NSAID question

since I'm an RNYer, thought I'd pop over here to ask this question. I have a close friend who just got admitted to the hospital, in intense pain... I reminded her wife that she can't have NSAIDS, And she told me they were giving her Tramadol, but since it's in an IV, It was OK. I really thought this wasn't the case, and I'm confused!!

I thought NSAIDS, No matter how administered, were a big no-no...

Is that only for RNYers, and not VSGers??

I really don't want her subjected to the chance of further complications down the road because of this, but I also don't want you alarm her wife anymore than she already is.

Thanks.

Tramadol isn't an NSAID. Are you thinking Toradol?

Tramdol is not in the NSAID family and is not given IV. Did you mean Toradol which is an NSAID?

An IV use should be fine as it will not be chronic and bypasses the stomach.

Toradol via IV is still a problem for VSG since it had a systemic effect. (My one and only ulcer came from Toradol. Yay.)

Yes, Toradol. Sorry. On my phone, and already very worried about her...

I would want my advocate, were I in the hospital and unable to advocate for myself for whatever reason, to not allow Toradol to be administered to me.

NSAIDs are a big NO-NO with the bypass - it's that stomach/intestine ansastomosis that's the problem there, which doesn't exist with the sleeve configuration. The sleeve based procedures are more tolerant of them, but recommendations for/against them vary widely amongst surgeons, primarily based upon their relative sleeve/bypass experience - the docs who are more sleeve oriented or specialized (like the DS gang) are more amenable to NSAID use than their more bypass oriented colleagues.

As long as they make sure that the doctors treating her know of her surgical history and possible sensitivity to such medications, let them consult with her bariatric surgeon, or at least those resident at that hospital, and let them take if from there. It is not a one-size-fits-all situation.

You always say this yet current ASMBS recommendations say no NSAIDs for VSGers. This has changed from original recommendations so it's not just an antiquated holdover due to RNY recommendations. As the ASMBS is comprised of all manner of healthcare professionals, it seems like a wise guideline to follow.

Those surgeons who have the experience to appreciate the differences between the different procedures understand the different tolerances between those procedures, rather than the one-size-fits-all recommendation that some doc posted on the ABMBS website. The practice of medicine often involves tradeoffs between potential side effects and the desired end result of a particular course of treatment, which may involve medications that are contrary to some blanket statement intended for general public consumption - this is what professionals are for and why we consult them.

In general, I will take the advice of those who specialize in a particular procedure over those who are generalists who may apply experience from one procedure to others they may not be as familiar with. In the OP's case, if the responsible bariatric surgeon advises against the use of this medication for her case, I have no argument with that, as that is what she (or her insurance) has paid them for, but likewise I have no problem if that surgeon is agreeable with their use for this case, and neither should you. Overall, this fits into the same category as the common forum advice to ignore professional dietary guidance that may be contrary to popular internet fad diets.

ASMBS guidelines are not 'some doc' posting on their website.