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General anesthetic management of a patient with multiple chemical sensitivity for oral surgery: a case report
Aiji Sato Boku1, Shota Furuno2, Yuji Kamimura3
1Department of Anesthesiology, Aichi Gakuin University School of Dentistry, 2-11 Suemori-dori Chikusaku, Nagoya, 464-8651, Japan. bokuaiji@dpc.aichi-gakuin.ac.jp.
Background:
Multiple chemical sensitivity (MCS) was first described in 1987. It is said that MCS is caused by neurological and immunological mechanisms in addition to psychosomatic mechanisms. When performing general anesthesia in patients with MCS, careful perioperative management is necessary.
Case Presentation:
The patient was a 32-year-old man. Wisdom teeth extraction under general anesthesia was scheduled under the diagnosis of pericoronitis. In 2015, he was diagnosed with MCS. Since then, he experienced sweating and urticaria when exposed to artificial fragrances. We prepared the surgical surroundings by letting the patient touch every possible equipment. In selecting the anesthetic drugs, a completely intravenous route was selected because of the possibility that artificial fragrance of inhalation anesthesia could induce symptoms. There was no allergic reaction during the preoperative period.
Conclusions:
It is important to reduce psychological burden of patient and to eliminate all possible reactive substances to prevent symptom onset.
