Anaesthesia for patients with idiopathic environmental intolerance and chronic fatigue syndrome
M. McD. Fisher* and M. Rose
+ Author Affiliations
Royal North Shore Hospital of Sydney, St Leonards, NSW 2065, Australia
*Corresponding author. E-mail: mfisher@med.usyd.edu.au
Accepted July 21, 2008.
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Abstract
Background Idiopathic environmental intolerance syndrome (IEI), formerly known as multiple chemical sensitivity syndrome (MCSS), and chronic fatigue syndrome (CFS) are controversial diseases and there is little information in the literature regarding the appropriate conduct of anaesthesia in such patients.
Methods We studied 27 patients referred to our anaesthetic allergy clinic with IEI and CFS and performed literature and web searches on anaesthesia in these disorders.
Results The patients had a significant incidence of adverse events related to anaesthesia which were not allergic in nature. The adverse effects usually occurred postoperatively and were self limiting. Patients with IEI and CFS are not at risk of anaphylaxis and there is no scientific evidence that any drug or technique is excessively hazardous. Neither our patients nor the review of the scientific literature supported available web-based recommendations for the anaesthetic management of patients with IEL and CFS.
Conclusions We suggest that the anaesthetist may be best to use the technique they would use if the patient did not have CFS or IEI but avoid drugs to which there is a history of adverse response. Anaesthesia is likely to be associated with adverse effects in these patients but the effects are not likely to be severe. A series of recommendations for the safe and harmonious conduct of anaesthesia in patients with CFS and IEI are provided.
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4 comments:
Thanks for this. It's a problem I've had several times in the past, yet I never seem to be believed.
Having had to undergo 6 seperate surgeries since my diagnosis, I can confirm that this is true. I've had several instances of drugs either not working or causing significant problems. I could not get the Navy commander to tell me exactly what they were but apparently they were bad.
There are notes on my surgical record to confirm this.
The last 3 surgeries were in a hospital where they used different anaesthesia because of the noted problems, with no significant side effects.
I also have hyper sensitive skin one surgeon insisted on using tape sutures and crepe bandages, both of which I am allergic to! I warned him and my red band was ignored.
After an operation I slept for almost 7 days solid and took approx 6 months to fully recover back to ME (ab)normal during which time I was mostly bed bound.
I'm currently living with shoulder pain that (allegedly) an operation will cure but I can't do anything about it until the shoulder becomes a bigger problem than the after effects of the anaesthetic.
I passed out for 2 hours after a spinal block and was sick and bedridden for three months.
That was 10 years before my major ME-crash. Early signs ...
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