I have read more than once with fellow sufferers about bad experiences with a lumbar puncture. They found that the symptoms of RLS (and / or PLMD) were extra severe after surgery. In their hospital bed, their troubled legs almost drove them crazy.
Some had already sporadically suffered from restless legs before. However, after the operation they did not get rid of the complaints. These complaints even developed into a progressive condition. So, over time, their symptoms began to increase.
What I also read with one of them was that there are possibilities to reduce the problems. There are also alternatives, so other ways to anesthetize. The doctor must of course be aware of the fact that the patient in question suffers from restless legs.
All of this seems worth investigating for anyone who, for whatever reason, needs surgery. The better you know the advantages and disadvantages, the better you will be able to make the best possible choice.
What should you consider if you need some form of anesthetic such as a lumbar puncture? I deal with the following questions:
- What is a lumbar puncture and is it a problem to get one if you have RLS?
- Are there any alternatives?
Lumbar puncture
With an lumbar puncture, the doctor pricks close to the spine. A lumbar puncture is also called regional anesthesia.
There are two types of : a spinal puncture and an epidural. The spinal puncture is intended for anesthesia during surgery. After this injection, you will not feel anything in the lower part of the body for a few hours. The epidural is usually used as pain relief after surgery. This injection provides pain relief in the area between the chest and legs. You can still move your legs.
In a pregnancy where the delivery takes place in hospital, the lumbar puncture is often also an option. In that case it concerns the epidural. The purpose of the shot is to reduce the pain level to an acceptable level. It is important that the anesthetic has worn off when the woman starts pushing.
Lumbar puncture and restless legs
As mentioned above, I have read quite a few times with fellow sufferers that they had bad experiences with an lumbar puncture. This was the case in people who had had surgery as well as in women who had an epidural prior to childbirth. They all developed (extra) severe symptoms of RLS after the procedure.
In the run-up to surgery, restless legs should be a standard topic of conversation between doctor and patient. The doctor should ask about it. In any case, the patient should be given the space to say something about it. As a patient it makes sense to prepare well for the preliminary discussion with the doctor in this regard.
The long lying down probably plays a role in the extra effect of restless legs. Pain and lack of sleep are also factors. Some patients have RLS before surgery. In others, the complaints arise from being immobile for a long time after the operation.
In addition to the lumbar puncture, there are also other medications that are often used during an operation. Some of these can be unfavorable for someone with restless legs. For example, there are drugs that counteract the effect of dopamine. Some medications make opiates less effective. Certain antidepressants can also cause additional complaints.
Alternatives
When choosing the type of anesthetic during an operation, a number of things must be taken into account. First of all, it depends on the type of operation. The overall health of the patient also plays a role, as does your personal preference.
Alternatives to a lumbar puncture are:
- Narcosis
- Local anesthesia
Major, long-term operations usually take place under narcosis. This means that you are unconscious during the operation. With narcosis you will be given a sleeping aid, painkillers and a muscle relaxant. Most common side effects are nausea, vomiting and sore throat.
A side effect of narcosis can also be that complaints of existing conditions get worse. This is usually temporary. After a few days the anesthesia will have disappeared from the body and these complaints should also diminish. The same types of side effects can occur with local anesthesia.
If you see RLS as an existing condition, it is very questionable whether narcosis (or some other form of anesthetic) is a better option than a lumbar puncture.
Conclusions
It seems that there is not really a type of anesthetic that is guaranteed not to cause additional problems with restless legs. There are, I think, a number of things you can do to reduce the chances of this happening.
I have listed them here for you:
- Discuss with your treating doctor or surgeon before the operation or – in case of pregnancy – before delivery that you suffer from restless legs.
- Prepare yourself well for that conversation. If you are on medication for RLS, write its name on a piece of paper and bring it with you.
- Talk to the doctor about whether it is possible to replace some medications used during surgery with others if they may be unfavorable for your RLS.
- If necessary, adjust the time of taking the medications you use for restless legs, so that they work as beneficial as possible during and after the procedure. Do this in consultation with your attending physician.
Do you have any other suggestions for fellow sufferers yourself?
Ik heb een ruggenprik aangezien ik werd geopereerd aan de prostaat. Wat een ellende, ik heb tijdens en na de operatie heftige rls gehad.
Ik heb toen ik op de uitslaapkamer kamer meteen gevraagd om Oxycodon en gekregen. Toen ik mijn benen weer enigszins kon bewegen is het geleidelijk aan afgezakt. Een ruggenprik doe ik dus niet weer.
Algehele narcose gekregen i.v.m. herniaoperatie. De dagen daarna vrijwel geen last van RLS. Na een dag of 5 weer als vanouds.
Ik had ook last van rusteloze benen terwijl de ruggeprik nog lang niet uitgewerkt was. Ik had 3 uur eerder nog ropinirol in genomen. Gelukkig duurde het maar ‘n minuut of 10. Daarna ebte het weg. Het verbaasde me wel. Normaal trekt mijn spier dan flink aan maar dat kon toen natuurlijk niet. Ik vind het verbazingwekkend dat je benen onrustig zijn terwijl je ze niet voelt.
Hoi Monique,
Ik heb een prostaatoperatie ondergaan met een ruggenprik. Heb tijdens en na de operatie heel veel last gehad. Aangezien je je benen niet kunt bewegen is dit echt vreselijk. Als het ooit weer moet gebeuren dan onder volledige narcose. Ik heb het van tevoren duidelijk aangegeven dat ik ernstige rls heb. Kennelijk zijn de meeste artsen niet op de hoogte met wat rls kan doen zelfs met een ruggenprik.
Groet Johan
Ook als je meldt dat je RLS hebt, nemen de anesthesisten en urologen je niet serieus!,
Opm. Van een uroloog: mijn vrouw neemt inhibin en dat heeft haar ook geholpen. Ik heb hem een folder van de RLS overhandigd, hij is er niet weer op terug gekomen. Sindsdien wordt ik onder narcose gebracht.
Hallo Frits,
Ik heb hier een bericht geplaatst en ben benieuwd naar jouw ervaringen met een operatie met een ruggenprik.
Groet Johan