Anesthesia problems, fibromyalgia and surgery issues
General anesthesia represents a risk to fibromyalgia sufferers because it is a stress, decreases immunity and increases infections to which fibromyalgia sufferers are prone.
The stress of anesthesia makes fibromyalgia worse so it should be avoided at all cost and local anesthesia or regional anesthesia such as spinals, epidurals or regional blocks are to be preferred. They also have the added advantage of a good post operative pain cover but they must be done properly by very experienced anesthesiologists. Comfort of the patient whilst performing them is of the utmost importance to avoid stress.
If general anesthesia is unavoidable it should be as stress-free as possible pre-operatively, per-operatively, and in the post operative period.
Preparation for anesthesia should be applied to all types of anesthesia so as to reduce the stress. There are no absolute rules that can be applied and after investigating with anesthesiologists and pain specialists the followings are strong recommendations to avoid problems. In any case the choice remains with the anesthesiologist.
.Limit Morphine
.Avoid Pain
.use α-2 agonists
.avoid BZD
.clonazepam for panic attacks
.avoid sux
.avoid AChE inhibitors (stigmins)
.Provide Post-op Analgesia +++
.Magnesium
.Ketamine
.N2O
.Sevoflurane ~ MAC 2
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A good understanding of the NMDA receptors is necessary to avoid anesthesia problems
For a detailed process to avoid NMDA receptors activation click here
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