Anesthesia in patients with multiple chemical sensitivity: current understanding

Multiple Chemical Sensitivity (MCS) is a pathological condition that we do not yet have a clear understanding of from an etiological and clinical point of view. The underlying mechanisms of the disorder are still being investigated and the most frequently reported symptoms by patients are malaise, fatigue, headache, arthralgia, insomnia and dermatitis. Although this condition may entail a real risk of the occurrence of adverse reactions following exposure to many substances, often inhaled, or the taking of drugs, medical/scientific literature provides only a little information regarding the safest course of action to be taken when patients affected by MCS need to undergo anesthesia. It is for this reason that an electronic search of existing literature has been made, using PubMed and Scopus as a primary source, in order to find articles about patients affected by MCS and who have undergone anesthesia. The time frame considered was January 2000–December 2022. The research showed only 13 articles that dealt with anesthesia in patients with multiple chemical sensitivity in the years in question. Only 6 works, all case reports, describe the drugs used to perform anesthesia. Five cases were for general anesthesia and one was a case of subarachnoid block. No major complications related to anesthesiological practice were reported in any of the cases. The limited data does not enable the identification of anesthesiological practice and anesthetic drugs that can be used more safely in MCS patients, but the absence of serious adverse reactions in the case reports described, and in the literature in general, is reasonably reassuring about the possibility of anesthesia in MCS patients without causing serious complications by implementing easily achievable measures.