Treatment

7 Tips for Surgery with Fibromyalgia

Karen Lee Richards Mar 30, 2012 (updated Jan 9, 2014)
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If you have fibromyalgia and are facing a surgical procedure, you may have heard horror stories about post-operative flare-ups and long, painful recovery periods. While it’s true your recuperation period may take longer than the average person, there are steps that can be taken to reduce your pain levels and minimize your chances of a severe flare.

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Pain medication
Pain medication
Ask that you be given pre-operative opioid pain medication about 90 minutes before your surgery to minimize central sensitization.
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Magnesium sulfate
Magnesium sulfate
Two to three grams of magnesium sulfate given intravenously over a period of 45 – 60 minutes might also block central sensitization.
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Avoid muscle relaxants
Avoid muscle relaxants
Sometimes increased postoperative pain in fibromyalgia patients is due to the use of a muscle relaxant drug called succinylcholine during surgery. Talk to your anesthesiologist about other options if this drug was to be used.
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Be mindful of intravenous lines
Be mindful of intravenous lines
The arm with your intravenous line should be kept near your body, not over your head or otherwise away from your body. It’s best that you not be kept in any one unusual position for any longer than absolutely necessary in order to reduce the potential for pain or discomfort after the surgery.
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Minimize neck hyperextension
Minimize neck hyperextension
If an endotracheal tube is used to help you breathe during the procedure, care should be taken to minimize neck hyperextension. Request that you be given a soft neck collar to wear.
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Local anasthetic use
Local anasthetic use
Request that a long-acting local anesthetic be infiltrated into your incision. Even though you won’t be awake to feel it, if the area is not anesthetized, pain impulses will be sent to the spinal cord and brain, which can trigger central sensitization.
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PCA pump
PCA pump
When you leave surgery, a patient controlled analgesia (PCA) pump should be in place.  In most cases, opioid medications should be administered during the first few days following surgery.  PCA pumps allow a certain amount of medication to be delivered continuously, with the added feature of letting the patient add extra medication at pre-set intervals as needed.