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Old 05-18-2011, 03:43 PM #1
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Default Anesthesia and PN

I had a cardiac EP Study with ablation surgery on Monday. Due to my multiple medical problems, they chose general anesthesia for better control...instead of the versed/fentanyl cocktail. Immediately after waking I noticed my left leg was semi 'asleep'. I thought it was do to position for the several hour procedure (especially with the ganglionitis), but even after being up for a couple days, it hasn't gone away. It seems mostly sensory, but some very slight motor heaviness most noticeable when walking.

My question is whether anesthesia drugs effect existing PN in this way? I emailed my cardiologist who did the procedure and he felt it could be related to the anesthesia and hopes it will resolve in a few days...but to let him know. What seemed odd was it being one-sided where as all my regular PN problems are bilateral. I have had many surgical procedures with general before but nothing quite like this side-effect.

Thanks in advance for input.
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Old 05-18-2011, 03:56 PM #2
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I think it is hard to say.

Nitrous oxide... will affect nerves in one treatment.

But midazolam is a benzo... and those aren't typically hard on nerves. The benzos will have a anti-spasm effect, which may translate into soft muscles...but I would not expect one sided or only one limb. I would think all would be affected to some extent.

I am thinking it is a compressive thing. So many people have compressive issues, after surgeries. Just lying on your back may compress one side of your spine just enough if there were subtle problems there to begin with..

Midazolam does interact with other drugs however...so typing into a drug checker with your other meds would reveal that.
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Old 05-18-2011, 07:14 PM #3
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Originally Posted by mrsD View Post
I think it is hard to say.

Nitrous oxide... will affect nerves in one treatment.

But midazolam is a benzo... and those aren't typically hard on nerves. The benzos will have a anti-spasm effect, which may translate into soft muscles...but I would not expect one sided or only one limb. I would think all would be affected to some extent.

I am thinking it is a compressive thing. So many people have compressive issues, after surgeries. Just lying on your back may compress one side of your spine just enough if there were subtle problems there to begin with..

Midazolam does interact with other drugs however...so typing into a drug checker with your other meds would reveal that.

I'm guessing he just used the midazolam as an initial sedative, not the main course, so to speak. Would/could Nitrous oxide effect just one side?

I'm also starting to think it is from positional (compression), since it's not improving as the anesthesia wears off. Even the doctor made a brief mention of this as well. I think he's just hoping it was the anesthesia so it would be resolved in a few days.

In your experience with others having this type of problem, does it eventually improve...in a relatively short period of time?
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Old 05-19-2011, 07:16 AM #4
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Lightbulb

If the nerves on that side were weaker or mildly damaged, I would think any Nitrous exposure would accelerate that.

The studies where Nitrous has caused problems were in people with marginally low B12 to begin with. People with good stores of B12 may not have a reaction from one Nitrous administration.

What other anesthetics were used? Any neuromuscular blocking agents?
This link shows neuromuscular blockade and how it works.
http://en.wikipedia.org/wiki/Muscle_relaxant
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Old 05-19-2011, 09:19 AM #5
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Originally Posted by mrsD View Post
If the nerves on that side were weaker or mildly damaged, I would think any Nitrous exposure would accelerate that.

The studies where Nitrous has caused problems were in people with marginally low B12 to begin with. People with good stores of B12 may not have a reaction from one Nitrous administration.

What other anesthetics were used? Any neuromuscular blocking agents?
This link shows neuromuscular blockade and how it works.
http://en.wikipedia.org/wiki/Muscle_relaxant
Unfortunately, I don't know what other anesthetics were used...until I see the operative report.

The only things I'm aware of were several cardiac agents used to induce arrhythmias as part of the EPS (like atropine, adrenaline, etc). They also needed multiple rounds of vaso-constrictors as my BP kept dropping (I have neurally mediated hypotension).

One other very odd post-op problem is some very significant nerve pain on the roof of my mouth and portions of my tongue when trying to eat. It is NOT an irritation type pain yet quite profound. Even something very soft causes significant pain. I have heard of PN including burning mouth issues, but have never experienced it before. Something neurally must have been triggered, compressed, irritated, etc. The leg issue (even a little of the same in the left arm/hand) seem more like compression in the neck to effect both, yet the mouth is above the neck so who knows, maybe it's more of a toxic issue. I'm confused for sure.

BTW, my B-12 sits around 900 so I doubt it's an issue.
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Old 05-19-2011, 09:22 AM #6
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Question

Were you intubated?
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