Reports of susceptibility to GA in certain patients of Venezuelan origin
There have been varied reports of extremely rare cases of severe neurological injury following general anaesthesia, in patients from Venezuela and Chile in particular.
The actual numbers are unclear as the information to date is largely from unpublished sources but seems to be less than 20 individuals (mostly paediatric) and with the cases going back over 20 years. A cohort study of seven patients of Venezuelan origin showed severe neurological deterioration after exposure to general anaesthesia, with increased vulnerability to sevoflurane being implicated [Rozo et al. 2025].
From a report by the Venezuelan Society of Anesthesiology (SVA), it is suggested that the neurological injury may be related to a specific mitochondrial DNA variant which is associated with the Carabobo state in Venezuela. Volatile anaesthetic agents may be more likely to trigger this injury than propofol, although information is still somewhat speculative at this stage. [Sanz-Pons J et al. 2026]. Formal investigation is necessarily continuing.
Alerts have been published by the SVA as well as the American Society of Anesthesiologists. Both societies highlight that information is mostly from informal sources and that evidence is still emerging. They emphasise that this is exceedingly rare, and linked to a very specific population.
Advice at this stage is that if a patient is identified who has maternal lineage from Venezuela, along with suggestive family history (for example, slow emergence from anaesthesia, unexplained death under or after anaesthesia etc.), they should be classified as Theoretical Mitochondrial Risk and managed under regional anaesthesia or a TIVA protocol avoiding exposure to inhalational anaesthetics.
The American Society of Anesthesiologists has information about genetic testing of high-risk individuals if facilities and time allows.
ANZCA and SPANZA will update this advisory as further information emerges.
