Anesthetic problems in concomitant systemic lupus erythematosus (literature review)

Based on available literature sources, we have analyzed the impact of systemic lupus erythematosus (SLE) on organs and body systems, the main pathological aspects of the interaction of dosage forms used for its treatment with anesthetic drugs for the purpose of increasing the anesthetic safety of such patients during surgical interventions. Patients with SLE have different abnormalities of varying intensity. Numerous features of the course of the pathological condition create significant problems in the anesthetic provision of various surgical interventions. Anesthesia in emergency surgery in such patients can be difficult, since the time for developing perioperative strategies is limited. SLE is a very complex systemic autoimmune disease that presents major challenges in the surgical context; in the field of anesthesia, such patients should always be considered at higher risk. Given the heterogeneity of manifestations, it is difficult to establish unified management protocols, so the anesthesia plan must be appropriate for each specific case. Patients with SLE still have a higher incidence of postoperative complications and a 2- to 7-fold higher risk of in-hospital postoperative mortality compared to people without SLE. Anesthesiologists must be knowledgeable about the pathophysiology and potential organic lesions, which often affect airway patency, ventilation therapy, hemodynamic control, and renal function support. Therefore, multidisciplinary management and adequate preoperative assessment are essential for surgical risk stratification and readiness to avoid or treat serious complications such as bleeding, thrombotic, cardiovascular and other events early. A well-planned perioperative management and a skilled multidisciplinary team approach can contribute to a positive outcome of surgery and anesthesia in patients with SLE. Currently, there are no clear regulatory documents on anesthetic care for patients with concomitant SLE. This topic remains poorly studied, so there is an important problem in developing high-quality research that allow a better understanding of the anesthetic consequences of SLE with the creation of appropriate clinical protocols; facilitate the management of these patients; optimize the safety of anesthesia; reduce the rate of complications and associated mortality.

Abstract licence: CC BY

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