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Correspondence  |   September 1995
Altered Taste and Smell after Anesthesia: Cause and Effect?
Author Notes
  • Department of Anesthesiology, Sparrow Hospital, Lansing, Michigan 48912
Article Information
Correspondence
Correspondence   |   September 1995
Altered Taste and Smell after Anesthesia: Cause and Effect?
Anesthesiology 9 1995, Vol.83, 647-648.. doi:
Anesthesiology 9 1995, Vol.83, 647-648.. doi:
To the Editor:--Some time ago I submitted a letter to the editor relaying an incident in which a 47-yr-old woman experienced the onset of altered taste and smell approximately 6 weeks after having received an uneventful general anesthetic for cystoscopy and ureteroscopic stone extraction. The anesthetic consisted of 50 mg lidocaine and 200 mg propofol administered intravenously for induction, 80 mg succinylcholine to facilitate tracheal intubation, and 1-2% isoflurane in 60% N2O with oxygen for maintenance. The anesthetic was uneventful, and the patient was discharged to home the same day.
The letter was rejected for publication because there appeared to be no plausible causative factor. Because I could not find anything in the literature to support the claim, the editorial decision served to confirm my belief that a causal relationship did not exist. Unfortunately, the patient remained unconvinced and brought the matter to litigation.
During the process of discovery, I obtained a copy of a letter written to the patient's husband from a Robert I. Henkin, M.D., a taste-and-smell specialist from Washington, D.C. In his letter, Henkin related the patient's symptoms to the anesthetic she had received. Specifically, he blamed halogenated hydrocarbons as being capable of inducing taste and smell distortions, although the patient had received a halogenated ether. In addition, Henkin referred to the textbook Otolaryngology [1] as a source to support his view. Of course, Henkin is the author of the chapter "Olfaction in Human Disease" in the book. The only references to anesthesia or surgery as causative factors are found in Table 1on page 3 and Table 4 on page 18. [1] These tables were compiled from the results of a survey carried out by the author. Clearly, almost 70% of cases of taste and smell dysfunction are related to postinfluenza (24.8%), idiopathic (19%), head trauma (15.4%), and allergic rhinitis (10.4%); 3.5% of patients related symptoms after systemic surgery. It would seem that the evidence implicating anesthesia as a cause for the patient's complaints is circumstantial at best.
Table 1. Taste and Smell Dysfunction after General Anesthesia
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Table 1. Taste and Smell Dysfunction after General Anesthesia
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The lawsuit has been dismissed with prejudice. These events have made me realize how important it is for anesthesiologists to be aware and wary of what our colleagues in other disciplines are telling our patients about anesthesia.
Bruce T. Adelman, M.D., Department of Anesthesiology, Sparrow Hospital, Lansing, Michigan 48912.
(Accepted for publication June 12, 1995.)
REFERENCE
REFERENCE
Henkin RI: Olfaction in human disease, Otolaryngology. Edited by English GM. New York, Harper and Row, 1982, pp 1-39.
Table 1. Taste and Smell Dysfunction after General Anesthesia
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Table 1. Taste and Smell Dysfunction after General Anesthesia
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