Wearing Fentanyl Patch During Surgery

[bex57]

Hi Everyone-

I'm hearing mixed answers from medical professionals, and wanted to hear what you had heard from your experiences or from your doctors to help me make my own decision at this point.

I am having arthroscopic surgery tomorrow morning (orthopedic surgeon doing my surgery). I use the fentanyl patch for my neck and back pain and my pain management doctor feels that it is okay for me to continue to wear the patch during surgery (he is an anesthesiologist). I talked to the pharmacist today and he said that I absolutely should take off the patch, and even should take it off a few hours before since the medicine is still in the body and releasing so I don't technically need the patch attached to my skin for the last few hours before the surgery.

Can you share with me your experiences please?

Thanks so much!

[Jaybay]

I ran into the same question before my last surgery.  My pain doc also did the anesthesia, and she told me to leave the patch on.  The pre-op nurses freaked when they saw it and refused to let me leave the area until I allowed them to remove it.  The absolutely would not listen to me or wait for my pain doc to come in and settle the dispute.  Finally my pain doc came in wondering what was holding me up, and about ripped those women a new one.  Apparently there were notes peppered throughout my chart to LEAVE THE PATCH ON and nobody bothered to read it.

Then there was the Nurse Rached in recovery.  I'm still out of it with the anesthesia and post-op pain meds and she starts suspiciously questioning me about "all these pain medications" and particularly the fentanyl patch.  "Just WHERE are you getting all these pain meds and WHY do you 'think' you need them?"  My husband stepped in with that particular Rached and told her that if she didn't start behaving in a more professional manner he would go to the charge nurse first and the director of nursing second.  Yeah baby!  

Anyway, as long as you personally tell the anesthesiologist him/herself (along with the pre-op Racheds who write it down in your chart) you'll be fine.  They can make adjustments to the big bombs they drop on you for surgery.  Anesthesiology is really an art form.  It's not a one-size-fits-all proposition.  They have to account for different medical conditions, body sizes, metabolism, current medications, any known allergies or past adverse reactions, which is why they constantly monitor your oxygen saturation, pulse, blood pressure, etc.  That amount of fentanyl in your patch is like a mosquito compared to a well-aimed fly swatter.  No worries!

[happyhbmom]

The anesthesiologist can adjust for it, if they know you use it beforehand.  I was using the fentanyl patch when I had an endoscopy under twilight sleep with propofol, and I kept it on.

[mellie4]

When I had my surgery last month, I left my Fentanyl patch on.  All my doctors, the surgeon, pain management team, and 2 nurse friends were all in agreement on that.

[bex57]

Thanks, all.

Talked to all of the doctor's today. Seems they don't really know either. I am going to make my own decision and listen to the pharmacist's advice because they have been right 100% of the time, as opposed the the anesthesiologist (my pain doctor- thank goodness he is not the one doing my surgery tomorrow morning) who has been wrong before on drug interactions. I listened to him and I ended up in the emergency room..... I am going to take my patch off a few hours before surgery and when I get home (since my surgery is outpatient) I will put the patch back on afterwards. I talked to the nurse at the surgery center and she said the anesthesiologist said that was fine for me to take the patches off a couple hours before, as I am not going to go into withdrawals without wearing it for a few hours. I am going to bring extra patches though with me just in case the doctor changes his mind in the morning. I figure it is better to be prepared!

I wish my doctor's were more informed about dealing with patients on fentanyl patches and going through surgery. They just don't deal with this very often. What scares me is that my PMP is an anesthesiologist and is the head of anesthesiology at the local hospital. I sure wouldn't want him anywhere near me for something like that!!! Very Scary after what he did after prescribing my some recent medicine.

[design112]

I would call the orthopedic surgeon office who is doing the surgery and ask them what they think.  I'm sure if your pain doctor told you to keep it on, it's probably ok, but you will need to make sure you tell the anesthesiologist about it to keep your pain under control and the medications that they use are correct. I'm in the same situation, I use a fentanyl patch and am having surgery next Wednesday.  I've been given no information on whether to wear it or not.  I'm going to keep wearing it until the office calls me and checks me in, then I'll ask her/him what I need to do about it.  I wish you the fastest and easiest recoveries and hope this will take care of some of your pain issue!  Keep us informed.

Karen

[mdmstellar]

From what I understand, from extended research on the fentanyl patch when I was on it a few years ago, the patch can lessen the effects of pain medications, anesthesia, or other medications that you may be given before, during and after surgery, or even have some other interactions...Course I am not a medical professional, but that's what I have read.