Alcohol, prescription medications, surgery, and a safe recovery certainly do not go together. Whether your patient is an occasional drinker or fully dependent on alcohol (about 8% of the US), it’s a good idea for your injured workers to stop drinking before surgery. Zero alcohol for a minimum of 48 hours prior to surgery is a minimum, whereas a week or two of abstinence if preferable.
Support and guidance reinforcing the message of reduced alcohol is key. PeerWell’s digital musculoskeletal program encourages reduced alcohol intake through health literacy content, stress and resilience techniques and links to resources for more assistance when needed.
Why Alcohol and Anesthesia Don’t Mix
Like alcohol itself, general anesthesia suppresses functions such as breathing, heart rate, and blood circulation. Alcohol and anesthesia must be metabolized in the liver. Therefore, which alcohol and anesthesia occur in tandem, the body has more difficulty keeping up.
In addition, both anesthesia and alcohol can cause nausea and vomiting. This may increase your patient’s risk of aspiration which skyrockets the risk of fatality. The anesthesiologist may need to adjust the dosage if your patient has alcohol in their system or in the case of chronic alcohol use. If a higher dose of anesthesia is needed, it can increase the risk of cardiac events, especially if your patient already has cardiovascular comorbidities. Alcohol also thins the blood, raising the risk of uncontrolled bleeding.
It’s important that your patients get proper health literacy information to educate them on the gravity of alcohol and anesthesia interaction, or chronic alcohol use before surgery. Open and honest dialogue between patient and provider, which the PeerWell program encourages, helps to mitigate the risks.
Alcohol and Complications: Before and After Surgery
Alcohol consumption can lead to severe complications both during and after their musculoskeletal procedure. It can also lead to a longer LOS and a drawn-out recovery time.
In addition to pre-op and surgery risk, studies show that alcohol consumption increases the risks of postoperative complications and bleeding, admission to intensive care units, and death. Alcohol can interact with medications your patient is given just before, during, and immediately following surgery. This can result in an adverse interaction or cause some drugs to be less effective. This includes pain medications, sedatives, or other medications. Drinking also raises the chances of infection of the surgical site, which can lead to sepsis and septic shock, a potentially life-threatening condition.
Alcohol can also cause:
- issues with the heart and lungs
- severe dehydration
- high blood pressure (hypertension)
- low blood pressure (hypotension)
- irregular heart rate (arrhythmia)
- weakened heart muscles (cardiomyopathy)
For those dealing with addiction, withdrawal can be a long process with additional complications. Therefore, it’s best to address alcohol dependence as early as possible in the patient’s PreHab.
Withdrawal symptoms may occur 6 hours to 5 days after the last drink and can include:
- gastric upset
- increased blood pressure
- anxiety, agitation
- delirium, hallucinations
Arm your patient with the information they need at least one week before surgery. This way, there is a better opportunity for withdrawal to be controlled.
Helping your injured worker reduce the risks associated with alcohol may involve:
- Starting them on an alcohol addiction treatment program (like AA)
- Offering them medications to control withdrawal symptoms
- Changing their date of surgery (if it’s safe to do so)
- Making adjustments to anesthesia and other medications
Communicating with Patients and Injured Workers’ About Alcohol Use
The worst-case scenario is that your patient does not realize the severity of alcohol use. Patients often withhold information, sometimes due to unawareness. Other times, your patient may not truthfully share their alcohol consumption because of guilt or shame.
By providing a holistic, musculoskeletal recovery program to patients, you are arming them with total health literacy about their condition and procedure. This education will arm injured worker’s with the necessary tools to curb alcohol on their own or reach out for help.
There are a myriad of factors that help to reduce your injured worker’s risk and improve recovery times. Alcohol cessation is one of these factors. A complete conservative care and surgery optimization (PreHab and ReHab) program should guide patient’s through: Physical Therapy, Life Management, Nutrition, Pain Management, of course,
and Health Literacy. In combination, the many elements that influence recovery can be addressed in a way that is manageable to each individual patient.