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Review
. 2025 Mar 23;17(3):e81040.
doi: 10.7759/cureus.81040. eCollection 2025 Mar.

Anesthetic Considerations in Athletes: A Review

Mohd Batchi  1 , Hashaam Ghafoor  1   2 , Anwar Ul Huda  1 , Ali O Mohamed Bel Khair  1 , Osman Ahmed  1   2 , Ekambaram Karunakaran  1 , Siddalingappa Suresh Orekondi  1 , Shameen Salavudheen  1 , Mohamed Sheriff Poolakundan  1 , Jagadish Adiga  1 , Tafazzul Husain  1 , Aisha Abdalraheem Hamad Elawad  1 , Ahmed Hussein Mohamed Almaqadma  1
Affiliations
Review

Anesthetic Considerations in Athletes: A Review

Mohd Batchi et al. Cureus. .

Abstract

Athletes present a unique challenge for anesthesiologists because of their specific physiology and the demands of their sport. Anesthesia for athletes requires careful consideration of factors such as muscle mass, hydration status, and the potential for drug interactions with performance-enhancing substances. Additionally, the use of specific anesthetic agents, such as inhalational and intravenous anesthetics, requires adjustments to the dosing regimen to ensure adequate anesthesia. Sports anesthesia is a subspecialty that encompasses not only expert knowledge regarding regional and general anesthesia and pain management but also the pathophysiology unique to athletes and psychological concerns associated with professional sports and complete knowledge about World Anti-Doping Agency guidelines as well as substance abuse. Moreover, the pressure of being scrutinized by a broad circle of concerned persons, including family members, team members, coaches, club owners, media, and fans, makes this an area of excellence and expertise. This review highlights how an athlete's physiological changes can alter anesthetic drug effects. Considering the importance of vigilant preoperative assessment, selecting the proper anesthesia plan, and perioperative strategies for better recovery and performance outcomes.

Keywords: anesthesia consideration; athlete; complications; performance enhancing drugs; sport medicine.

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Conflict of interest statement

Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.

Figures

Figure 1
Figure 1. Changes in the relative proportion of FW, LBW, and TBW with increasing BMI for a male 1.75 m in height
FW: fat weight; LBW: lean body weight; TBW: total body weight Credit: Permission to reproduce this image has been obtained from reference [2].
Figure 2
Figure 2. The ECG of a 29-year-old male asymptomatic soccer player demonstrating sinus bradycardia (resting heart rate of 44 bpm)
This ECG also demonstrates early repolarization in I, II, aVE V2 to V6 (arrows), voltage criterion for LVH (S-Vl 1 RVS > 35 mm), and tall, peaked T-waves (circles). LVH: left ventricular hypertrophy Credit: Permission to reproduce this image has been obtained from reference [55].
Figure 3
Figure 3. Differentiating HCM and physiologic cardiac changes in an athlete (athlete’s heart)
HCM: hypertrophic cardiomyopathy; LV: left ventricular; LA: left atrium Credit: Permission to reproduce this image has been obtained from reference [56].
Figure 4
Figure 4. Anatomical features and variations in coronary artery anomalies. (A) Illustration showing a slit-like ostium, where the coronary artery’s orifice is elongated compared to the normal rounded ostium of the right coronary artery. (B) Depiction of an interarterial course of the coronary vessel, passing between the aorta and the pulmonary artery. (C) Acute take-off angle of the coronary artery, with the proximal segment emerging at an angle of <45° and a tangential course. (D) Proximal narrowing of the vessel, characterized by >50% narrowing of the proximal cross-sectional diameter and an elliptic shape (height/width ratio > 1.3), often associated with segmental hypoplasia
LAD: left anterior descending; RCA: right coronary artery; PA: pulmonary artery Credit: Permission to reproduce this image has been obtained from reference [64].
See this image and copyright information in PMC

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