The role of Viagra (sildenafil) before and after surgery has always been crucial. Special caution is advised to be practiced in such cases. Viagra can interact with anesthetic drugs and can lead to life-threatening complications.
Keep reading to know more about Viagra and its post-surgical use.
Surgical Anesthesia
Anesthesia is an integral part of a surgical procedure. Surgery, being a painful intervention, requires patients to be put to sleep to avoid agony during the procedure. Anesthesia is the treatment that induces sleep.
Anaesthesia, by definition, is the state of unconsciousness, analgesia, amnesia, smooth muscle relaxation, and loss of reflexes (1). Patients are said to be anesthetized if they show unconsciousness with other mentioned characteristics.
Right after induction of anesthesia is a disinhibitory state, that is, temporary enhancement of body reflexes and excitation of respiratory and cardiovascular systems, which is followed by a state of unconsciousness, loss of reflexes, and maintenance of regular respiration and blood pressure.
Why Is Anesthesia Given?
Anesthetics are drugs that bring about anesthesia by depressing the central nervous system. Patients usually achieve recovery after clinical duration (CD) of administered anesthetic has been over.
Anesthesia could become a medical emergency for patients if they do not regain consciousness after the standard CD has been reached; this may lead to depression of body systems.
The prolonged CD might occur when the right amounts of anesthetics are not given, or proper preoperative anesthesia assessment is not made.
Anaesthesiologists need to know patients’ history before tailoring the anesthesia plan.
All the information about their general health is needed to be asked, and patients are strictly advised to cooperate and disclose every information, be it about the drug they are using or any other sensitive details since anesthesia care is not restricted to surgery only.
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Viagra Response in Surgery
You should exercise great caution if you use Viagra (sildenafil).
Viagra is a drug commonly used for treating erectile dysfunction. Patients usually don’t inform their anesthesia providers about their Viagra usage probably because they are embarrassed, or they consider it insignificant.
But this, if not shared, can be proven lethal.
The function of Viagra is to relax smooth muscles and dilate vessels. This dilatation can cause a drastic drop in blood pressure of patients who are being prepared for anesthesia.
Patients are counseled not to take Viagra 24 hours before and after surgery because the nitric oxide of Viagra when combined with anesthetics, can aggravate hypotension, and this abnormal fall in blood pressure may lead to heart and multi-organ failure (2).
Viagra After Prostatectomy
Prostate cancer is one of the major causes of impotence, but patients of prostatectomy can restore their lost impotence with Viagra, if not restored itself.
Failure of firm erection right after surgery is due to diminished blood supply to the penis probably because of penile nerve shock and damaged vessels. This treatment should not start soon after prostatic surgery as the body is in the state of trauma, and body functions require time to settle down (3).
If erectile dysfunction does not restore naturally, then the patient should start treatment with Viagra after a few months. Patients do not experience an actual erection after the first dose; three to four attempts with Viagra are often required to produce a penetrative erection.
The treatment can be continued until a significant recovery (4).
Viagra After Bypass Surgery
Viagra does affect not only the arteries of the penis but also all other arteries. It widens all systemic arteries causing blood pressure to drop extremely low.
Patients are counseled to not use Viagra before and after bypass surgery as Viagra directly affects arteries. Viagra interferes with anesthetics and has been seen producing severe hypotension during bypass surgery.
Treatment with Viagra can be resumed after the heart attains normalcy (5).
Anesthesia and Viagra: A Lethal Combination
Anesthetics remain present for up to 24 hours following surgery, though consciousness is regained soon after the CD has been achieved.
Any drug, particularly Viagra, if quickly introduced after surgery, can interact with anesthetics, the outcome of which can be lethal, as stated above. Therefore patients are advised to avoid Viagra for a day until the anesthetic has been eliminated (6).
References
- Eger II EI, Sonner JM. Anaesthesia defined (gentlemen, this is no humbug). Best practice & research Clinical anaesthesiology. 2006 Mar 1;20(1):23-9.
- KROVVIDI H. Severe hypotension due to synergistic action of sildenafil with epidural analgesia. BJA: British Journal of Anaesthesia. 2008 Dec 29;101(eLetters Supplement).
- Theresa Defino. Viagra Useful for Impotence Following Prostate Surgery. Nov. 30, 1999. Obtained from: https://www.webmd.com/erectile-dysfunction/news/19991130/viagra-useful-impotence-following-prostate-surgery
- Zippe CD, Jhaveri FM, Klein EA, Kedia S, Pasqualotto FF, Kedia A, Agarwal A, Montague DK, Lakin MM. Role of Viagra after radical prostatectomy. Urology. 2000 Feb 1;55(2):241-5.
- Herrmann HC, Chang G, Klugherz BD, Mahoney PD. Hemodynamic effects of sildenafil in men with severe coronary artery disease. New England Journal of Medicine. 2000 Jun 1;342(22):1622-6.
- Fodale V, Di Pietro R, Santamaria S. Viagra, surgery and anesthesia: a dangerous cocktail with a risk of blindness. Medical hypotheses. 2007 Jan 1;68(4):880-2.
