Anaesthesia Q&A with Dr Anton Krige – Summary

This Q&A features Dr Anton Krige, Consultant Anaesthetist, addressing questions from patients—particularly those with ME/CFS—about anaesthesia, pain management, and hospital care.

Low Dose Naltrexone (LDN) and Surgery

• LDN may reduce the effectiveness of opioid pain relief.
• Regional anaesthesia and multimodal (non-opioid) pain relief are preferred.
• LDN is unlicensed in the UK and not widely known among NHS doctors.

Emergency Surgery and LDN

• Pain relief would rely on nerve blocks and non-opioid medications.
• General anaesthesia may still be used alongside regional techniques.

Modafinil Use

• Not used in NHS anaesthesia; primarily prescribed for narcolepsy.

Self-Administering Medication in Hospital

• Must be discussed with the hospital team and pre-op clinic.

Hospital Pain Teams

• Acute Pain Teams manage post-operative pain and are led by anaesthetists.
• Chronic Pain Clinics may offer treatments like IV lidocaine for certain pain conditions (not ME itself).

POTS Awareness

• Most anaesthetists are not familiar with POTS.
• Few cardiologists in the UK specialise in it.

Allergies to Surgical Tapes

• Common issue; alternatives like Mefix and Mepore are available.
• Inform the anaesthetist and nurse on the day of surgery.

Anaesthetist Training Pathway

• 5 years medical school → 2 years foundation → 7 years specialty training.
• Additional training for sub-specialties like ICU, paediatrics, and pain management.

Roles Beyond the Operating Theatre

• Anaesthetists also work in critical care, pain clinics, pre-op assessments, and research.

Impact of COVID-19

• Shifted to full-time critical care with more frequent, shorter shifts.

Training on ME for Anaesthetists

• Advocates for including ME in comorbidity education.
• An educational article on ME and anaesthesia is in development for publication.

Improving Outcomes for ME Patients

• Not about new procedures, but increasing awareness and understanding.
• Anaesthetists already have the skills—just need patient-specific knowledge.