Sato Boku Aiji, Furuno Shota, Kamimura Yuji, Sento Yoshiki, Kako Eisuke, Okuda Masahiro, Shibuya Yasuyuki, Sobue Kazuya
Department of Anesthesiology, Aichi Gakuin University School of Dentistry, 2-11 Suemori-dori Chikusaku, Nagoya, 464-8651, Japan.
Department of Oral and Maxillofacial Surgery, Nagoya City University Graduate School of Medical Sciences, 1 Kawasumi Mizuho-cho, Mizuho-ku, Nagoya, 467-8601, Japan.
JA Clin Rep. 2019 Feb 14;5(1):10. doi: 10.1186/s40981-019-0226-1.
Multiple 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.
The 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.
It is important to reduce psychological burden of patient and to eliminate all possible reactive substances to prevent symptom onset.
多重化学敏感性（MCS）于1987年首次被描述。据说，MCS除心身机制外，还由神经和免疫机制引起。在对MCS患者实施全身麻醉时，围手术期需要进行仔细的管理。
患者为一名32岁男性。在诊断为冠周炎后计划在全身麻醉下拔除智齿。2015年，他被诊断为MCS。从那时起，他接触人工香料时会出现出汗和荨麻疹。我们让患者触摸每一件可能用到的设备来准备手术环境。在选择麻醉药物时，由于吸入麻醉的人工香料可能诱发症状，所以选择了全静脉途径。术前期间未出现过敏反应。
减轻患者的心理负担并消除所有可能的反应性物质以预防症状发作很重要。
