Anesthesia for Tattoos Should Follow Same Safety Standards as Elective Surgery

CHICAGO – With the emerging trend of using anesthesia or sedation for lengthy tattoo sessions, the American Society of Anesthesiologists (ASA) issued new guidance urging caution to emphasize that these procedures should meet the same safety standards as any elective surgery or procedure.

Pain management for tattooing typically includes topical anesthetics, ice packs or breathing techniques. However, as tattoo sessions have grown longer and more detailed — sometimes lasting eight hours or more — some people have opted to use anesthesia to minimize the pain and reduce the number of sessions.

To maximize safety and ensure the best care, ASA stresses that anesthesia should always be administered by a qualified anesthesia professional, such as an anesthesiologist, in a facility equipped to handle emergencies and monitor patient safety, just as is done for a colonoscopy, MRI, plastic surgery, or any other procedure. Anesthesiologists follow key safety practices recommended by the ASA. These include standards and statements for pre-anesthesia evaluation, basic monitoring during procedures, post-anesthesia care, and safe use of propofol. ASA also provides specific recommendations for various health care settings, including office-based procedures and outpatient (ambulatory) surgery.

“Choosing to undergo anesthesia for a tattoo comes with risks that go beyond the tattoo itself, and should be approached with serious consideration, like you would for any other elective surgical or cosmetic procedure,” said ASA President Donald E. Arnold, M.D., FACHE, FASA. “Anesthesia is very safe when delivered by an anesthesiologist, who has the education and training to provide the best care, including determining the most appropriate anesthesia for each patient, monitoring their vital signs during the procedure and managing complications if they arise.”

To ensure safety, the ASA guidance advises that patients who opt for anesthesia or sedation for tattoos:

• be informed of the risks associated with anesthesia and sedation,
• undergo a pre-procedure evaluation, including medical history and physical examination, to assess their overall health for anesthesia. Patients should share any medical records and health conditions with their anesthesiologist and understand they may need additional medical testing before the procedure, and
• review and consent to an anesthetic plan and post-anesthesia care, including post-procedure transportation and recovery care instructions, which require patients to recover before leaving the facility and have a ride home, as with any procedure involving anesthesia.

“Patients should understand that a tattoo artist's studio is not a medically appropriate setting for anesthesia,” said Dr. Arnold. “Only facilities with the necessary emergency equipment, staff, and protocols should be used — chosen by the anesthesiologist based on the patient’s health, the duration of the tattooing session and safety requirements.”

Additional considerations for patients receiving anesthesia for a tattoo are the same as those for elective surgery, such as avoiding eating or drinking before the procedure and being prepared to have a urinary catheter if the procedure is long. ASA also notes that long periods of lying still increase the risk of bruising or soft tissue or nerve damage. When awake, people can alert their tattoo artist that they need a break or to reposition. When the patient is under anesthesia, the anesthesia professional has the expertise to reposition the person appropriately and comfortably as needed.

ASA’s guidance underscores that the desire to minimize tattoo pain should not come at the expense of patient safety and that qualified anesthesia professionals and appropriate medical facilities are essential when anesthesia is involved, no matter the setting or the procedure.

Read ASA's full Patient Guidance on Anesthesia Care for Tattoo Procedures. Learn more about anesthesia for tattoos and download our Anesthesia Care for Tattoo Procedures checklist at https://madeforthismoment.asahq.org/anesthesia-for-tattoos/.

THE AMERICAN SOCIETY OF ANESTHESIOLOGISTS
Founded in 1905, the American Society of Anesthesiologists (ASA) is an educational, research and scientific society with more than 59,000 members organized to advance the medical practice of anesthesiology and secure its future. ASA is committed to ensuring anesthesiologists evaluate and supervise the medical care of all patients before, during, and after surgery. ASA members also lead the care of critically ill patients in intensive care units, as well as treat pain in both acute and chronic settings.

For more information on the field of anesthesiology, visit the American Society of Anesthesiologists online at asahq.org. To learn more about how anesthesiologists help ensure patient safety, visit asahq.org/madeforthismoment. Follow ASA on Facebook, X, Instagram, Bluesky, and LinkedIn.

# # #