Can Allergies to Sleep Medications Affect General Anesthesia?

Q: Can Allergies to Sleep Medications Affect General Anesthesia?

Hello： I must say you have a good understanding of anesthetics! I hope my explanation will provide you with further insight into anesthesia and anesthesia safety. <br>Here are the responses to your questions, item by item：<br>1. <br>Before surgery, patients are advised to undergo

Are sleeping pills and general anesthetics the same?

I have decided to undergo orthognathic surgery next year, but I remember being allergic to a sleeping medication containing flurazepam when I was a child.
Since both sleeping medications and anesthetics induce sleep, I am concerned about whether I can still receive general anesthesia if I am allergic to flurazepam.
I researched that the main agents for general anesthesia are propofol and isoflurane.
I would like to ask: 1.
With the advancement of technology, can anesthesiologists avoid using any drugs that may cause allergies during general anesthesia if they are aware of them? 2.
Will I be turned away by the anesthesiologist due to my allergy to flurazepam? 3.
Since both sleeping medications and anesthetics induce sleep, are there any similarities between propofol, isoflurane, and flurazepam? 4.
Do isoflurane or propofol contain any components of flurazepam? 5.
I am 24 years old and do not smoke, but can I still receive general anesthesia if I am allergic to flurazepam? My biggest fear is that I might be unable to undergo surgery due to my allergy to flurazepam, especially since I am already in braces.
I know that communication with the anesthesiologist needs to happen a few days before the surgery, and I do not want to find out at that time that I cannot have the surgery, as all the money and effort I have invested would be wasted.

allen, 20~29 year old female. Ask Date: 2017/10/22

Dr. Lin Xiuying reply Anesthesiology

Hello: I must say you have a good understanding of anesthetics! I hope my explanation will provide you with further insight into anesthesia and anesthesia safety.
Here are the responses to your questions, item by item:
1.
Before surgery, patients are advised to undergo an anesthesia consultation.
The purpose is to understand the patient's medical history, medication history, and physiological status.
Among these, the history of drug allergies is crucial to avoid using medications that may cause allergic reactions.
However, it is important to note that not all anesthetics have been previously used by the patient, and the patient's physiology can continuously change.
Therefore, a patient who was not allergic before, or one who was allergic in the past, may not necessarily have the same reaction upon subsequent exposure.
Nevertheless, if a known allergy to a specific drug exists, avoiding its use remains a golden rule.
More importantly, healthcare providers must be able to promptly recognize allergic reactions and manage them effectively, which is an unchanging principle!
2.
As long as the physiological condition allows, an anesthesiologist will not refuse to anesthetize you simply because you are allergic to flurazepam.
3.
Essentially, medications act on the brain to induce sleep.
The drugs you mentioned—flurazepam, propofol, and isoflurane—are three different classes of medications that act on different receptors in the brain to produce sedative effects.
Generally, being allergic to flurazepam does not imply that you will also be allergic to the other two drugs.
Please rest assured!
Finally, I would like to remind you: if you do require anesthesia for surgery in the future, you can ask your surgeon to refer you to an anesthesia consultation clinic, where an anesthesiologist can carefully evaluate and address your concerns.
Wishing you all the best!

Reply Date: 2017/10/22

More Info

When considering the implications of allergies to sleep medications, particularly in the context of general anesthesia, it is essential to understand the distinctions between various classes of drugs and how they are utilized in medical settings. Your concerns about undergoing general anesthesia for your upcoming orthognathic surgery, especially given your allergy to flurazepam, are valid and warrant careful consideration.

1. Understanding Drug Allergies: Flurazepam is a benzodiazepine, a class of medications commonly used for their sedative and anxiolytic effects. While both benzodiazepines and general anesthetics can induce sleep, they operate through different mechanisms and are chemically distinct. General anesthetics like propofol and isoflurane do not contain flurazepam or any benzodiazepines. Therefore, your allergy to flurazepam does not inherently preclude you from receiving general anesthesia.

2. Anesthesia Providers' Expertise: Modern anesthesiology has advanced significantly, and anesthesiologists are trained to recognize and manage drug allergies. They will review your medical history, including any known allergies, and will select anesthetic agents that are safe for you. It is crucial to communicate your allergy to your anesthesiologist during your preoperative assessment. They will ensure that any medications used during your anesthesia are free from the components that could trigger an allergic reaction.

3. Potential for Refusal of Anesthesia: It is unlikely that an anesthesiologist would refuse to provide anesthesia solely based on an allergy to flurazepam. Instead, they will work with you to find suitable alternatives. The goal of the anesthesiology team is to ensure your safety while providing effective anesthesia for your procedure.

4. Comparative Mechanisms of Action: While flurazepam, propofol, and isoflurane all induce sedation, they do so through different pathways. Flurazepam enhances the effect of the neurotransmitter GABA at the GABA-A receptor, leading to increased inhibitory neurotransmission. In contrast, propofol is an intravenous anesthetic that also acts on GABA receptors but has a different pharmacokinetic profile, leading to rapid onset and recovery. Isophrane, a volatile anesthetic, works by affecting multiple neurotransmitter systems and is used for maintaining anesthesia during surgery.

5. Chemical Composition: Neither propofol nor isoflurane contains flurazepam or any benzodiazepine derivatives. Thus, there is no risk of cross-reactivity between these anesthetics and your known allergy.
6. Your Health Status: At 24 years old and without other significant health issues, your overall health is likely to be favorable for undergoing general anesthesia. The key is to ensure that your anesthesiologist is fully aware of your allergy and any other medical history that may be relevant.

In summary, your allergy to flurazepam should not prevent you from undergoing general anesthesia for your surgery. It is essential to have an open dialogue with your anesthesiologist about your allergy and any concerns you may have. They will take the necessary precautions to ensure your safety and comfort during the procedure. It is advisable to discuss your concerns well in advance of the surgery date, ideally during your preoperative consultation, to ensure that all parties are aligned and prepared for your care.

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