Anesthesia Risks: What Patients Should Know

While the idea of "going under" may worry you, anesthesia risks are pretty low these days. As a matter of fact, not only have errors become relatively uncommon, but anesthesia is one of the safest areas of health care today, maintains Dale Bratzler, DO, MPH, medical director at the Oklahoma Foundation for Medical Quality in Oklahoma City.

But even so, anesthesia does still pose some risks. Here are ways to lower them:

• Ask your doctor about alternatives to general anesthesia. While general anesthesia is sometimes necessary, ask about other approaches -- like a local or spinal anesthetic. See if you might have a choice.

• See if you can meet with your anesthesiology team. This is a great way to go over your options and understand your anesthesia risks. Ask if your age or any other health conditions might affect your risks.

• Find out if any family members have ever had a bad reaction to anesthesia. Although very rare, some people do inherit a genetic susceptibility to have dangerous reactions to anesthesia. So it's always worth asking your family to make sure. If someone in your family has had such a reaction, tell your doctor.

• Make sure your doctor knows if you or anyone in your family has ever had a bad reaction to anesthesia before. This should go without saying, but some people just assume that their surgeon must already know their complete medical history. That isn't the case. Make sure to tell everyone -- nurses, anesthesiologist, and surgeon -- if you've ever had a problem with anesthesia before. Don't hesitate to repeat yourself.

• Follow the doctor's instructions about eating. The night before surgery, your doctor will probably tell you that you shouldn't eat anything after midnight. This is one of the most important instructions to follow. Why? If you go under anesthesia with food in your stomach, you may vomit up some of this food and breathe it in. This can lead not only to aspiration pneumonia but then potentially make it impossible to get oxygen into your lungs during the anesthesia procedure -- and without oxygen systems within your body fail and you can die. If you do eat after midnight, inform the surgical staff immediately; your surgery may need to be postponed or cancelled. Simply following your doctor's advice will almost eliminate this anesthesia risk.

Reviewed by Celia E. Dominguez, MD, July 20, 2007 .

SOURCES: Peter B. Angood, MD, vice president, chief patient safety officer, The Joint Commission, Oakbridge Terrace, Ill.; and co-director, International Center for Patient Safety. Dale Bratzler, DO, MPH, medical director, Hospital Interventions Quality Improvement Organization Support Center (QIOSC), Oklahoma Foundation for Medical Quality, Oklahoma City. Carolyn Clancy, MD, director, Agency for Healthcare Research and Quality (AHRQ), Department of Health and Human Services, Rockville, Md. Nancy Foster, vice president, Quality and Safety Policy, American Hospital Association, Chicago. Fran Griffin, RRT, MPA, director, Institute for Healthcare Improvement, Cambridge, Mass.