ESRA19-0653\u2005Anesthesia for elite athletes: a systematic literature review

Abstract

Background and aims Sports participation has been growing rapidly since the 1960s. Anesthesiologists are increasingly confronted with athletes in a perioperative setting. the right choice of type of anesthesia technique, pain management of injuries, specific physiologic adaptations of the athlete and knowledge of prohibited substances are eminent for a correct approach of this subpopulation. This review aims to give an overview of athlete’s specific anesthetic management in perioperative and postoperative settings. Methods The study consists of a systematic search in PubMed, Medscape, and ResearchGate. the authors retrieved 881 articles using all MeSH terms of which 243 articles were screened using the search criteria referring to anesthetic management in the perioperative setting and after removing duplicates. Seventy-nine articles were eligible for full-text assessment and 63 articles were included in this synthesis (figure 1). Abstract ESRA19-0653 Figure 1 Flowchart of the systematic review according to the PRISMA guidelines Results An anesthesiologist should recognize the most common benign ECG findings in athletes like bradycardia and isolated left ventricle hypertrophy. Preoperative evaluation should also identify possible consumers of performance-enhancing drugs. Intraoperative points of interest for anesthesiologists is mainly avoiding drugs on the prohibited list of the World Anti-Doping Agency (WADA). Post-operative and chronic pain management are still developing fields in this population. the International Olympic Committee (IOC) proposed treating acute pain with a combination of paracetamol, NSAIDs, topical analgesics, injectable NSAIDs and local anesthetics. Conclusions Although elite athletes are amongst the fittest people on earth, unique characteristics of this population requires careful preoperative evaluation and perioperative management. Chronic pain management in athletes is a developing field with a need for further expertise.