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Sex and gender differences in anesthesia: Relevant also for perioperative safety?
Daniela Filipescu1, Mihai Ştefan2
1Professor of Anesthesiology and Intensive Care Medicine, University of Medicine and Pharmacy "Carol Davila", Bucharest, Romania; Chief of Department - Anesthesia and Intensive Care Medicine 2, "Prof Dr CC Iliescu" Emergency Institute for Cardiovascular Diseases, Bucharest, Romania.
Abstract:
Sex (a biological determination) and gender (a social construct) are not interchangeable terms and both impact perioperative management and patient safety. Sex and gender differences in clinical phenotypes of chronic illnesses and risk factors for perioperative morbidity and mortality are relevant for preoperative evaluation and optimization. Sex-related differences in physiology, as well as in pharmacokinetics and pharmacodynamics of anesthetic drugs may influence the anesthesia plan, the management of pain, postoperative recovery, adverse effects, patient satisfaction, and outcomes. Further studies are needed to characterize outcome differences between men and women in non-cardiac, cardiac, and transplantation surgery in order to individualize perioperative management and improve patient safety. Transgender patients represent a vulnerable population who need special perioperative care. Gender balance increases team performance and may improve perioperative outcomes.
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