An Update on Systemic Sclerosis and its Perioperative Management

Area of Science:

• Immunology
• Rheumatology
• Anesthesiology

Background:

• Systemic sclerosis (SSc) is a complex autoimmune disease causing fibrosis and organ dysfunction.
• Its rarity and multi-system involvement pose challenges for anesthesiologists.
• Limited evidence-based guidance exists for perioperative care in SSc patients.

Purpose of the Study:

• To review current evidence on SSc pathophysiology and management.
• To analyze anesthesia-related literature for SSc patients.
• To propose an optimal perioperative strategy for SSc care.

Main Methods:

• Literature review of SSc pathophysiology and management.
• Analysis of anesthesia-specific studies in SSc.
• Extrapolation of findings into perioperative recommendations.

Main Results:

• SSc patients face increased risks of perioperative myocardial infarction.
• High prevalence of interstitial lung disease and pulmonary arterial hypertension in SSc.
• Neurological disease, gastric dysmotility, and difficult airways are common in SSc.

Conclusions:

• Improved SSc medical management increases the number of patients needing perioperative care.
• Optimal perioperative strategy must address systemic manifestations beyond airway challenges.
• Risk stratification should include cardiac, pulmonary, and neurological factors in SSc.