist is trained in how to gauge midazolam+fentanyl properly.

When I had fentanyl+midazolam pumped into my vein, and came out of it afterwards, it felt a bit midazolam-heavy. I think they do this so you don't have any memories of the surgery and what not. Needless to say I had no conscious memory about my surgery and thank god for the anesthesiologist doing his job right.

You really don't want to wake up in the middle of a surgery though.... so... you could mention you have taken benzodiazepines for anxiety and you would normally take like a few milligrams of Xanax (I wouldn't mention phenazepam to them, it's not like they are familiar with it compared to Xanax) and you just wanted to let them know this so the surgery goes well.

When I had my surgery they also gave me a "test shot" and I barely felt anything from it so I kept acting upset (because I was and was in a lot of pain). I'm sure they'll do the same to test the effects of how you react, etc. to gauge what you'll need.

For HR reasons I'll say you should mention it. Your health/life is definitely worth telling them the truth.

i am lucky that i still have all four of my wisdom teeth. maybe give diclofenac a try, of the OTC NSAIDs it's the most effective in my opinion.

Diclofenac is RX only over here.

I personally hate it because it's so sedating.

Diclofenac can be really hard on the kidneys too. There's a reason why it should not be OTC.

 

[xxxyyy]

yes, here it's OTC in low formulations. in my opinion it's the only NSAID that's worth a fuck, i sometimes have pretty bad back pain and in the absence of opioids it's the only thing that helps. how does its safety profile compare to say, paracetamol?

 

[Captain.Heroin]

yes, here it's OTC in low formulations. in my opinion it's the only NSAID that's worth a fuck, i sometimes have pretty bad back pain and in the absence of opioids it's the only thing that helps. how does its safety profile compare to say, paracetamol?

Well I can't say about the safety profile, I just know that when I was taking diclofenac and two other NSAIDs, the doctors told me to monitor what my urine looked like for signs of kidney failure.

Most of the time in the US, diclofenac is started in an IV in a hospital setting, so that if there's an adverse reaction, they'll notice quickly and be able to discontinue.

Giving me rx's of dilcofenac for the first time was fine for me, as my body handled it well.

I actually prefer ketorolac, as it is also sedating but just seemed to work better for me. Is that available OTC in Germany?

 

[Cone]

Mentioning benzo usage would... actually work in this situation.

I guess it would come down to how I phrase it.

"I take xanax recreationally and it takes me 4mgs to get off."

Or...

"I have a script for xanax at 2mgs, but sometimes I have to take 4 if I'm having a rough day."

But this raises a question in the doctors mind - why didn't I mention that I was on xanax when they ask "What prescriptions do you take?"

Captain H: you mention your experience being "midazolam heavy" when you came out of it. Were you using benzos at the time? Did you have a tolerance, and the anesthesiologist adjusted the dose accordingly?

Maybe I'm bugging out over nothing.

I'm sure there's others on this forum that have been in a similar predicament before.

 

[Jktm]

Just take your prescription with you the day of and show him and tell him you forgot to mention it. People forget shit.

Usually if you wake up during proceedure, they quickly give you a push of something so that you go back under, and you're out within seconds. They also do things to maintain anesthesia. And like CH said, they heavily dose you with an amnesiac, so if you do wake up screaming, you probably won't remember it.