Q&A 61: anaesthesia and MS

It is crucial to look out for complications and have a contact number and a plan to manage these complications if the need arises.

Case

My partner is 54 and was diagnosed with primary progressive MS about 25 years ago. He’s on ocrelizumab (Ocrevus) and takes gabapentin and baclofan to manage symptoms. He goes to the gym regularly to use the elliptical to lift weights and stretch, and he can take walks of up to about 2 miles with poles, but he has balance issues as well as bladder and bowel trouble. Cognitively, he’s in great shape and still works full-time in a high-level administrative position.

My question: He is having an ablation next week for atrial flutter, and I can find little information about how PwMS recover from anaesthesia. He will come home the same day if all goes as planned, but I am worried about potential weakness. Will I get him from the car and into the house? He’s 6’5” and 200+ pounds. When he gets sick, his MS symptoms are exacerbated—the last time he had Covid, he needed a walker to get from the car into the house, and he usually gets awful headaches with nausea when he’s sick.

Should I expect the same following this procedure that’s done under general anaesthesia? Are there other things I should be prepared for? There’s very little information about MS and anaesthesia—maybe because there isn’t much to say that’s different from the general population!

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Prof G’s answer

We wrote a review article for HCPs managing people with MS (pwMS) undergoing anaesthesia in response to many questions like yours. The article is open-access so you can download it for review….