Discuss the fact that you have fibromyalgia with your surgeon and
anesthesiologist about 2 weeks before you are scheduled for surgery.
The American Society of Anesthesiologists recommends that all herbal
medications be discontinued 2 to 3 weeks before an elective
Pain after surgery is inevitable,
because all surgeries result in trauma to the skin and
post-surgical pain is usually accentuated in fibromyalgia
patients due to enhanced pain processing (see
Request that you
wear a soft neck collar to reduce neck hyperextension (if an endotracheal tube is anticipated).
This will help minimize inadvertent stretching of your neck muscles
during positioning while your are unconscious.
Request that your
arm with the intravenous line be kept near your body, not away from your
body or over your head. This will help minimize inadvertent stretching
of your arm and shoulder muscles during positioning while your are
"postoperative myalgia" is due to the use of a muscle relaxant drug
succinylcholine. If you have experienced this in previous
surgery, I suggest you mention this to your anesthesiologist.
Request that you be
given a pre-operative opioid pain medication – about 90 mins. prior to
surgery. Opioids are morphine or morphine related drugs. The rationale for
the pre-operative use of opioids is to minimize “central
sensitization” - as this inevitably worsens the widespread body pain
that you are already experiencing. Two to three grams of
magnesium sulfate given intravenously over a period of 45 – 60
minutes has also been recommended to minimize central sensitization.
Ask to have a
long-acting local anesthetic infiltrated into your incision - even
though you will be asleep during the procedure. The rationale for this
is to minimize pain impulses reaching the spinal cord and brain, which
in turn accentuate central sensitization.
Postoperatively you will need more, and usually longer duration, of
post-operative pain medication. In most cases opioids should be
regularly administered or self administered with a PCA pump (patient
Postoperatively you will require a longer duration of post-operative convalescence,
physical therapy in many cases.
Gentle stretching and reconditioning of muscles should start soon
after the incision is well healed.