Despite letting my anesthesiologist know I have had a problem with severe muscle pain for a few days after 2 prior surgeries, and that I was told this was a reaction to "scoline", I was given this med again during a 2 hour surgery. This time I woke up with severe chest tightness, wheezing, numb tongue (3 weeks), and difficulty breathing. What more can a patient do to keep safe? This info was even listed on my red allergy bracelet and I had typed a letter that was placed in my chart about a scoline allergy and that my mother had a similar problem. I am now scared to think about when my AICD/pacemaker needs replacing in 4-6 yrs. Thank you for your time. 

It sounds like you did everything possible to inform the hospital staff and doctors about your scoline reaction. But, are you quiteﾠsure that scoline is what you were given? Do you have a copy of the anesthetic record? Have you discussed any of this with your anesthesiologist? Scoline typically causes muscle pain a day or so after a surgical procedure. It is not usually associated with chest tightness, wheezing or a numb tongue. Nor does it cause difficulty breathing, except while the drug is actually in effect - a matter of just a few minutes. Although scoline is a very effective muscle relaxant itﾠis not the only muscle relaxant,ﾠthere are several other options. If you need to be intubated again your anesthesiologist should be able to offer an alternative without the same side effects. Replacement of an AICD/pacemaker is not a procedure in which scoline or any other muscle relaxant is needed so that should be a bit reassuring for you. Assuming you are correct, and that scoline (succinylcholine) was given, I am not sure what else you could have done to prevent this. 

I have many allergies to antibiotics. One that I am concerned about with my upcoming pacemaker/AICD surgery (under general anesthesia) is sulfa. I heard that sulfa is in one of the general anesthesia meds. Is this true? I won`t be talking with my anesthesiologist until the morning of my surgery so just wanted to know if this is a concern. Also, after a D&C many yrs ago I had severe body muscle aches so much so that I developed pneumonia post-op from not breathing correctly (b/c it hurt to take a deep breath). Could the general anesthetic have had anything to do with this? Thank you so much for your time. 

No, sulfa is not a general anesthesia medication. The term sulfa refers usually to the sulphonamide (or sulfonamide) antibiotics, developed more than fifty years ago. It can also refer to any drug containing a sulphur molecule. The sulfonamides were very successful early antibiotics, before penicillin arrived. A large number of related compounds were produced. Among the related drugs are the thiazide diuretics, and the sulfonylureas which are blood sugar-lowering agents used to treat diabetes. Allergy to a particular sulfa drug increases the risk that you will react to another sulfa drug. There are no anesthetics in common use that would pose a particular risk to you if you have a "sulfa allergy". The aches and pains you experienced so many years ago were probably due to the muscle relaxant drug called succinylcholine. 

I had an appendectomy 24 hours ago under general anesthesia. When I awoke from surgery, both legs, especially in the quads, were extremely sore to the point that it was hard for me to walk without a good bit of slow "warm up" steps for about an hour. When I got home and over night, the muscles in my entire body, from my calves up to my jaw were extremely tight and achy, as if I had done a massive weight lifting routine. Today, the day after surgery, when I chew food, the first few minutes are painful because of the jaw soreness, and the muscles throughout my body are still extremely sore. They seem to loosen up a bit while moving, but still ache. Any ideas? Should I be worried? 

It is very likely that the soreness you have experienced is due to the muscle relaxant drug called succinylcholine, or "scoline". In a certain number of cases generalized muscle pain results, which gets better on its own after a few days. For more information please look for my previous response to a similar question. 

My father who never has pain suddenly developed severe, generalized pain, 1 day post-op. He received the drug Scoline. After reading your web site, I realize he now has Scoline Myalgia. Now I need to know what to do about it. How long does it last? How can I flush these chemicals out of his body quickly? He has a much bigger problem now then he did before his surgery. My father is not a whiner, and never complains. He is in excruciating pain now. He took only regular strength Tylenol post-op. He refused to take anything stronger. Tylenol does nothing for this pain. He was operated on 11-10-06. On 11-11-06, the pain started. Today 11-12-06, the pain is unbearable. PLEASE help us as soon as possible. My Father is suffering! Thankyou. 

This is not an emergency service. You should contact your doctors to arrangeﾠfor properﾠdiagnosis and treatment. If your father has scoline myalgia this is a self-limiting condition (gets better on its own) that is usually treated with simple pain medicines like Tylenol. There are no chemicals to be flushed out of the body as succinylcholine is metabolized (broken down) very quickly by enzymes in the bloodstream. 

I had general anesthesia yrs ago and had severe muscle aches afterwards (developed pneumonia from difficulty expanding my lungs) for several days. My mother had problems with anesthesia many yrs ago and didn`t fully come out of the anesthesia for several days...her heart also stopped on the OR table. My physician told me to make sure I told my next doctor this if I should need surgery again but I can`t remember what was used so to avoid it in the future and the records are all gone now since was so long ago. Any thoughts on what could cause my kind of problem? Thank you for your time. 

I'm afraid that really isn't enough information to decide what happened to you or your mother.ﾠYour stories are best told to your doctors in as much detail as you can gather, including your ages at the time, the surgical procedures, what was done to treat you, how long it took to recover, etc. Succinylcholine is a muscle relaxant drug that sometimes causes muscle pain afterwards. There are still some good reasons for using this drug, and the risk of muscle pain seems to fall with advancing age. There are very many causes for cardiac arrest. Be assured that life-threatening reactions to anesthesia drugs are very rare...although that is what some people are afraid of. Choose a good hospital and competent professionals to take care of you, don't smoke, and trust in the good outcomes that generally occur from anesthesia today.ﾠ 

I had breast surgery a few years ago and will have to undergo a similar procedure again. I experienced severe muscle and joint pain 8 to 10 hours after the surgery and the pain lasted for about 36 hours. I had never experienced anything so painful before, and I am more than a little concerned about this happening again. What accounts for this pain? 

Thanks for your question. The severe muscle and joint discomfort you experienced after breast surgery is known as "postoperative myalgia". This is a fairly common, quite distressing, but rather interesting condition. It usually appears on the first day after surgery, is often described as feeling similar to the pain one might suffer after unaccustomed physical exercise, and is usually located in the neck, shoulder and upper abdominal muscles. There are a few theories about the cause of postoperative myalgia, but it is usually attributed to the use of a muscle relaxant drug called succinylcholine. Hence this is sometimes referred to as "scoline pain". Although the problem of postoperative myalgia has been recognized for many years, the exact way in which succinylcholine causes this muscle pain is not fully understood. Most believe that it is due to uncoordinated contraction of muscles that occurs a few seconds before the muscle relaxation that is the desired effect of the drug. It is also not clear how best to prevent scoline pain, short of avoiding the use of this drug altogether. It is natural to ask then why we continue to use this medication, and the reason is that succinylcholine, despite a few significant side-effects, is a very reliable and quick-acting muscle relaxant that helps the anesthesiologist "secure" the airway (place a breathing tube). Myalgia from succinylcholine is most common in young female patients, especially those undergoing ambulatory surgery (going home the same day as the surgery). The incidence of myalgia with succinylcholine ranges widely - in some reports it's as low as 1.5% but can be as high as 80 - 90%. To add to the mystery, some patients experience myalgia even when they are not given succinylcholine at all! Naturally you would like to avoid this very unpleasant experience at your forthcoming surgery. The good news is that there are other muscle relaxant drugs than can almost always be used instead of succinylcholine. This will not guarantee that you do not have the myalgia again but probably makes it much less likely. If the use of succinylcholine cannot be avoided, (this is rare), there are methods for decreasing the incidence and severity of the muscle pain, such as giving a very small dose of another muscle relaxant before the succinylcholine, or by giving a local anesthetic medication called lidocaine. Typically the pain lasts 2 or 3 days and it can be quite severe, as you've described. Fortunately it does go away without specific treatment. Standard pain medicines, such as acetaminophen can be prescribed. You or your anesthesiologist may be able to obtain the records of your previous anesthetic and hospital stay. This will supply clues about what happened to you during your last surgery. Be sure to discuss your concerns with your anesthesiologist, whose job is to evaluate you thoroughly and come up with a plan to provide you with a safe anesthetic, with minimum side-effects. Good luck!