Abstract
BackgroundMultiple 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 presentationThe 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.ConclusionsIt is important to reduce psychological burden of patient and to eliminate all possible reactive substances to prevent symptom onset.
Highlights
Multiple chemical sensitivity (MCS) was first described in 1987
Kato suggested that MCS is caused by neurological and immunological mechanisms in addition to psychosomatic mechanisms [2]
We describe our experience of performing general anesthesia in a patient with MCS for extraction of wisdom teeth
Summary
Multiple chemical sensitivity (MCS) was first described by Cullen in 1987 and diagnostic criteria of MCS were defined (Table 1) [1]. When performing general anesthesia in patients with MCS, careful perioperative management is necessary because of the administration of multiple types of drugs. We describe our experience of performing general anesthesia in a patient with MCS for extraction of wisdom teeth. Due to the anatomical reasons, tooth extraction under general anesthesia was considered necessary general anesthesia had a high risk of exposure to many chemical substances. 5. Symptoms are elicited by exposures that are demonstrable (albeit of low level). 6. Exposures that elicit symptoms must be very low, by which we mean many SDs below average exposures known to cause adverse human responses. In 2015, the patient had similar symptoms even after exposure to a smoke concentration below the reference value as determined by occupational administrative measures (suspended particles of 0.15 mg/m3) and was diagnosed with MCS. Course of anesthesia During preoperative evaluation before anesthesia, the patient reported sharing a space with a person who uses
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