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study on the aftereffects of general anaesthesia in POTS patients


Y.Alice.D

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Hi! 

I'm going to get a knee surgery next week, and I'm pretty nervous because of the anaesthesia. I remember that there was a study on the aftereffects of general anaesthesia in POTS patients, and according to that study one's POTS-symptoms could get worse afterwards.

My anaesthesiologist hasn't heard of POTS before but has done tons (!) of research on the internet after I left. However, he said that he couldn't find the study I mentioned. He asked me if I could send it to him, but I can't find it either. I'm absolutely sure that it exists! Has anyone read it? Could you please, please send me a link? I'm SOOO glad that I have an anaesthesiologist on my side who not only listens and cares but is also eager to learn! I don't want to disappoint him! 

 

 

 

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Hi 

I had knee surgery last Thursday under general anaesthetic, like you I was so nervous as I was very ill after my hysterectomy, at that time I was undiagnosed but very symptomatic.

My anaesthesiologist didnt know about POTS. Due to lack of fluids I arrived at hospital with a full blown migraine. The staff were amazing and listened to my husbands explanation of POTS and it’s management resulting in me being taken to the ward and being given fluids before my op. I had to walk to theatre so by time I got there I was in excruciating pain from the migraine. They asked for my hand and said pain killers going in and the next thing I awoke in the recovery room! 

I have a history of panic and hitting out as I come out of anaesthetic so I had forewarned them, my first words were did I hit anyone and the nurses laughed no we left you to come around on your own ! 

I made them aware of my high adrenaline so pain and nausea could be a problem . My Bp also crashes. I woke up without any pain, no nausea, no panic and feeling like I had just been asleep. I do think that anaesthetic has really improved.i went to theatre at 1.45 pm and was on my way home by 6 pm.

Interestingly my HR was normal upon standing for two days after surgery I am sure that was due to fluids.

The staff were just amazingly  kind and listened to what would help so I have written to thank each department .

Hope this helps x

 

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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3349351/

https://www.anesthesiaconsiderations.com/

https://print.ispub.com/api/0/ispub-article/13170

https://www.researchgate.net/publication/6621500_Postural_Orthostatic_Tachycardia_Syndrome_Anesthetic_Implications_in_the_Obstetric_Patient

@Y.Alice.D - I had several surgeries since onset of POTS and always had a certain anesthesiologist assigned who was experienced in the special considerations of anesthesia during surgery. Most other anesthesiologists were too afraid to do anesthesia on me.  Post-op CAN be difficult, usually I need several weeks of reconditioning to regain my pre-op functional status. Administration of IV fluids before, during and after surgery has always been very beneficial to me. 

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11 hours ago, Y.Alice.D said:

Hi! 

I'm going to get a knee surgery next week, and I'm pretty nervous because of the anaesthesia. I remember that there was a study on the aftereffects of general anaesthesia in POTS patients, and according to that study one's POTS-symptoms could get worse afterwards.

I recently had general anesthesia and also had a very knowledgeable anesthesiologist on my side. I started getting IV fluids as soon as I checked in and even better, they recently changed the guideline of “nothing by mouth after midnight” and I was allowed to drink fluids up to one or two hours before I arrived at the hospital, so I was not dehydrated. Yes, it takes some time to get over the anesthesia but there have been no long-term negative effects. Best wishes!

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I just had to cancel an endoscopy the morning of a few weeks ago because I couldn't handle the prep (ie no water). Sjogren's makes me naturally dehydrated and I told them the no water thing was going to be a disaster for me. Evidently they haven't gotten the notice yet about any change in protocol because they had me stop drinking at midnight for an 11 am procedure. 

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  • 2 weeks later...

Thank you all so much for your response! 🙂

I couldn't find the said study anymore--probably I was just wrong and it doesn't exist at all! 

@Pistol, thank you for the links! 😀 They were helpful nevertheless!

The surgery went very well, by the way! My anaesthesiologist went a couple of additional miles in addition to the one he had already gone before I posted my question here--he was extremely well informed, and I felt as safe as can be! He explained to me in detail why I should not get a lumbar anaesthesia (which I initially thought might work around the assumed postoperative exacerbation of POTS-symptoms), and he gave me additional fluids before everything started--just like Pistol recommended (but I didn't need to tell him!). And when he finally gave me the anaesthesia, he and his nurse held one of my hands and comforted me! Isn't that sweet? 

When I woke up I felt really good! Also, my POTS-symptoms didn't get worse over the course of the week after the surgery! That took a lot off my mind! 😅

 

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@Y.Alice.D I also just had surgery that required general anesthesia. I did super-well, had IV fluids the day before and during surgery as well as the next day. No major POTS related problems, just as with you. I am glad you did well!!!!!

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