Steinkirchner et al. (2026)
- Authors: Felix M. Steinkirchner, Christina K. Kaufmann, Richard F. Kraus, Maximilian Käss, Elisabeth Schieffer, Bernhard M. Graf, Christoph Lassen, Viktoria Kimmerling, Alexander Dejaco
- Institutes: Department of Anesthesiology, ME/CFS Research Group, University Hospital Regensburg, Regensburg, Germany, Department of Cardiology, Angiology and Intensive Care, University Hospital Gießen and Marburg, Marburg, Germany
- Publisher: medRxiv
- Link: DOI
Summary
This study is the first systematic attempt to compare the surgical experiences of ME/CFS patients against a matched control group. It confirms that while general anesthesia is hemodynamically safe, ME/CFS patients face a significantly higher burden of postoperative pain and require more intensive pain management. These findings provide a necessary clinical foundation for developing disease-specific perioperative guidelines and emphasize the need for anesthesiologists to prepare for increased analgesic requirements in this population.
What was researched?
The study investigated the intraoperative hemodynamic stability and early postoperative recovery outcomes, such as pain and nausea, in patients with ME/CFS undergoing general anesthesia.
Why was it researched?
Due to the autonomic and immune dysregulation seen in ME/CFS, there are concerns regarding surgical safety, yet clinical data to guide perioperative management has been almost entirely lacking.
How was it researched?
Researchers conducted a retrospective matched-pair analysis at a German tertiary center, comparing 15 ME/CFS patients with 15 controls matched for age, sex, and procedure type between 2015 and 2026.
What has been found?
ME/CFS patients exhibited lower minimum heart rates and systolic blood pressure during surgery, but these remained within safe limits. Notably, ME/CFS patients reported much higher maximum pain scores (5.0 vs 1.0) and required opioid 💊 rescue analgesia significantly more often (80% vs 33%) than controls.
Discussion
The study is limited by its small sample size and retrospective design, which prevented the systematic tracking of post-exertional malaise (PEM). However, the use of matched pairs and manual verification of diagnoses strengthens the reliability of the observed pain differences.
Conclusion & Future Work
General anesthesia appears to be well-tolerated hemodynamically in ME/CFS, but tailored analgesic strategies are essential to manage the increased postoperative pain burden. Future prospective research is needed to evaluate long-term recovery and the impact of surgery on PEM.