Biologisch Medisch Centrum Utrecht Epe| Dr John Chia
Infectious disease specialist practicing in Torrance, California, USA
Paul van Meerendonk

Deze site is opgericht door een zeer tevreden cliŽnt van het Biologisch Medisch Centrum

Biologisch Medisch Centrum
HINTS
ATP energie
Behandeling CVS/ME
Dr Myhill
Dr Teitelbaum
Dr Meirleir
Dr Cheney
Dr Chia
Arts Paul van Meerendonk

ADP-ATP efficiency
Mitochondrial dysfunction
Cvs en fibromyalgie
Video xmrv cvs
Virus gevonden
Virus en DNA
Viruses and mitochondria
Virussen en immuunsysteem
Zware metalen

Cadmium
CVS ME aantoonbaar
CVS legitiem
esme
Research direction

Glutathion
Carnitine
D-ribose
Vitamine B12
Vitamine D
Nac
FIR
EPD Desensibilisatie
Oxymatrine
Gc MAF
Raltegravir
CT
Meetresultaten 1

Meetresultaten 2
Meetresultaten 3
Meetresultaten 4

 

Recommendations For Persons With CFS Or Fibromyalgia Who Are Anticipating Surgery

CFS is a disorder characterized by severe debilitating fatigue, recurrent flu-like symptoms, and neurocognitive symptoms such as difficulties with memory, concentration, comprehension, recall, calculation and expression. A sleep disorder is not uncommon. All of these symptoms are aggravated by even minimal physical exertion or emotional stress, and relapses may occur spontaneously. Although mild immunological abnormalities (T-cell activation, low natural killer cell function, dysglobulinemias, and autoantibodies) are common in CFS, subjects are not immunocompromised and are no more susceptible to opportunistic infections than the general population. The disorder is not thought to be infectious.

Persons with CFS frequently re-activate latent herpes group viruses, which may produce a mild, subclinical hepatitis with slight elevations of the transaminases. Thus, hepatotoxic anesthetic agents should be avoided because they could potentiate the liver problem or even provoke fulminant hepatitis.

Intracellular magnesium and potassium depletion has been reported in CFS. For this reason, serum magnesium and potassium levels should be checked pre-operatively and these minerals replenished if borderline or low. Intracellular magnesium or potassium depletion could potentially lead to cardiac arrhythmias under anesthesia.

Up to 97% of persons with CFS demonstrate vasovagal syncope (neurally mediated hypotension) on tilt table testing, and a majority of these can be shown to have low plasma volumes,low RBC mass, and venous pooling. Syncope may be precipitated by cathecholamines (epinephrine), sympathomimetics (isoproterenol), and vasodilators (nitric oxide, nitroglycerin, a-blockers, and hypotensive agents). Care should be taken to hydrate patients prior to surgery and to avoid drugs that stimulate neurogenic syncope or lower blood pressure.

Allergic reactions are seen more commonly in persons with CFS than the general population. for this reason, histamine-releasing anesthetic agents (such as pentothal) and muscle relaxants (curare, Tracrium, and Mevacurium) are best avoided if possible. Propofol, midazolam, and fentanyl are generally well-tolerated. Most CFS patients are also extremely sensitive to sedative medications -- including benzodiazepines, antihistamines, and psychotropics -- which should be used sparingly and in small doses until the patient's response can be assessed.

Finally, HPGA Axis Suppression is almost universally present in persons with CFS, but rarely suppresses cortisol production enough to be problematic. Seriously ill patients might be screened, however, with a 24 hour urine free cortisol level (spot or random specimens are usually normal) or Cortrosyn stimulation test, and provided cortisol supplementation if warranted.

http://www.anapsid.org/cnd/drugs/anesthesia.html