Surgery with Anesthesia Does Not Raise Person’s Risk of MS Relapse, Study Finds

Surgery with Anesthesia Does Not Raise Person’s Risk of MS Relapse, Study Finds

No excessive relapse risk appears to exist for people with multiple sclerosis who undergo surgery that requires anesthesia, researchers report, challenging long-held assumptions associated with MS and surgery.

Their single-site study, “Multiple sclerosis relapse risk in the postoperative period: Effects of invasive surgery and anesthesia,” was published in the Multiple Sclerosis Journal.

Postoperative relapse in MS patients is a common concern. This concern is echoed by neurologists, anesthesiologists, and surgeons, with supporting evidence from small, descriptive case studies.

This perception of surgical risk can have a dampening effect on clinical decisions, causing delays in necessary surgery and preoperative neurology consultations.

A team led by researchers at the University of Michigan (UM) MS Center conducted a retrospective review of MS adult patients being followed at that center, who had undergone an invasive surgical (major or minor) procedure requiring full anesthesia between 2000 and 2016. 

The researchers defined relapse as an acute, neurological change lasting for 24 hours or more, without the presence of infection or fever that might indicate a post-surgical complication. Researchers analyzed the patients’ relapse history dating back two years, and up to 90 days after surgery. 

Researchers identified 281 MS1 patients who underwent 311 major and 299 minor surgeries at the UM MS Center.

Patients were categorized into demographic groups taking into account age, sex, ethnicity/race, MS type [relapsing MS or progressive MS], smoking status, MS treatment prior to surgery, lesion assessment, surgical procedure type, and relapse dates, both pre- and post-operative. 

Statistical analyses were used to identify an association between surgical procedures and relapse risk, in addition to accounting for variability between the different demographic groups.

Results showed a total of 12 relapses following surgery, mostly in white women with relapsing MS. These patients were all significantly younger (mean age of 39, compared to 49 in those without postoperative relapse), and all had a higher frequency of lesions on MRI scans before surgery.

Results were reported as an odds ratio, which is the likelihood that a relapse will occur postoperatively compared to preoperatively. The odds ratio equaled 0.56 without accounting for age, and 0.66 with age adjustment. A value of 1 or below means no significant difference in relapse risk.

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5 comments

  1. George Beckwith says:

    Interesting and re-assuring. My wife was diagnosed with Relapsing MS 3 years ago after a severe relapse but has not had a relapse since. She was old for an MS diagnosis (56) but had had some episodes in prior years which might have been earlier signs of MS. And she has always had an extreme sensitivity to anesthesia. Even if use of anesthesia appears not to trigger a relapse, I wonder if MS can contribute to a sensitivity or unusual reaction to anesthesia when it is used. Which would mean that some caution or lower doses might be recommended.

    • Monica says:

      I have MS. My first episode was 2 weeks after giving birth in 99 (I was 30) and my second episode was 2 weeks after toe surgery where I did of course have anesthesia. I am very sensitive to anesthesia every time. I have had a few surgeries and procedures where I was under and other than it taking me long to feel normal after the anesthesia (which stays in your body for actually about a month) I haven’t had another episode. I am thinking it isn’t the anesthesia that is the issue but the actual surgery and healing that may contribute to an episode happening. I do agree that perhaps MS contributes to the sensitivity.

  2. CM says:

    Hmm. 2013 was my first surgery as an adult (age 58). When I woke up from the anesthesia, I was unable to count backwards from 100. I had a brain MRI a few months later that showed white matter disease.
    In 2014 (age 59), I had another surgery, and although I didn’t seem to have an adverse reaction to being put under, about 2 months later I had what I though was a stroke, went to a hospital, and had another brain MRI that showed much more white matter disease than the previous year.
    In 2015 I had a preliminary dx of protein in my spinal fluid, and then finally, in 2016 (age 60) was diagnosed with RRMS after two lesions were found in a (third) brain MRI.
    So, for me, I will always be anxious about any surgeries I might undergo, no matter what any scientific study might say.

  3. Christine says:

    I find this interesting… I was completely UNAWARE THAT I HAD MS, when I had a rotator cuff surgery in Jan of ’12. For all the orthopedic surgeries I’ve had, I’ve NEVER had a problem with anesthesia. Came right out of it. I begged NOT to have the nerve block only because I’m a control freak and don’t like the idea of feeling “out of it” for a while. I lost, and they did it…. And couldn’t get me to come out of it…. For quite a while.
    A little over a month later, I started with a couple of issues… It compounded until the end of March until October 31st….my fave holiday, being told, I had MS. And I’d had it for apparently 12 yrs and almost a dozen lesions, but one active and wrecking life right now🥵.
    I’m finding it hard to believe that nerve block didn’t push me over the edge… Took almost 6 yrs to get a grip on it, and now this med too shit the bed and I start over… Damn nerve block 🤬😁 I blame IT. For real

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