CRPS and Surgery – Unhappy Bed Fellows

For anyone suffering CRPS, the suggestion of surgery is extremely worrying. Any form of surgery can cause the condition to worsen and/or spread.

However, if surgery is unavoidable, treatment protocols exist to minimise the risk of exacerbating the condition. These include (but are certainly not limited to) recommendations in respect of:

● the type of drugs used before, during and after surgery;

● the most appropriate needle size for IV lines;

● the warming of fluids before introducing them into the body;

● the monitoring of body temperature before, during and after surgery.

A significant risk factor though are medical staff themselves. Many, particularly those involved in perioperative and postoperative care have a terrifying lack of knowledge and understanding of CRPS. That is not necessarily their fault; simply a result of inadequate awareness and training. Also, these are professional people who are often working under considerable pressure of time. That has to be squared with what is being requested by or on behalf of the CRPS sufferer, which is likely to be less straightforward and far more time intensive than the procedures they are used to.

So what is the answer?

There can be no guarantee that all protocols will be followed. Indeed, we shouldn’t lose sight of the fact that any surgery, whether or not you suffer from CRPS, carries risk – the ultimate risk of course being death. The overwhelming priority of the surgical team is to keep the patient alive. That priority clearly overrides any CRPS protocols should a conflict arise.

However, subject to that, prior to surgery the CRPS sufferer and those close to them need to feel satisfied at each and every stage that medical staff are aware of and sympathetic to the protocols. That begins as early as the initial referral to the surgeon and continues through the first consultation, pre-operative tests, pre-operative admission, (crucially) the day of surgery itself and even continues beyond discharge from hospital.

At any of those stages, a CRPS sufferer should not feel (or be made to feel) like a nuisance. Remember, the protocols would not be in place if the medical profession as a whole did not recognise the risk factors.