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Anesthesia is a common method used to prevent pain during surgeries and other medical procedures. It is generally considered safe, but it can cause some side effects, including muscle aches. Muscle soreness can be caused by the muscle-relaxing medications administered to patients to facilitate the insertion of a breathing tube. Malignant hyperthermia, a rare but serious reaction to anesthesia, can also cause fever and muscle contractions. This condition can be life-threatening and requires immediate medical attention. While muscle aches are a known side effect of anesthesia, serious complications are rare, and anesthesiologists are trained to prevent and treat these issues effectively.
| Characteristics | Values |
|---|---|
| Muscle aches | Caused by the muscle-relaxing medication used to insert a breathing tube. Succinylcholine is one such medication. |
| Muscle aches | A rare inherited syndrome can also cause fever and muscle contractions during surgery. |
| Muscle aches | Back pain can occur if the surgery lasts longer than 40 minutes, as the patient is lying still on a hard operating table, causing the ligaments in the back to be overstretched. |
| Muscle aches | Muscle aches are one of the most common complications of anesthesia, along with nausea, vomiting, and sore throat. |
| Muscle aches | Muscle aches are usually not dangerous and do not last very long. |
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What You'll Learn
Muscle stiffness and backaches
Backaches can also occur after anaesthesia, especially if your surgery lasts longer than 40 minutes. This is because you are lying still on a hard operating table for a long time, which causes your ligaments to overstretch. Normally, you would move around to relieve the stretching, but you cannot move while under anaesthesia, so the ligaments remain stretched and become sore. To help prevent this, the operating team may place an inflatable cushion under you.
In addition to muscle stiffness and backaches, other common side effects of anaesthesia include nausea, vomiting, nerve pain, a sore throat, chills caused by low body temperature (hypothermia), and itching. These side effects are usually unpleasant but not dangerous, and they don't last very long. Your anaesthesiologist is trained to prevent and treat these complications.
While rare, more serious complications related to anaesthesia include malignant hyperthermia, a potentially deadly reaction that can cause fever and muscle contractions. This can lead to organ failure if not treated quickly. Another rare complication is nerve damage, which can cause temporary or permanent neuropathic pain, numbness, or weakness.
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Malignant hyperthermia
The risk factors for malignant hyperthermia include a family history of the condition, a history of muscle tissue breakdown (rhabdomyolysis), and certain muscle diseases caused by inherited gene changes. If you have a relative with a history of problems with anesthesia, it is important to inform your healthcare provider and anesthesiologist before any procedure requiring anesthesia.
The diagnosis of MH can be challenging due to the variability in the presentation and onset of signs. The "gold standard" test for MH is the in vitro contracture test (IVCT), which is based on the contracture of muscle fibres in the presence of halothane or caffeine. This test is used to determine an individual's susceptibility to MH.
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Nerve damage
Although nerve damage is a rare complication of receiving anaesthesia, it can cause temporary or permanent neuropathic pain, numbness or weakness. Anaesthesia can damage nerves in several ways. Firstly, mechanical trauma, which is a direct injury caused by a needle or catheter or an indirect injury caused by a compressing haematoma. Secondly, local anaesthetic toxicity, where the risk increases with the dose and concentration of the anaesthetic. Thirdly, epinephrine use, which can cause nerve damage through a direct ischemic mechanism or an indirect pharmacokinetic effect on local anaesthetic clearance.
The nerves most commonly affected by anaesthesia are the ulnar, common peroneal, femoral, and sciatic nerves, as well as the brachial and lumbosacral plexi. The risk of nerve damage is higher in men, smokers, obese or very thin patients, and those with diabetes and hypertension. Most of these nerve injuries are transient, and a full recovery is the most frequent outcome.
To avoid nerve damage, providers will use ultrasound imaging to guide needle placement. Additionally, people with conditions such as diabetes, high blood pressure, and smoking, which cause poor blood flow, are more susceptible to nerve damage due to reduced oxygen levels reaching the nerves during surgery.
Anaesthesia can cause muscle aches through the use of medications like succinylcholine, which relaxes the muscles so a breathing tube can be inserted. Muscle aches can also occur from lying still on a hard operating table for an extended period, causing the ligaments in the back to overstretch and become sore.
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Postoperative delirium
POD is the most common complication of surgery for older adults, affecting up to 50% of seniors, according to the American Geriatric Society. It is also more prevalent in patients with existing neurocognitive disorders and those undergoing complex or emergency procedures. POD can be caused by unmanaged pain, an infection, a reaction to medication, or lack of sleep. Certain medications, such as tricyclic antidepressants, antihistamines, benzodiazepines, gabapentinoids, and scopolamine, may also increase the risk of POD.
There is currently no medication to treat POD, and prevention is key. Antipsychotic drugs to control hallucinations or agitation can interrupt the brain's natural healing processes, delaying recovery and worsening the condition. The first step in treating POD is to identify and address the underlying cause. This may include working with the patient's family to provide general comfort and support, such as encouraging proper eating, exercising, and sleeping.
To reduce the risk of POD, pre-surgical evaluations such as the UT Southwestern Perioperative Optimization of Senior Health (POSH) program can be used to assess a patient's potential risk of developing POD and other complications. Effective perioperative interventions for POD include depth-of-anaesthesia monitoring, intraoperative dexmedetomidine infusion, and multimodal analgesia.
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Common complications
While general anaesthesia is considered very safe, it can cause a range of side effects, from minor inconveniences to significant and potentially serious complications. The most common complication is nausea, which can be prevented or treated with medication. Other common side effects include vomiting, muscle aches, a sore throat, nerve pain, and grogginess. These side effects are usually unpleasant but not dangerous and do not last long.
Muscle aches can be caused by the medications used to relax your muscles so that a breathing tube can be inserted. This can cause muscle stiffness and soreness for several days after your operation. Backaches are also common after anaesthesia, especially if the surgery lasts longer than 40 minutes. This is due to the patient lying still on a hard operating table for an extended period, causing the ligaments in the back to become overstretched and sore.
In rare cases, anaesthesia can cause more serious complications, including malignant hyperthermia, a rare and potentially deadly reaction to anaesthesia that can occur in people with a specific genetic mutation. This condition causes a high fever and muscle contractions and can lead to organ failure if not treated quickly. Another rare complication is anaesthesia awareness, where the patient remains conscious during surgery but is unable to move or communicate. This can be very distressing and may cause long-term psychological problems similar to post-traumatic stress disorder.
Older people are more prone to postoperative delirium, a condition causing confusion that comes and goes for about a week and can lead to long-term memory and learning issues. Certain pre-existing conditions can also increase the risk of complications, including advanced age, diabetes, kidney disease, heart disease, high blood pressure, lung disease, and obesity.
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Frequently asked questions
Yes, muscle aches are a common side effect of anesthesia. This is because of the muscle-relaxing medication used to insert a breathing tube.
Muscle aches are one of the most common complications of anesthesia, along with nausea, vomiting, and sore throat. These side effects are usually unpleasant but not dangerous and don't last very long.
Muscle aches are caused by the medication used to relax your muscles so a breathing tube can be inserted. Succinylcholine is one such medication that may cause muscle stiffness and aches for several days after your operation.
If you are at a higher risk of developing muscle aches, your anesthesia team may use an alternative muscle relaxant. It is important to discuss your medical history and any relevant health conditions with your healthcare team before surgery.
Serious complications from anesthesia are very rare. However, some rare but serious complications include malignant hyperthermia, a dangerous reaction to anesthesia that can cause fever and muscle contractions, and anesthesia awareness, where the patient remains conscious during surgery.
