Those familiar swirling red and white stripes along a barber’s pole once advertised gruesome medical treatments. In the 1100s, monks were forbidden by papal decree from bloodletting. Because haircutters owned sharp instruments as part of their profession, they started performing these “procedures”. Soon their medical offerings included tooth extractions, setting broken bones, and suturing wounds. The red stripes found on barber poles became a representation of blood, the white stripes bandages. Unfortunately, these procedures did not include anesthesia. There was a stick for gripping––perhaps, symbolized by the barber’s pole––and that’s about it.
Barber-surgeons “operated” until the mid-1700s. Even long after that, painful medical procedures were done without anesthesia–other than a few gulps of whiskey. In the 1840s, William T.G. Morton sought a more effective anesthetic other than the nitrous oxide being used by his fellow dentists. Collaborating with surgeon John Collins Warren, Morton demonstrated ether’s effectiveness as an anesthetic in 1846. With many advancements and discoveries since then, pain-free and safe surgery has been available for over 150 years. If you or a loved one is preparing for surgery, it is normal to be worried about side effects from anesthesia. So what are they and how should you prepare for surgery?
Anesthesia Safety
Almost everyone tolerates anesthesia with very little side effects. In the 1960s, there was at least one anesthesia-related death for every 10,000 surgeries. Today it’s closer to one out of 200,000 surgeries. There can be risks, especially for patients who may be more medically complex such as those over the age of 60 or have pre-existing cardiac conditions. Generally speaking, patients have a much higher risk from the surgical procedure than from the anesthetic.
General anesthesia is usually used for longer, more serious surgeries. For shorter, less serious procedures a local anesthetic and or sedation can potentially be used. With either anesthetic, these have few side effects.
Side Effects of General Anesthesia
Some of the more common side effects from anesthesia may include decrease in body temperature, nausea and vomiting, muscle aches, injury to mouth or teeth, and rare but serious complications.
Although strictly monitored, during surgery your temperature can drop. That’s why you’ll likely feel cold upon awakening. Similarly, you may feel sore afterward because of muscle relaxants used during surgery, or even a bit itchy as a side effect of opioids that might be used. One common side effect related to general anesthesia is a bit of mental fuzziness. As you regain consciousness in the recovery room, you might wonder where you are. You might later forget conversations you have immediately upon awakening. Doctors recommend that you avoid driving a car or making important decisions for up to 48 hours after surgery. However, some older people take longer to recover. If a loved one seems to be having difficulties with memory or other uncharacteristic mental issues, you will want to consult your healthcare provider before a procedure that involves anesthesia. You can lower these risks by avoiding certain medications used during an anesthetic which can be discussed with your anesthesia provider prior to surgery.
It’s normal to have some nausea and vomiting along with dry mouth and possibly even difficulty urinating. Again, these are short-term side effects from anesthesia.
One extremely rare side effect is post-traumatic stress disorder due to intraoperative awareness. In serious and rare cases, this can lead to anxiety and PTSD-like symptoms. Certain surgeries, such as heart and OB surgery can have higher incidence of intraoperative awareness. However, keep in mind this is an extremely rare complication and to discuss any concerns with your anesthesiologist prior to surgery.
The risks of forgoing surgery can be far greater than the risks of complications from anesthesia. Before the operation, the anesthesiologist will ask about risky behaviors. Heavy drug users may be harder to sedate; and those who drink heavily or smoke are at more risk for complications. Be honest about your habits, and don’t forget to discuss allergies. If you’re obese, have high blood pressure, lung conditions, diabetes, or a number of other conditions you may be at greater risk for side effects from general anesthesia. Remember, It’s normal to be concerned. If you follow your doctor’s pre-surgery guidelines and avoid eating, drinking, or taking prohibited medications prior to your procedure, the risk of anesthesia can be greatly minimized.
Written by John Bankston
References
- Historical development of modern anesthesia
- How Safe Is Anesthesia? 5 Common Concerns
- Anesthesia-related Cardiac Arrest
- Local anesthesia side effects
- Lasting effects of general anesthetics on the brain in the young and elderly: “mixed picture” of neurotoxicity, neuroprotection and cognitive impairment
- Clinical Evidence for Any Effect of Anesthesia on the Developing Brain
- 5th National Audit Project (NAP5) on accidental awareness during general anesthesia: summary of main findings and risk factors
- Update on post-traumatic stress syndrome after anesthesia
- Anesthesia Risks