Baclofen and general anesthesia

[joethelion]

There are a couple of threads here warning about use of baclofen before or even after surgery involving general anesthesia but I felt it would be better to get more opinion about this, as it seems to be very important.

My wife is at 80mgs/day and will go through a surgery with general anesthesia. When we told the anesthetist about the bac, she simply decided `baclofen is not necessary!` and we chose not to tell her why she is taking the pills.

Normally my wife takes the pills 30 in the morning, 30 after lunch and 20mgs when going to bed. She will have the surgery at around 11.00am. So what we will possibly do is (also what the anesthetist agreed), she won`t take her night dose and the morning one, and she will continue normal dosage by starting with 30 when she will be able to have medication orally again, possibly in the afternoon.

Do you think this is conservative enough in terms of not causing interaction between bac and anesthetics ? And would it cause any withdrawal problems ?

Thanks in advance for any comments !

[Ne/Neva Eva]

Baclofen and general anesthesia

Geez, Joe. I have no idea of course. I'm not so sure I'd take the anesthesiologist's word for it, though. Bac withdrawal is not to be taken lightly. If your wife were taking it for a reason that the anesthesiologist might understand (for instance, spasticity) her response might be very different. If the anesthesiologist thinks it's an 'elective' thing (which it sort of is, but that doesn't mean the withdrawals might not be relevant) it would be easy for her to dismiss it. It seems to me that a second opinion, or more informed opinion, might be in order. You know?

It might not be a big deal, but I'd want to make sure.

[Xadrian]

Baclofen and general anesthesia

In my particular case, skipping 1 dose accidentally hasn't been a problem. It seems to take a while before the brain and body react to the withdrawal. When I tapered off baclofen I did it pretty abrubtly. From 50 mg to 10 mg for 3 days and then nothing.
Although in my case I only experienced severe headaches, I wouldn't recommend to do it like that.

By the way, as far as I know baclofen does not interact with the anaesthesia, so why can't she take her night dose?

[COSGringo]

Baclofen and general anesthesia

Get a 2nd opinion!

[RedThread12]

Baclofen and general anesthesia

I agree with the second professional opinion idea.

Here's my non-professional one, with some questions, first. How sensitive is your wife to variations in dose, and has she ever accidentally skipped one? 80 mg is not so much, in the big picture. Your plan would work fine for someone like me, who is not particularly sensitive to changes of as much as 20-30mg/day, and skipping a couple of doses. I'm don't think there's a precise amount of time before withdrawal symptoms start, but it seems you'll be working in about a 24 hour time period? So, if you can't get a second opinion, or that opinion supports the first, I think your plan is a good one. Just my $.02.

[joethelion]

Baclofen and general anesthesia

Honestly, there are days when she misses a dose. We associated one time with some mild cravings, but other than I`m not sure she had any withdrawal trouble with that. Hopefully there will be maximum 20 hours between 2 doses.

In fact she had another operation several months ago, also with general anesthesia, and she did take her night pills that time. Maybe if she takes them a bit early, it will be ok.

[cookinghappy]

Baclofen and general anesthesia

I would definitely be honest with the medics. They are there to care for her, not to judge her. They see people with all sorts of private lives every day. They do need to care for her in full knowledge of how her body might react to certain medicines. I do understand the embarassment, but it is important to be honest. Hope the op goes well!

[COSGringo]

Baclofen and general anesthesia

I agree. An anesthesiologist really needs to be on top of everything. Tricky stuff from what I understand.

[redhead77]

Baclofen and general anesthesia

Hi Joe,

I think I would ask the anesthetist/anesthesiologist what kind of anesthesia they planned to use and go from there. Your specific question of whether bac would interact with anesthetics would probably depend on what anesthetic is used (if you have the time before the surgery). At least the person administering the anesthesia already knows she's on it, so that's the important thing.

With that, you all (you, your wife, and the person administering the anesthesia, if you want to explain it to them) can decide how best to proceed. I think there are ways around this if you didn't want to divulge why she takes the bac.

I also think missing a dose or two wouldn't cause too much of a problem (not medical advice ), but it might not be necessary to miss both doses anyway (as you've indicated).

Good luck and may your wife's surgery go well! :l

[joethelion]

Baclofen and general anesthesia

Thanks a lot for the good wishes, and all the contribution !

It all went OK; she took her last dose (20 out of 80mg) yesterday at around 8pm (instead of 11pm); today skipped the morning dose (30mg) and took the mid day dose (30 mg) at 6pm, several hours after operation. No sign of withdrawal or interaction with anesthetics.

Thanks again

As a side note; recently it`s been 6 months since the nightmare ended; everything is still like a fairy tale (in terms of alcohol problem at least); we just go out once per week, have 2-3 glasses of wine and that`s it. Even on the new year`s eve, I was a little drunk but she didn`t even want the 4th glass; said she didn`t feel like it

[YouKayBee]

Baclofen and general anesthesia

In the Nal/TSM thread you say you and your wife have been following TSM. I assume this means she is taking Naltrexone and to me this is much more important. I presume she didn't take any for a few days before her op because this would have caused problems for the anaesthesia.

[redhead77]

Baclofen and general anesthesia

That's great news, Joe! I'm glad everything was okay.

UK, does nal cause problems with anesthesia? I was under the impression it was only opiates that could be a problem. I'd very much like to hear about it if you know of something. I haven't taken a naltrexone in some time, but would like to know in case I do, and just for the sake of knowledge. Thanks!

[YouKayBee]

Baclofen and general anesthesia

redhead77;1440123 wrote: That's great news, Joe! I'm glad everything was okay.

UK, does nal cause problems with anesthesia? I was under the impression it was only opiates that could be a problem. I'd very much like to hear about it if you know of something. I haven't taken a naltrexone in some time, but would like to know in case I do, and just for the sake of knowledge. Thanks!

Sorry for some reason I thought anaesthetics were opiod related, quick google shows they aren't so no problem.

[Cashregister]

Baclofen and general anesthesia

Any CnS inhibitor can cause issues with coming out of a general anaesthetic. Always be totally up front with your anaesthetist. What you take can really effect how you wake up. I've had over 20ops under general in the last 10years - be careful and tell all. Cashy xx

[Otter]

Baclofen and general anesthesia

My wife went through surgery on very high doses of baclofen and everything was fine but you must do what the docs say. They don't like you experimenting with their insurance policies.