General anesthesia
When undergoing surgery, a patient may receive general anesthesia, which renders the patient unconscious, local anesthesia, which only numbs a part of the body, or sedation, which merely relaxes the patient without losing consciousness.
Note that general anesthesia may have severely debilitating effects on some people with ME/CFS. In some cases, these negative effects of general anesthesia appear to be permanent.
Some ME/CFS specialists recommend that patients avoid general anesthesia whenever possible. Several doctors have even produced documents outlining their recommendations for anesthesia:
The New Jersey ME/CFS Association has also produced a wallet-sized card you can download and print out. (Laminating the card appears to give the recommendations more heft with hospital personnel.)
At the dentist
When you go to the dentist, you may be offered injections to numb a part of the mouth. To do this, the dentist may use an anesthetic that includes epinephrine as a component. Epinephrine is also known as adrenaline.
Unfortunately, many people with ME/CFS report dramatically negative effects from injections containing epinephrine. Therefore, they are advised to ask their dentist for an anesthetic without epinephrine.
Why do patients have such dramatically negative effects from injections containing epinephrine? No one knows for sure, but Dr. David Systrom has one explanation. He explains that it might be due to a type of dysautonomia where there is inadequate stimulation of blood vessel constriction, and up-regulation of the post-synaptic epinephrine receptors.