The world of anesthesiology faces an unanticipated safety challenge as disposable e-cigarettes are found to contain neotame, an artificial sweetener with potential toxicity that may complicate perioperative care, paralleling growing evidence that hypertension influences postoperative delirium.
As e-cigarette use climbs among surgical populations, anesthesiologists are encountering a variable that could undermine patient safety. The introduction of neotame in common e-cigarettes poses new risks for anesthesia, based on preliminary findings from Duke Health Discovers Potentially Toxic Additive in E-Cigarettes, which are yet to undergo extensive clinical trials. Neotame’s incorporation into disposable devices raises speculative concerns about drug–chemical interactions that could potentially alter anesthetic pharmacodynamics and precipitate hemodynamic or neurologic instability.
Artificial sweeteners like neotame are of speculative concern in anesthesia contexts, with ongoing research needed to ascertain their perioperative impact. Earlier findings from Duke Anesthesiology suggest that additive toxicity may complicate perioperative outcomes, though specific guidelines on anesthetic adjustments in response to these sweeteners are not yet established.
Layered upon this, hypertension emerges as another potent contributor to perioperative cognitive risk. NIH-funded research highlights that patients with poorly controlled blood pressure face a markedly higher incidence of postoperative delirium, with an odds ratio of 2.5 (95% CI: 1.8–3.4), emphasizing the necessity of meticulous hemodynamic optimization throughout the perioperative period.
Collectively, these insights argue for an expanded preoperative evaluation that includes targeted screening for e-cigarette use and a rigorous approach to blood pressure management. Tailoring anesthetic strategies—whether by modifying agent choice, depth of sedation or intraoperative monitoring—may mitigate the dual threats posed by neotame toxicity and hypertensive cerebral vulnerability.
Key Takeaways:- The increasing use of e-cigarettes, particularly those containing neotame, presents new anesthesia risks due to potential toxicity.
- Artificial sweeteners, like neotame, should be carefully considered in anesthesia planning for their possible implications on patient safety.
- Hypertension has been shown to significantly impact postoperative cognitive outcomes, stressing the importance of managing blood pressure perioperatively.
- Future anesthetic protocols may need to adjust in response to these evolving insights, demanding closer monitoring and preoperative evaluations.