Should a patient's gender alter the anesthetic plan?

A significant effort has been made in the past few years to determine whether a patient's gender has a significant effect on their anesthetic requirements or outcome. It remains unclear whether there is sufficient evidence to alter an anesthetic regimen based on a patient's gender.

In well-controlled studies, subtle pharmacokinetic differences between the sexes can be observed. Pharmacodynamic differences have also been observed between the sexes, particularly for muscle relaxants and opioids. Outcome studies have revealed that women are also more likely to experience adverse side-effects such as postoperative nausea.

There are subtle differences between men and women. However, these differences are of a similar magnitude to those that may exist between other commonly encountered factors, such as smoking versus non-smoking, occasional versus regular ethanol consumption, or perhaps, most importantly, the increased age of the patient. If these are combined with pre-existing medical conditions and other patient variables, such as ethnicity, the potential gender effect on anesthesia may easily be overshadowed.