Caution

Anonymous
July 28, 2010 at 5:49 am

Hi, I would just like to re-emphasize that it is important for all the doctors–especially the anesthesiologist to know that one has had GBS or has CIDP and also that say that, for some people, there IS a risk with anesthesia. Some people do well, but any medical procedure is a body stress and people need to discuss their particular cases with anesthesiologists. In particular, please note.
1. A number of people advocate using lots of caution with succinylcholine as an anesthesia drug and it is often worth using another agent.
2. Some people with GBS or CIDP have residual respiratory weakness and it is important to think about this as part of the support of breathing during surgery and after (especially if there is going to be chest or abdomen surgery since these also affect breathing–chest for obvious reasons and abdomen because people do not breath as well if it hurts to do so).
3. Some people had the onset of GBS right after surgery and there may be something about surgery that predisposed to this in that person. Surgeries may involve cutting across nerves and tissues and this can expose antigens again to the immune system.
4. I work with children with another immune disease that attacks the nervous system and they typically get transiently worse when getting anesthesia (and sometimes the anesthesia is for MRI scans in these very young children so there is no surgery). From this, it seems that anesthesia can act to stimulate inflammation. I recommend people not have surgery unless it is really necessary until the immune process is better controlled. This relates to CIDP, but also early GBS. If anesthesia is needed, propofol seems one of the gentler and less inflammatory anesthesia drugs.
5. Some people have a pain flare after anesthesia and surgery.
6. It can also be a bit harder to recover from major surgery because a person is at baseline not 100% in strength. If the surgery will be major and require rehabilitation, make sure that there is a plan that takes into account that the person has residual weakness or pain.
WithHope for a cure of these diseases