Expert: JM Starkman, MD - 8/2/2011

Question
I know that compazine is oftern used pos- operatively, preoperatively or intraoperatively to counteract nausea sometimes produced from anesthestics. It is to my understanding that compazine sometimes causes extraparymidial reactions such as tardive diskinisia and can be treated with sedatives like benzodiazapines.

My quesyion is if compazine is adminitered prior to the procedure and a reaction occurs, can the sedation from the anesthesia relieve the side effects of the compazine like a benzo would or no? Or in the reacovery room post op, would any remainin sedative affects from the surgery relieve the compazine side effects?

Answer
This is an interesting question and can only be answered with a "logical" answer, not a studied one since there's no way to study it (It would be unethical to seek study participants for the sole purpose of causing a serious reaction to then observe;  retrospective analyses would have too many independent variables to be of much use clinically.  So...........my answer is that the reaction to phenothiazines you mention is properly treated with diphenhydramine (Benadryl).   To some extent, because of the depressant nature of anesthetics, reactions--esp motor reactions--may be repressed or hidden in their presence depending on the degree of anesthesia being administered.  If you're allergic or have had a bad reaction to any of these drugs before, you should find an alternative in the future mutually exclusive of anesthesia.