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Cluster Headache Help and Support >> Cluster Headache Specific >> CH and anesthesia

Message started by bcsanders on Apr 22nd, 2019 at 1:19pm

Title: CH and anesthesia
Post by bcsanders on Apr 22nd, 2019 at 1:19pm
Hi all.   I am 50 years old.  Have been episodic about 30 years.   I am not in cycle right now.   But my question is this.  I may need a medical procedure that required a general anesthesia.   Never had general anesthesia in my life.   Has anyone had any incidence that anasthesia could trigger a cycle.   Nervous enough about the whole anasthesia thing let alone if it could bring on headaches.   Been on the vitamin D therapy.   Seems to be very helpful.  A few years since an episode.   

Thanks all.

Brett C

Title: Re: CH and anesthesia
Post by Peter510 on Apr 22nd, 2019 at 2:53pm

I am a chronic sufferer and had a general anaesthetic last year with no problems at all.

I also am on the D3 Regimen with significant success.


Title: Re: CH and anesthesia
Post by austindh on Apr 22nd, 2019 at 3:28pm
As I understand it most general anesthesia these days is intravenous, and during the procedure one is given pure oxygen via nasal canules.

The administration of the O2 might actually prevent CH during the procedure and after.

Does anyone have a comment on these ideas?

Title: Re: CH and anesthesia
Post by Mike NZ on Apr 22nd, 2019 at 6:28pm
Hi Brett

I've not seen anyone post about anasthesia triggering a cycle or have read about it in research publications. However with CH being rare plus anasthesia not exactly being uncommon it isn't too surprising that there isn't much linking the two.

However surgery is almost certain to result in inflammation, especially if it is a non-minor operation where it is expected that there will be inflammation, e.g. hip replacement or similar.

From reading posts that Batch has made, surgery is highly likely to result in D3 related levels in your body dropping significantly, which increases the chance of CHs.

You may wish to discuss this with your surgeon and ask about taking some additional D3 before the surgery and afterwards.

Since O2 is readily available at hospitals, I'd discuss beforehand with the nurses / doctors about your CH and how it can be aborted using high flow rate oxygen with a non-rebreather mask. This is a lot easier to do prior to being hit by a CH than trying to explain mid-CH why the mask type matters and you need more than a couple of litres per minute as the flow rate.

Hi Austindh

Welcome to the forums!

Oxygen doesn't really work as a preventive and at the flow rates provided via nasal cannula it is unlikely to be able to abort CHs.

Tell us more about yourself and any CH questions you have.

Title: Re: CH and anesthesia
Post by Batch on Apr 23rd, 2019 at 4:01am
Hey Bret,

I've researched anesthesia as a CH trigger and results are mixed.† Much of the confusion centers around the difference between local and general anesthesia.† Under local anesthesia or spinal blockade, the incidence of CH attacks is about the same as usual.† In simple terms, as long as you're semi alert during local anesthesia and the local anesthesia occurs coincident with the usual time the CH beast jumps ugly, you'll get zapped!† Otherwise, it's a crap shoot with the CH beast jumping ugly as usual.

Under general anesthesia, we're as close to death as we'll ever be with the transmission of pain totally blocked, so the CH beast could jump real ugly under general anesthesia and we would be off in La La land and never know it...† You might have a puffy eyelid as a clue the CH beast made a call while you were out, but other than that, you're home free under general anesthesia... until it wears off...† After that, you've faced with the same old crap shoot.

Take care,

V/R, Batch

Title: Re: CH and anesthesia
Post by bcsanders on Apr 23rd, 2019 at 11:39am
Thank you all.    Appreciate the time and advice.  Will let you know how it works out.   

Title: Re: CH and anesthesia
Post by pattik on Apr 23rd, 2019 at 3:46pm
Hi Brett,

I underwent general anesthesia for cataract surgery 18 months ago, and I'm also on the D3 regimen. They don't take you as far under with that procedure as some other procedures, but I had no CH issues from it.

Depending on what your upcoming procedure involves, there could be a fair amount of an inflammatory response, which could trigger CH. There have been other threads on this forum regarding surgery and CH, and you might want to do some research on this. I may be heading for knee surgery, and I'm going to see if preemptive D3 dosing might not only help with recovery, but also avoid a CH recurrence. Food for thought anyway. Good luck with the procedure if it happens!

Take care,

Title: Re: CH and anesthesia
Post by maz on Apr 24th, 2019 at 4:06am
I had a procedure to treat my CH and I had a general aneasthetic for that.  It didn't trigger a CH, nor had any effect on it at all.

Title: Re: CH and anesthesia
Post by Falcon on May 14th, 2019 at 11:19pm
Iíve had a lithotripsy to get rid of a kidney stone & a colonoscopy done under anesthesia. Both times I told the anesthesiologists about my monster.

The first surgery, the lithotripsy was done as emergency surgery & I just happened to get lucky that my neurologist was on call in the ER & I got to speak to him. He told my surgical team what to watch for & what to do.

When I went for the colonoscopy I asked for oxygen on standby. I also brought a letter from my neurologist for my surgical file before my procedure. And I made sure I had my Maxalt with me.

Additionally request from your surgeon that you have both a triptan & high-flow oxygen on you list of Rx that you can request as needed. They can write an order for it while you are in the hospital or at recovery.

Hope that help!

Title: Re: CH and anesthesia
Post by Traveller on May 18th, 2019 at 8:08pm
I had general anesthesia for shoulder surgery a few years ago while I was in cycle.   What was a shock is that the night after surgery I was completely comatose on oxycontin and had a CH blow right through the narcotics like they weren't even there.  Couldn't feel a damn thing in my shoulder but my pal the CH was there in full force.  Direct evidence that narcotic pain relievers are useless for CH.

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