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Continuing Education in Anaesthesia, Critical Care & Pain Advance Access originally published online on March 4, 2009
Continuing Education in Anaesthesia, Critical Care & Pain 2009 9(2):61-64; doi:10.1093/bjaceaccp/mkp004
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© The Author [2009]. Published by Oxford University Press on behalf of The Board of Directors of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Anorexia nervosa: perioperative implications

Angela M. Denner, MBBS BSc MRCP
Specialist Registrar in Anaesthetics
Department of Anaesthesia
Poole Hospital
Longfleet Road
Poole
Dorset BH15 2JB
UK

Stephen A. Townley, MB BCh BSc MRCP FRCA
Consultant Anaesthetist
Department of Anaesthesia
Royal Hampshire County Hospital
Romsey Road
Winchester
Hants SO22 5DG
UK
Tel: +44 1962 825042 Fax: +44 1962 825044; E-mail: stephentownley@hotmail.com

The first 150 words of the full text of this article appear below.


Key points

Anorexia nervosa may affect any physiological system.
Electrolyte disturbance is common.
All patients should be anaesthetized as though they have a full stomach.
Careful perioperative positioning and body temperature regulation are vital.
A collateral history should be sought from family members/GP as patients often conceal information.

 

Anorexia nervosa is a psychiatric disorder with multi-system physiological sequelae. The lifetime risk for developing the full disorder in women is thought to be 0.3–1%1 and the prevalence among teenagers and young women is ~0.3%.2 Males account for 10–20% of cases.

Formal diagnostic criteria may be found in the International Classification of Diseases, 10th Revision (ICD-10) (Table 1). The disorder is characterized by strict, psychologically driven weight loss which is attained by restricting food intake. Weight loss may be further augmented by overexercise and purging practices. There are two broad types of anorexia nervosa represented in approximately equal proportions. The restricting . . . [Full Text of this Article]


   Physiological sequelae of anorexia nervosa
 
Cardiovascular

Respiratory

Renal

Gastrointestinal

Endocrine

Immunological and haematological

Neurological

Musculoskeletal

Dermatological


   Anaesthetic considerations
 

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