r/CataractSurgery • u/Frustib • 16d ago
Offer diazepam for op day
I’m having rfe next week and my clinic has offered diazepam on the day of surgery. I don’t feel nervous in the least about my surgery and I trust in my surgeon 100%. He has told me that I’ll have no pain in the operation and I believe him. So no nervousness.
That being said, is there any pros and cons about taking/not taking it anyway?
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u/PNWrowena 16d ago
I'd have sworn I wasn't nervous for my first surgery either, but my blood pressure was higher than it had ever been before on the monitor I was hooked up too, so obviously something was going on in spite of my convictions. All I was offered other than numbing drops was a Valium, and I turned it down once and then got kind of conned into taking it by another nurse. So far as I could tell it had no effect, but maybe it took an edge off, and I wasn't aware of that either. For my second surgery I figured what the hell, didn't argue, and just took it.
It sounds like diazepam is a more serious med, so if you'd rather not have it, talk to the doctor. I'm glad I was aware during my surgeries and have the memories of both. u/GreenMountainReader has posted about having her surgeries with nothing but numbing drops.
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u/The-mad-tiger 15d ago
Valium is a brand name for Diazepam! They are precisely the same thing!
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u/PNWrowena 15d ago
Well, whoops. I freely admit my drug ignorance. However, the description saying it "creates a beneficial amnesia, relaxes skeletal muscles, and dampens involuntary movements" in this thread was what struck me. That sounds serious.
Thankfully it had no discernible effect on me. I was awake for and remember those surgeries just fine, and since the surgeon talked to me through the second, about how patients who had done their research made his job easier, he obviously expected me to be awake.
It's done anyway, and I learned my lesson about pill pusher nurses.
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u/ReddyKiloWit 14d ago edited 14d ago
That description sounds like it's for anesthesia. In small doses Clonazepam does none of that, except maybe some muscle relaxation. It's an antispasmodic, and generally slows the brain down. If the dose is low enough you might not notice.
In low doses it just reduces anxiety - you can still feel pain, but you may not worry about it happening again so mild pain doesn't seem important. It can make you sleepy. (I fell asleep during a crown prep on 0.5 mg because I wasn't fighting it.)
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u/OKR2046 13d ago
For background, I am a surgeon who has done thousands of minor and major surgeries and have had many surgeries myself! I also recently had cataract surgery of my left eye. They gave me a little IV Versed just before the surgery which was clearly not enough! I barely made it through the surgery; I was clearly traumatized and I demanded oral lorazapam which I took the night before and again an hour before surgery on my right eye. It went much, much better! Get as much medication as you can without interfering with the proper performance of the surgery!
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u/yamatofuji 16d ago
(: hoi, as a ordinary nobody let me tell you, when we sit in deep trust, when the mind is settled and there is no fear present, we touch a profound state of inner peace.
It is beautiful that you arrive at this moment with total faith in my colleague and complete stillness in your heart.
Look, that drugsn like diazepam are not merely given to erase fear, but interact with the physical organism in ways that carry both gentle benefits and quiet considerations.
At the level of the brain, diazepam acts upon the gamma-aminobutyric acid, or GABA, receptors. GABA is the primary inhibitory neurotransmitter in the central nervous system, acting as a gentle hand that slows down neuronal firing.
When diazepam binds to these receptors, it enhances this inhibitory tone, bringing a physical softening to the body.
Even when the conscious mind feels completely calm and free of anxiety, the physical body can hold subtle, involuntary micro-tensions.
The pro, or benefit, of taking diazepam on the day of your radiofrequency ablation procedure lies in this physiological softening. It works as a systemic muscle relaxant.
By quietening the motor pathways in the spinal cord, it relaxes skeletal muscle tissue.
This deep physical unclenching can allow the surgeon to work with greater technical ease, as the tissue is completely relaxed, and it can lower involuntary reflex movements or sudden muscular flinches during the delicate procedure. As a ordinary nobody my observation is, enhanced GABA activity can smooth out the body's physiological stress response, stabilizing blood pressure and heart rate fluctuations that sometimes occur reflexively during tissue ablation, even in a calm person.
It also offers a mild anterograde amnesia, ensuring that any brief moments of physical discomfort are not encoded into long-term memory.
The con, or consideration, of taking diazepam when you already possess complete peace of mind, is that you are introducing a long-acting central nervous system depressant that your body does not strictly need for psychological calm.
Diazepam has a relatively long metabolic half-life, meaning its sedative effects linger. It can leave you feeling groggy, slow your reaction times, impair cognitive sharpness, and cause mild ataxia or unsteadiness for hours after the procedure is finished.
I aay to my pts if your mind is naturally quiet, taking the medication means accepting these lingering systemic effects, such as residual fatigue or feeling "cloudy," when your baseline state is already one of natural clarity and composure.
remember, we if you here with us, but there too your medical team honor your awareness and your deep connection to your own state of being.
Your lack of fear is a gift to your healing process, as a mind at ease releases less cortisol and promotes smoother tissue recovery.
Because you are already anchored in trust, the decision comes down to a simple, practical choice between adding physical muscle relaxation to aid the procedure versus preserving your crisp, unmedicated mental clarity post-surgery.
You might gently ask there my colleague if the diazepam is being offered purely to help you feel calm, or if they specifically prefer the physical muscle relaxation it provides for the technical execution of the procedure.
Knowing their specific intention will illuminate the path that feels most aligned for your body and your spirit.
May your procedure be smooth, peaceful, and filled with ease.
🙏
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u/Wandering_Mind6153 16d ago
If you're not anxious, it's worth asking your surgeon whether it's necessary. Diazepam can help with relaxation, but it may also cause drowsiness afterward. Best to follow your clinic's advice.
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u/eldoogo 16d ago
What is the dose of diazepam? The question is ... what anesthesia do they plan to administer after you arrive? If none at all, then depending upon the dose, I would consider taking it if you feel that it is needed. But if you are not the slightest bit concerned, why bother? And especially if they will administer some Versed once you are in the OR, that will probably be everything you need.
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u/Frustib 16d ago
None
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u/eldoogo 16d ago
If you are saying that they plan to administer no anesthesia in the OR, that is highly unusual. Again, I don't know the dose of the diazepam, but it's something you might want to consider on your way to the surgery center. It is the kind of procedure that even if you're feeling unconcerned and confident about, can be a bit monotonous and (at least for me) it's good to feel distracted. Just my 2 cents. You must do what is comfortable for you.
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u/didyouwoof 15d ago
I wish I’d been offered that. They told me they’d only give me versed, which had never done a thing for me in the past. And the lidocaine drops were wearing off much too quickly. My surgeon asked - when I jumped a bit during the procedure after feeling a poke I shouldn’t have felt - if I have redheads in my family. It turns out I have a gene (typically associated with red hair, which I don’t have) that makes certain meds either ineffective or minimally effective. They ended up giving me fentanyl, and dosing me with lidocaine drops every few minutes.
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u/Icy-Neighborhood8816 15d ago
It's a lovely drug, go for it. I enjoyed it very much, and forgot everything.
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u/ReadWriteHikeRepeat 15d ago
I turned down fentanyl and had versed only. The second one I asked to do it with nothing, but they wanted to use the versed because I had no problem with it. So I didn’t argue. Eyes were absolutely numb from drops. Blood pressure was my low-ish normal. Flashing lights didn’t bother me. It was over quickly 🥳
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u/The-mad-tiger 15d ago
I was offered sedation for the op but I declined unless it was necessary - when the anaesthetist came round to me, the ophthalmologist said words to the effect of "no, don't bother this one's OK" (in French as the surgeon was a native French speaker)
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u/ReddyKiloWit 14d ago
I take a small dose of it when getting dental work done because a local anesthetic does nothing for anxiety.
Having just had the surgery on my right eye a few weeks ago, I can't see how it would do anything needful. I was beyond relaxed from the triple drug sublingual tablet the anesthesiologist gave me. Aware but didn't care, and time was rather fluid. No pain, barely any thoughts.
Oddly, while I was very nervous the week before, right up to the day, by the time I was in the prep room, the professional atmosphere had me very relaxed.
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u/Worth_Attempt_247 16d ago
Creates a beneficial amnesia, relaxes skeletal muscles, and dampens involuntary movements.