Fibromyalgia: a primer for the anesthesia community

Area of Science:

• Anesthesiology
• Rheumatology
• Neuroscience

Background:

• Fibromyalgia is a chronic pain disorder characterized by widespread musculoskeletal pain, fatigue, and cognitive difficulties.
• Patients with fibromyalgia exhibit neurophysiologic abnormalities affecting sensory perception and neurotransmitter levels.
• While mood disorders are common, they do not solely explain fibromyalgia symptoms.

Purpose of the Study:

• To provide anesthesiologists with an overview of fibromyalgia.
• To discuss the potential implications of fibromyalgia in perioperative management.
• To contextualize fibromyalgia basics within the scope of anesthesia care.

Main Methods:

• Review of current research on fibromyalgia pathophysiology, diagnosis, and treatment.
• Analysis of neurophysiologic findings in fibromyalgia patients.
• Examination of recent diagnostic criteria and emerging therapeutic strategies.

Main Results:

• Fibromyalgia patients have altered central neurotransmitter levels, impacting pain inhibition and facilitation.
• A new self-report questionnaire from the American College of Rheumatology allows for continuum-based assessment of fibromyalgia severity ('fibromyalgianess').
• Emerging treatments include sodium oxybate, transcranial magnetic stimulation, and web-based cognitive behavioral therapy.

Conclusions:

• The impact of fibromyalgia on anesthesia care remains largely unknown.
• Significant pathophysiologic changes in fibromyalgia patients may affect anesthesia management.
• Future research is essential to elucidate the relationship between fibromyalgia and perioperative outcomes.