Progressive systemic sclerosis-clinical manifestations and anesthetic considerations

Progressive systemic sclerosis (PSS), also known as scleroderma, is a complex disease that involves multiple organ systems. Patients with PSS can pose significant challenge for an anesthesiologist. As the disease progresses, profound pulmonary, gastrointestinal, renal, cardiac, and musculoskeletal system changes occur. An anesthesiologist should understand these complex pathophysiological processes in order to minimize potential risks including aspiration and other pulmonary complications. In addition, the potential for reduced renal function and intraoperative hypothermia-induced vasospasm must be considered. Meticulous preoperative assessment and diagnostic evaluation along with prudent intraoperative management is critical to minimize potential postoperative complications.