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Anesthesia and Surgery for MS: What You Need To Know

Posted on April 06, 2021
Medically reviewed by
Evelyn O. Berman, M.D.
Article written by
Amanda Agazio, Ph.D.

Surgery is often a stressful situation that can trigger a cascade of fears for anyone. Many people living with MS worry that anesthesia and surgery may trigger a relapse or exacerbation of their symptoms. Although experts agree that surgery or anesthesia does not cause a relapse, there are some considerations for people with MS who are undergoing surgery to ensure they have a healthy recovery without exacerbating MS symptoms.

Does Surgery Trigger a Relapse of MS?

Scientific studies have shown that anesthesia and surgery do not increase the risk of relapse in people with MS. One study analyzed 281 patients and 609 surgeries. Among all the surgeries, only 12 people had a postoperative relapse, indicating that the risk of relapse was not increased with surgery and anesthesia.

Given the evidence, people with MS should not avoid necessary surgeries due to the fear of relapse. There is not an increased risk of relapse with surgery, and delaying necessary surgical procedures could have detrimental effects.

In rare cases when exacerbations do occur, they are likely due to other factors, such as infection and other uncommon complications.

Surgery and Body Temperature

Most relapses that occur after surgery are likely due to infection or a change in body temperature. Even small increases in body temperature (1 degree) can set off a flare due to heat sensitivity in MS.

Therefore, surgeons need to use suitable techniques to prevent infection. Anesthesiologists and other health care workers may also decide to monitor your body temperature closely before, during, and after surgery. If a relapse occurs after surgery, the typical course of action is treatment with high-dose corticosteroids.

Muscle and Respiratory Weakness and Surgery

People living with MS who have respiratory challenges may experience some difficulties or complications with general anesthesia and sedation. Additionally, the time spent in bed after surgery may be difficult for people with MS already experiencing muscle weakness. Physical therapy can help combat these symptoms and challenges.

Epidurals and MS

An epidural is a type of regional anesthetic used during childbirth and administered into the epidural space, between the vertebral canal and the spinal cord. Because of its proximity to the spinal cord and the central nervous system, some women with MS may have concerns about receiving an epidural. However, research has shown that epidural anesthesia does not increase the risk of relapse or exacerbation of MS.

Risks of Surgery and Anesthesia for People With MS

One risk your doctor should be aware of is the combination of nondepolarizing muscle relaxants used to treat MS and the general anesthesia drug succinylcholine. This combination may lead to abnormally high levels of potassium in the blood known as hyperkalemia.

Someone living with a chronic illness is likely frail and may also take more time to recover after surgery. It is important to be practical and recognize your limitations while in recovery. You may need to take more time off from work than others and ask for help during your recovery. You can plan for these things before your surgery to ensure you are prepared for the issues you may face.

Talk To Your Doctor About Your Concerns

Fear of surgery is normal, especially when you are living with a chronic health condition. You can speak to your neurologist, anesthesiologist, surgeon, or general practitioner about your apprehensions related to surgery. Be honest with your practitioner and let them know what your concerns are. Your health care provider can help you understand the realistic risks of surgery. You and your health care provider can also come up with a plan to help support your well-being after surgery. Equipping yourself with information and a plan of action is the best way to face the fears of uncertainty.

Ultimately, it is important not to delay surgery due to fear of relapse. There is no elevated risk of relapse with surgery or anesthesia, and delaying surgery could have harmful consequences for your health. The risk of relapse is not increased because of surgery or anesthesia.

Talk With Others Who Understand

MyMSTeam is the social network for people with MS and their loved ones. On MyMSTeam, more than 165,000 members come together to ask questions, give advice, and share their stories with others who understand life with MS.

Are you living with MS? Share your experience in the comments below, or start a conversation by posting on MyMSTeam.

All updates must be accompanied by text or a picture.
Evelyn O. Berman, M.D. is a neurology and pediatric specialist and treats disorders of the brain in children. Review provided by VeriMed Healthcare Network. Learn more about her here.
Amanda Agazio, Ph.D. completed her doctorate in immunology at the University of Colorado Anschutz Medical Campus. Her studies focused on the antibody response and autoimmunity. Learn more about her here.

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