Catastrophic neurologic injury after a routine anesthetic is the kind of signal that stops you in your tracks, and that’s exactly why we’re talking about new perioperative recommendations for patients with maternal Venezuelan ancestry. We’ve seen reports of otherwise healthy adults and children who deteriorated after general anesthesia, with sevoflurane appearing repeatedly in the documented events. That pattern has led the American Society of Anesthesiologists and the Society for Pediatric Anesthesia to issue updated guidance aimed at preventing harm while the science catches up. We walk through what clinicians need to know about the suspected mitochondrial link and why maternal lineage matters for risk assessment. We also discuss why a negative family history does not reliably protect a patient and why laboratories must be explicitly alerted to the mutation of interest because it has been historically labeled a normal variant. Then, we get practical: how to screen for maternal Venezuelan heritage with care and sensitivity, how to explain the question without implying anything about immigration status, and how to approach anesthetic planning when definitive genetic testing is unavailable. We cover current thinking on avoiding volatile anesthetics, when regional anesthesia may help, considerations around propofol infusions, processed EEG monitoring, and postoperative observation for return to neurocognitive baseline. If this is helpful, please subscribe, share the episode with your team, and leave a review so more clinicians can find these patient safety updates.For show notes & transcript, visit our episode page at apsf.org: https://www.apsf.org/podcast/306-venezuelan-ancestry-anesthesia-alert/© 2026, The Anesthesia Patient Safety Foundation

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