Should Robaxin (Methocarbamol) Be Stopped Prior to Abdominal Surgery?
No, Robaxin (methocarbamol) does not need to be routinely stopped prior to abdominal surgery, as it is not a medication that requires perioperative discontinuation based on current surgical guidelines.
Rationale for Continuation
The available perioperative guidelines for abdominal surgery do not identify muscle relaxants like methocarbamol as medications requiring preoperative discontinuation. The key perioperative medication management focuses on:
- Anticoagulants and antiplatelet agents require specific timing protocols for discontinuation before surgery 1, 2, 3
- Long-acting sedatives and benzodiazepines should be avoided preoperatively due to increased postoperative sedation without clinical benefit 1
- Chronic pain medications should be continued on the morning of surgery and prescribed postoperatively 1
Important Considerations
Sedative Effects
Methocarbamol has sedative properties that could theoretically interact with anesthetic agents 4. However:
- The primary concern with preoperative sedatives relates to benzodiazepines and long-acting agents, not muscle relaxants 1
- Short-acting anxiolytics may be used selectively for specific procedures like epidural catheter placement 1
Medication Continuation Strategy
Continue methocarbamol through the perioperative period following the guideline principle that medications for chronic pain and muscle spasm should not be interrupted 1. This approach:
- Prevents withdrawal symptoms or rebound muscle spasm
- Maintains baseline pain control
- Aligns with enhanced recovery protocols that emphasize continuation of chronic medications
Common Pitfalls to Avoid
- Do not confuse muscle relaxants with sedative-hypnotics: While methocarbamol has sedative properties, it is not classified among the long-acting sedatives that guidelines recommend avoiding 1
- Avoid alcohol interaction: Ensure patients are counseled to avoid alcohol perioperatively, as the combination with methocarbamol can cause severe CNS depression 4
- Monitor for postoperative sedation: Be aware that methocarbamol's sedative effects may be additive with opioids and anesthetic agents, requiring appropriate monitoring
Postoperative Management
Resume methocarbamol at the usual dose once oral intake is established, as there are no specific contraindications to its use after abdominal surgery 1. Consider that postoperative bowel dysmotility may temporarily affect oral medication absorption after major abdominal procedures 2.