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"What if I don't wake up?" (preventing general anesthesia complications)(includes American Society of Anesthesiologists anesthesia checklist)

Patients facing surgery with general anesthesia are prone to ask themselves this question. Fortunately, the fear of this possibility has little basis in fact. Serious complications from anesthesia rarely occur unless there has been a prior, unrecognized medical problem.

Fast-acting medications and new monitoring devices, together with improved safety standards in the use of anesthetic equipment, make modern anesthesia ten times safer than it was 20 years ago--and 100 times safer than 40 years ago. Moreover, with most general anesthetic agents in use today, the traditional unpleasant side effects--postoperative nausea, vomiting, prolonged drowsiness or headache--are much less common. Some intravenous agents are so free of such effects that ambulatory surgery patients can sometimes leave the recovery room and be safely driven home within a very brief time following their surgical procedure.

The American Society of Anesthesiologists has instituted such standards as requiring qualified members of the anesthesia team to be present throughout any procedure involving the use of anesthetics, and continual monitoring of oxygen levels, circulation, breathing, etc. Two new monitoring devices that help ensure an adequate supply of oxygen are the pulse oximeter, which reads blood oxygen levels by transmitting a special light into the blood vessels, and the end-tidal capnograph, which measures the amount of carbon dioxide in each breath.

Modern anesthetic drugs and technology have greatly enhanced the safety of surgical procedures, but the anesthesiologist must still rely on knowledge of the patient's medical history to use these tools to maximum advantage. Such information is often not available in emergency situations, however, when a patient arrives at the hospital unaccompanied by a knowledgeable family member and is unable to give a lucid history of his or her medical problems.

Yes, anesthesia complications and deaths do still occur, but they are usually the result of human error--and they are so rare that you're more likely to be seriously injured or killed driving to or from the hospital than while in the operating room.


The American Society of Anesthesiologists recommends that we take the time to review our own health history and that of family members by taking the following health quiz, entering and dating the information on a wallet-sized card, and always carrying it with us:


A: ALLERGIES (reactions to food, medicines, etc.)? N: NEUROLOGICAL conditions (like epilepsy, stroke)? E: ESOPHAGEAL conditions (like epilepsy, stroke)? S: STOMACH problems (ulcers or eating disorders)? T: TEETH (any loose teeth, dentures, or bridgework)? H: HEART disease (hearth attacks, family history)? E: EMPHYSEMA, asthma, or other lung diseases? Are you a smoker? S: SURGERIES in the past, and any anesthetic complications? I: IMMUNE SYSTEM (deficiencies, hepatitis, immunizations)? A: ARTHRITIS (or other conditions restricting movement)? M: MEDICATIONS (prescriptions and over-the-counter drugs)? E: ENDOCRINE disease (like diabetes, thyroid)?
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Author:Brown, Edwin W.
Publication:Medical Update
Date:Mar 1, 1996
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