Surgery and anesthesia are safer today than ever before, thanks to continuing advances in science. But this doesn’t mean there is zero risk. In fact, surgery and anesthesia are inherently dangerous, and as with any medication or procedure, there is always the chance that something can go wrong. Certain patients are more likely to experience problems or complications and possibly even death than others because of their age, medical conditions, or the type of surgery they’re having. If you’re planning to have surgery, there are ways to lower your risk, including meeting with your anesthesiologist.
If you’re planning to have surgery, there are ways to lower your risk, including meeting with your anesthesiologist.
An anesthesiologist is a medical doctor who specializes in anesthesia, pain management, and critical care medicine. This medical expert is responsible for planning your anesthesia care, administering the anesthesia, and monitoring you during surgery. To do this effectively, the anesthesiologist will conduct a health assessment before your surgery to learn about any medical conditions you may have, medications you use, your other health habits, and your past experience with anesthesia. Having all this information will help the anesthesiologist keep you safe. For example, the anesthesiologist might:
- Choose certain medications over others that will be safer for you.
- Monitor closely for specific side effects or complications that might be more likely for you, and have a plan to address them should they occur.
- Advise you on how to lower your risk before surgery by doing things like stopping certain medications, quitting smoking, or losing weight if your surgery is not urgent.
Your anesthesia risk might be higher if you have or have ever had any of the following conditions:
- Allergies to anesthesia or a history of adverse reactions to anesthesia
- Heart disease (angina, valve disease, heart failure, or a previous heart attack)
- High blood pressure
- Kidney problems
- Lung conditions (asthma and chronic obstructive pulmonary disease, or COPD)
- Obstructive sleep apnea
- Seizures or other neurological disorders
Smoking, or drinking two or more alcoholic beverages a day, also increases your risk.
General anesthesia causes you to become unconscious. This type of anesthesia, while very safe, is the type most likely to cause side effects and to carry risks. Most side effects are minor and temporary, such as nausea, vomiting, chills, confusion for a few days, and a sore throat caused by a breathing tube.
However, though rare, there are some more serious risks to be aware of:
- Postoperative delirium or cognitive dysfunction – A condition called postoperative cognitive dysfunction can result in long-term memory and learning problems in certain patients. It’s more common in older people because an aging brain doesn’t recover from anesthesia as easily. In addition to the elderly, people who have conditions such as heart disease (especially congestive heart failure), Parkinson’s disease, or Alzheimer’s disease, or who have had a stroke before are also more at risk. It’s important to tell the anesthesiologist if you have any of these conditions.
- Malignant hyperthermia – Some people inherit this serious, potentially deadly reaction to anesthesia that can occur during surgery, causing a quick fever and muscle contractions. If you or any family member has ever had heat stroke or suffered from malignant hyperthermia during a previous surgery, be sure to tell the anesthesiologist.
- Breathing problems during and after surgery – Anesthesia can be more dangerous for patients who have obstructive sleep apnea, a condition that causes them to stop breathing while they sleep. In patients with this condition, anesthesia can cause the throat to close up during surgery and make it more difficult to regain consciousness and take a breath after surgery.
The safest type of anesthesia is local anesthesia, an injection of medication that numbs a small area of the body where the procedure is being performed. Rarely, a patient will experience pain or itching where the medication was injected.
Regional anesthesia, which numbs a larger part of the body, such as from the waist down, is also safer than general anesthesia, but it does carry some risks. Patients sometimes experience headaches after having regional anesthesia. In rare cases, the injection can cause a collapsed lung if the needle is inserted in the chest area. Nerve damage from regional anesthesia also is a rare complication.
Anesthesiologists are the most highly skilled medical experts in anesthesia care, pain management, and critical care medicine with the education and training that can mean the difference between life and death.