General anaesthesia and post operative pain

Discussion in 'Fibromyalgia Main Forum' started by tansy, Jul 12, 2008.

  1. tansy

    tansy New Member

    I have problems with anaesthetics and this year had severe post operative pain that was poorly managed despite having had meds prescribed by my surgeon.

    It was clear that the hospital doctor on duty over the weekend did not know the procedure I had causes severe pain and that anaesthetics can themselves cause pain.

    PWFM often have amplified post operative pain.

    Below is a recent article published in Immune Support's library.

    tc, Tansy

    "General anesthesia used in surgery can increase post-op pain by activating body’s chemical irritant response, Georgetown researchers discover"


    “The choice of anesthetic appears to be an important determinant of post-operative pain.” – Gerard Ahern, PhD, Georgetown University Dept. of Pharmacology

    Washington, D.C. - The general anesthesia that puts patients into unconscious sleep so they do not feel surgical pain can increase the discomfort they feel once they wake up, say researchers from Georgetown University Medical Center. They say their findings, the first to scientifically explain what has been anecdotally observed in the clinic, may lead to wider use of the few anesthetics that don’t have this side effect, or to the development of new ones.

    In the June 24 issue of the Proceedings of the National Academy of Sciences (PNAS)1 the scientists report that “noxious” anesthesia drugs - which most of these general anesthetics are - activate and then sensitize specific receptors on neurons in the peripheral nervous system. These are the sensory nerves in the inflammation and pain pathway that are not affected by general anesthesia drugs that target the central nervous system – the brain and the spinal cord.

    “The choice of anesthetic appears to be an important determinant of post-operative pain,” says the study’s lead investigator, Gerard Ahern, PhD, an assistant professor in the Department of Pharmacology at Georgetown University Medical Center. “We hope these findings are ultimately helpful in providing more comfort to patients.”

    It has long been known that general anesthetics cause irritation at the infusion site or in the airways when inhaled, Dr. Ahern says.

    And investigators have also known that while they suppress the central nervous system, they can activate so called “pain-sensing” or nociceptive nerve cells on the peripheral nervous system.

    In fact, anesthesiologists often first use a drug to suppress inflammation and pain before delivering the anesthesia to put the patient to sleep.

    But what has not been understood is the specific mechanism by which anesthetics affect sensory neurons, or that they can continue to cause pain and inflammation even as they are being used during surgery, Dr. Ahern says.
    The Hypothesis

    The researchers tested the hypothesis that two specific receptors on the nerve cells (TRPV1 and TRPA1) which are often expressed together and which also react to other irritants, such as garlic and wasabi, were the ones activated by the noxious drugs.

    “Plants produce chemicals such as capsaicin, mustard and garlic that were meant to stop animals from eating them. When they are eaten, the two main receptors that react to them are TRPV1 and TRPA1,” Dr. Ahern says. In fact, TRPA1 is more commonly known as the mustard-oil receptor, and is a principal receptor in the pain pathway, he says.

    The Findings

    Experiments showed that general anesthetics appear to regulate TRPA1 in a direct fashion, and are thus responsible for the acute noxious effects of the drugs. Perhaps the strongest evidence is that mice bred without TRPA1 genes demonstrate no pain when the drugs are administered and used, Ahern says.

    “Most general anesthetics activate the mustard oil receptor, and animals that don’t have the receptor don’t have irritation,” he says.

    The research team also found that nerve-mediated inflammation was greater when pungent (chemical irritants) versus non-pungent inhaled general anesthetics were used.

    The Implications

    What both findings suggest is that sensory nerve stimulation throughout the body just before and during surgery adds to the pain that is felt after the patient is awake, Ahern says.

    “This is a provocative finding in terms of the clinical setting, because it was not really recognized that use of these drugs results in release of lots of chemicals that recruit immune cells to the nerves, which causes more pain or inflammation.”

    Some general anesthetics do not activate the mustard-oil receptor, but they may not be as effective in other ways, Ahern says. “This tells us that there is room for improvement in these drugs.”

    The study was funded by National Institutes of Health and the National Multiple Sclerosis Society. Co-authors include José Matta, PhD, Paul Cornett, PhD, Rosa Miyares, BA, Ken Abe, PhD, and Niaz Sahibzada, PhD, from Georgetown University.
  2. kellygirl

    kellygirl Member

    I am copying this! this is what happened to me after knee surgery. I had such overall pain I couldn't rise up from bed in the morning!

    Thanks for posting!
  3. tandy

    tandy New Member

    I had my 5th abdominal surgery this past Feb.
    I thought
    i'd be ok enough to not need help but I had to have my man call in work for 2 days to stay home with me.
    I had more pain than I thought.
  4. kat0465

    kat0465 New Member

    i had a 4 1/2 hour surgery march5th and i am just now starting to feel a little better from it,It was HORRIBLE< the bad flare & the pain after took me by surprise. of course after i had my surgery( hystrerectomy) i read that if you have it, that it will make other preexisting stuff worse, and boy were they right!!
    i even did my homework about the anesthesia & what shouldnt be used on us, had a long talk with the anesthesiologist,but it was still very hard to get over!!!
    i feel for anyone with this DD that has to have surgery, it's very tough!
  5. kellygirl

    kellygirl Member

    Will the sedation from a colonoscopy be just as bad?
  6. kellygirl

    kellygirl Member

    I'll let you know after I have it done. It is way past due. I should be scheduled for next month.
  7. charlenef

    charlenef New Member

    i had a endomertial ablation done 3 months ago they wanted to put me under general but i fought them and won i got a spinal and twilight sedation i didnt know a thing
  8. kellygirl

    kellygirl Member needs to be done whatever. Both of my children in their 30's had polyps. The doctor said it was the largest they have seen in someone their age.
  9. kellygirl

    kellygirl Member

    This is too important not to bump.......
  10. hi all,

    im due for a dental check up,when my dentists practice can find a nhs dentist..eekkk we have to wait ages until one becomes available.

    anyway,for many years ive known that the anaesthesia that is used while operating on none fibro people,has something in it that has terrible affects on my body.

    as soon as the liquid from the injection goes into my body,ill start to feel very hot,come over all strange and pass out.

    my heart will go into this strange thing that makes it beat far to fast, and feel like its going to explode out of my chest.

    so now i have to tell anyone that would want to put the anaesthesia needle into me,about the reaction i get from that injection.

    my dentist has made a note of it on my records,but one year they hadnt looked at my records properly and had gone ahead and gave me the wrong injection.

    so i passed out,and had to be brought round with gas and air.

    it happened years ago while i was in hospital as a day patient,having polyps taken out of my womb.

    im now given a different type of anaesthesia and the dentist says its something to do with adrenaline rush.

    i hope the hospital read my medical records properly,if i should have to go in for a operation in the future.

    i never want to feel that passing out feeling,again in my life,its horrible.

    take care,love fran
  11. kellygirl

    kellygirl Member

    Yes, I nearly died from a dentist that kept injecting me to numb a tooth. When I was at my doctor and told him what had happened he said they should never have given me that much to begin with, (about 6 injections) and they put them into the same vein directly into the bloodstream.

    My daughter told me that my heart could've stopped, she is an RN. When it beats that fast, it stops pumping blood.

    I now have a dentist that will tell me when he has to use the novacaine and will use very little along with the other med. I have had lots of dental work done by him and trust him.

    Sometimes it is difficult to numb me for dental work and he will have to use the novacaine as a last resort with the other safer anesthetic.

    My heart will race for about 30 seconds but he sits by me and talks to me.
    [This Message was Edited on 07/16/2008]