Vitamin deficiency, a neglected risk factor for post-anesthesia complications: a systematic review

Some evidence highlights individuals lacking an adequate level of vitamins may experience heightened susceptibility to post-anesthesia complications. The current study summarized the previous evidence assessing the impact of deficient vitamin levels on complications and outcomes following anesthesia.

A comprehensive search in scientific English databases was conducted from January 2000 to January 2024. The inclusion and exclusion criteria were applied, the full-texts were thoroughly analyzed, and the risk-of-bias was assessed.

A multitude of 1322 published articles were discovered based on search strategy and 14 eligible papers were enrolled. The mean age of patients was 39.3 years and the majority were male. Patients with vitamin B12 deficiency experienced both neurological and hematologic consequences post-anesthesia. Delirium was observed among patients lacking sufficient levels of vitamin D, and those deficient in vitamin K presented symptoms indicative of epidural hematoma. Post-anesthesia consequences were manifested with a delay, ranging from hours to days following the anesthesia procedure in vitamin K and B12 deficiency, while patients deficient in vitamin C and B1 experienced an acute onset of symptoms during surgery. Significantly, a notable proportion (42%) had pre-existing risk factors for vitamin deficiency prior to the surgery, while 35% of the risk-factors for vitamin deficiency were diagnosed after the surgery. There was a wide range of complete or partial recovery periods following surgical intervention, spanning over a few days up to several months according to the severity of symptoms.

Based on the evidence from the reviewed studies, this study robustly suggests that serum vitamins level before surgery should be measured among patients who are at risk of vitamin deficiency or have some related clinical symptoms.