Steinkirchner, Felix M, Kaufmann, Christina K, Kraus, Richard F et al. · BMC anesthesiology · 2026 · DOI
This small study compared 15 ME/CFS patients undergoing surgery with 15 matched controls to see how their bodies responded to anesthesia and surgery. Patients with ME/CFS showed lower blood pressure and heart rate during surgery, and experienced more pain afterward and needed more opioid medication; however, no serious complications occurred during anesthesia. The study was not designed to capture post-exertional malaise (symptom flare-ups after exertion), which is a central feature of ME/CFS and may occur after surgery.
ME/CFS patients require surgery but receive minimal empirical guidance on how their disease affects anesthesia safety and postoperative recovery. This is the first matched cohort to systematically examine hemodynamic responses and postoperative pain in this population, suggesting that while general anesthesia itself may not cause instability, postoperative pain management requires additional attention and that delayed PEM remains unmeasured.
This study does not establish causal mechanisms, does not determine optimal anesthesia or analgesia protocols for ME/CFS, does not assess post-exertional malaise or delayed complications, and does not generalise beyond the small cohort of 15 patients from a single centre. It does not prove that current anesthesia practice is safe for all ME/CFS patients or that the observed pain differences reflect disease-specific biology rather than differences in pain reporting or management.
About the PEM badge: “PEM required” means post-exertional malaise was an explicit required diagnostic criterion for participant inclusion in this study — not that PEM was studied, observed, or discussed. Studies using criteria that do not require PEM (e.g. Fukuda, Oxford) are tagged “PEM not required”. How the atlas works →
The first block is for the primary paper and is the citation you should use in research work. The atlas-snapshot line only applies if you are specifically referring to this atlas’s reading of the paper on the date shown.
Primary citation
Steinkirchner, Felix M, Kaufmann, Christina K, Kraus, Richard F, Käss, Maximilian, Schieffer, Elisabeth, Graf, Bernhard M, et al. (2026). Perioperative outcomes in patients with myalgic encephalomyelitis/chronic fatigue syndrome undergoing general anesthesia: a retrospective matched-pair study.. BMC anesthesiology. https://doi.org/10.1186/s12871-026-04102-5
BibTeX
@article{mecfsatlas-steinkirchner-2026-perioperative-outcomes,
author = {Steinkirchner, Felix M and Kaufmann, Christina K and Kraus, Richard F and Käss, Maximilian and Schieffer, Elisabeth and Graf, Bernhard M and Lassen, Christoph and Kimmerling, Viktoria and Dejaco, Alexander},
title = {Perioperative outcomes in patients with myalgic encephalomyelitis/chronic fatigue syndrome undergoing general anesthesia: a retrospective matched-pair study.},
journal = {BMC anesthesiology},
year = {2026},
doi = {10.1186/s12871-026-04102-5},
note = {PubMed: 42464211},
url = {https://www.mecfsatlas.com/evidence/steinkirchner-2026-perioperative-outcomes},
}Atlas snapshot reference
ME/CFS Atlas. Generator v1 / Scanner v1.4 / policy v0.1. Accessed 2026-08-17. https://www.mecfsatlas.com/evidence/steinkirchner-2026-perioperative-outcomes
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