TxANA Clinical Advisory to Members: Emerging Anesthesia Safety Awareness
TxANA is sharing emerging safety information for CRNAs regarding rare but severe neurologic injury, including death, reported in otherwise healthy adult and pediatric patients of Venezuelan ancestry following routine anesthesia. While these events are uncommon, given the large population of individuals with Venezuelan ancestry in Texas, the severity warrants increased clinical awareness.
Reports originating from professional anesthesia networks in South America, and more recently in Europe and the United States, suggest affected patients share maternal Venezuelan heritage. Some individuals were found to carry inherited mitochondrial gene variants that may increase sensitivity to certain anesthetic agents. Sevoflurane exposure has been reported in many cases; however, access to complete anesthetic records is limited, preventing detailed comparisons of specific drugs, dosing, exposure duration, and monitoring practices. As a result, causation and relative risk remain unclear.
In the absence of definitive screening tools or formal practice guidance, TxANA encourages CRNAs to apply heightened clinical vigilance and professional judgment, particularly when caring for patients with maternal Venezuelan ancestry. Consider the following clinical principles:
This advisory reflects an evolving clinical signal rather than established evidence. TxANA supports continued professional dialogue, reporting, and shared learning as more information becomes available. As CRNAs, we remain committed to patient-centered care, situational awareness, and thoughtful clinical decision-making. Continue to look for announcements both from TxANA and the AANA as more information unfolds.
Reports originating from professional anesthesia networks in South America, and more recently in Europe and the United States, suggest affected patients share maternal Venezuelan heritage. Some individuals were found to carry inherited mitochondrial gene variants that may increase sensitivity to certain anesthetic agents. Sevoflurane exposure has been reported in many cases; however, access to complete anesthetic records is limited, preventing detailed comparisons of specific drugs, dosing, exposure duration, and monitoring practices. As a result, causation and relative risk remain unclear.
In the absence of definitive screening tools or formal practice guidance, TxANA encourages CRNAs to apply heightened clinical vigilance and professional judgment, particularly when caring for patients with maternal Venezuelan ancestry. Consider the following clinical principles:
- Incorporate maternal ancestry into the pre-anesthetic assessment when appropriate
- Individualize anesthetic technique based on patient factors and procedural urgency
- Closely assess neurologic recovery and return to baseline in the postoperative period
This advisory reflects an evolving clinical signal rather than established evidence. TxANA supports continued professional dialogue, reporting, and shared learning as more information becomes available. As CRNAs, we remain committed to patient-centered care, situational awareness, and thoughtful clinical decision-making. Continue to look for announcements both from TxANA and the AANA as more information unfolds.
