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Fibromyalgia, also known as soft tissue rheumatism, is found to be strongly correlated with anesthesia. Fibromyalgia is characterized by generalized, excruciating pain in the body of the patient. However, general anesthesia that can relieve this pain tends to worsen the fibromyalgia symptoms. Patients of fibromyalgia are generally prone to infections, severe depression, and stress.
General anesthesia, if administered to such patients, tends to increase their stress and depression and also enhance the risk of infections by alleviating their immunity. Thus, the stress or the impact of anesthesia on the body of a fibromyalgia patient can worsen his/her condition even further. This means that general anesthesia must never be given to such patients in any condition whatsoever.
Instead, regional or local anesthesia of epidurals, spinals, and the regional blocks must be preferred in case of emergencies. Local or regional anesthesia also serves as a good pain cover for patients post-surgery. However, it must be applied only by highly experienced anesthesiologists as stress can be avoided in such conditions only if the fibromyalgia patient is comfortable with the procedure. In case general anesthesia cannot be avoided, it should be made stress-free to the maximum extent possible in the pre-operative, per-operative, and the post-operative sessions.
Fibromyalgia patients experience severe pain in their body due to activation of their NMDA receptors. In case the patient experiences any stress or discomfort while being anesthetized, the anesthesiologist must immediately relieve pain by limiting or avoiding the NMDA receptor antagonists, like Sux, AChE inhibitors, BZD, and morphine. To avoid problems and further complications, α-2 agonists, clonazepam, and post-operative analgesia +++ can be given to the patient. To conclude, fibromyalgia patients must therefore be given anesthesia very cautiously, only after thoroughly discussing the patient’s case history with pain specialists and anesthesiologists.
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