Benzodiazepines are some of the most common anti-anxiety drugs used to calm presurgery nerves, but your surgical team will discuss the best options for you.
Many people feel anxious before surgery — after all, undergoing an operation is not an everyday event. If you’re experiencing intense anxiety, you can contact your surgeon or another clinician in your care team and ask for anxiety medication.
It’s important to inform your care team of anything you take before surgery, including over-the-counter (OTC) medications or supplements. Some of these may cause a potentially harmful interaction or contribute to complications during surgery.
Keep reading to learn more about your options for anti-anxiety medications before surgery.
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Before surgery, you’ll meet with a clinician called an anesthesiologist. They’re responsible for giving you the medication you need during surgery to control pain (and if you’re being sedated, the medication that will put you to sleep). Anesthesiologists may also give you anti-anxiety medications before surgery.
Clinicians often prescribe benzodiazepines for pre-surgery anxiety. Benzodiazepines are a class of medications that are primarily used for treating anxiety, insomnia, and panic disorder. They tend to kick in quickly and don’t stay in your body for long, which makes them particularly useful ahead of surgery.
Benzodiazepines that are often used for pre-surgery anxiety include:
- alprazolam (Xanax)
- diazepam (Diastat, Valium, Valtoco)
- lorazepam (Ativan)
- midazolam (Versed, Nayzilam)
- triazolam (Halcion)
Other non-benzodiazepine medications prescribed for pre-surgery anxiety include:
- melatonin, which can be highly effective
- antihistamines that have a sedating effect, like hydroxyzine and promethazine
- pregabalin (Lyrica), an
anti-epileptic drug
For anxiety treatment on the day of your surgery, depending on the type of medication that’s prescribed, you may be given the medication orally (as a pill) or intravenously (via injection or IV drip).
For anxiety treatment leading up to your surgery, you’ll typically be prescribed medications in the form of pills.
Your anesthesiologist will choose a medication based on what will be safest and most effective for you.
Your care team will weigh up the risks and benefits of using pre-surgery anti-anxiety medication.
For example, high levels of pre-surgery anxiety are associated with worse pain following a procedure, according to
Common side effects of pre-surgery anti-anxiety meds
- drowsiness
- dizziness
- confusion
- headaches
- lightheadedness
- memory loss
- slowed breathing (also called respiratory depression)
If benzodiazepines are given to you on the day of your surgery, the risk of overdose or habit-forming drug misuse is low, as a clinician will monitor you closely. However, it’s important to note that long-term benzodiazepine use can lead to addiction.
It’s important to tell your clinicians — including the anesthesiologist — about:
- your medical history, including your mental health history
- any medications you’re currently taking, whether prescription or OTC
- any supplements, vitamins, or herbal teas you’re currently taking
This will help them determine the risks of prescribing pre-surgery anti-anxiety medication.
Not all pre-surgery anxiety needs to be medicated. Some people might find that they’re able to cope without medication. Certain activities and techniques might help you stay calm before surgery — for example, you might find it effective to listen to soothing music, meditate, or use breathing techniques.
However, it’s best to talk with a clinician about pre-surgery anxiety meds if:
- you’re unable to sleep
- your fear or worry is making it hard to focus on tasks
- your anxiety is affecting your work, relationships, and day-to-day functioning
- your usual coping techniques aren’t helping
- you can’t stop thinking about your surgery
Some people only have intense anxiety on the day of their surgery. Others might find it hard to cope with the anticipatory anxiety leading up to their surgery.
Not sure how to broach the topic of anxiety? The key is just to be honest about how the stress of your upcoming surgery is affecting you. Here are great examples of ways to start the conversation:
- “I’ve been struggling to cope with my anxiety leading up to this surgery. It’s affecting my ability to sleep and work. Is there any medication I could use to reduce my anxiety?”
- “A friend of mine struggled with anxiety before her knee surgery, and she was prescribed an anti-anxiety medication. She said it really helped. Would that be a possibility for me?”
- “My anxiety levels have been OK so far, but right now, I’m feeling very anxious about the surgery itself. Can you recommend any anti-anxiety medications?”
- “I’m concerned about my anxiety levels leading up to the surgery. Will I be prescribed an anti-anxiety medication on the day of the operation?”
Remember that it’s your care team’s job to look out for your health and well-being. It’s more than OK to speak up and ask for help if needed.
Not all pre-surgery anxiety meds will be suitable for every patient — if you have a specific medical condition, for example, some medications will have too many risks of unwanted side effects. Your surgery team will help you find the best options to manage your stress levels.
Benzodiazepines are commonly used for treating anxiety before surgery. These are sedative-hypnotic medications that are often prescribed for anxiety and insomnia. But many other options, as well as non-medication ones, exist to help reduce anxiety symptoms.
Pre-surgery anxiety is common. If your anxiety is intense on the day of surgery, or leading up to surgery, ask your clinician whether anti-anxiety medication is a good choice for you.