Mitochondrial Genetic Susceptibility to Anesthetic Neurotoxicity in Venezuelan Pediatric Patients: A Call for Vigilance and Further Research

Maternally inherited mitochondrial mutations may underlie severe neurological injuries and fatalities observed in Venezuelan pediatric patients following routine general anesthesia. This pharmacogenetic vulnerability notably increases neuronal sensitivity to inhalational anesthetics like sevoflurane. Our findings advocate for the avoidance of sevoflurane as an induction agent in this population, favoring safer intravenous alternatives. Given limited genomic surveillance and underreporting in Latin America, the actual prevalence and impact of this mutation remain unclear. Urgent research priorities include comprehensive genomic sequencing, metabolic profiling, and pharmacokinetic studies to clarify the mutation’s role and guide anesthetic management. Immediate clinical measures should incorporate enhanced perioperative vigilance and family history assessment. To mitigate this emerging risk, strengthened transnational pharmacovigilance cooperation and capacity building in genomic diagnostics are essential. This work underscores the need for heightened awareness, diagnostic preparedness, and preventative strategies to protect genetically predisposed pediatric patients from anesthesia-related neurotoxicity.