Anaesthetic implications of anorexia nervosa

The provision of anaesthesia for patients suffering from anorexia nervosa or bulimia nervosa is not without its risks. The anaesthetist needs to appreciate that these eating disorders can predispose the patient to significant risk of multi-organ dysfunction related to starvation and purging. Any such organ dysfunction can have serious implications on morbidity and mortality. Therefore, careful peri-operative management is essential to avoid anaesthetic complications. Both disorders are common, with incidences in the general population of up to 30% in girls and young women. A review of the literature on the provision of anaesthesia for anorexic patients was carried out to evaluate the potential impact of these disorders on the patient's physiology and the subsequent implications for anaesthesia.