Anesthesia, General: Precautions

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Although the risks of serious complications from general anesthesia are very low, they can include heart attack, stroke, brain damage, and death. Anyone scheduled to undergo general anesthesia should thoroughly discuss the benefits and risks with a physician. The risks of complications depend, in part, on a patient's age, sex, weight, allergies, general health, and history of smoking, drinking alcohol, or drug use. Some of these risks can be minimized by ensuring that the physician and anesthesiologist are fully informed of the detailed health condition of the patient, including any drugs that he or she may be using. Older people are especially sensitive to the effects of certain anesthetics and may be more likely to experience side effects from these drugs.

Patients who have had general anesthesia should not drink alcoholic beverages or take medication that slow down the central nervous system (such as antihistamines, sedatives, tranquilizers, sleep aids, certain pain relievers, muscle relaxants, and anti-seizure medication) for at least 24 hours, except under a doctor's care.

People with certain medical conditions are at greater risk of developing problems with anesthetics. Before undergoing general anesthesia, anyone with the following conditions should absolutely inform their doctor.

ALLERGIES. Anyone who has had allergic or other unusual reactions to barbiturates or general anesthetics in the past should notify the doctor before having general anesthesia. In particular, people who have had malignant hyperthermia or whose family members have had malignant hyperthermia during or after being given an anesthetic

should inform the physician. Signs of malignant hyperthermia include rapid, irregular heartbeat, breathing problems, very high fever, and muscle tightness or spasms. These symptoms can occur following the administration of general anesthesia using inhaled agents, especially halothane. In addition, the doctor should also be told about any allergies to foods, dyes, preservatives, or other substances.

PREGNANCY. The effects of anesthetics on pregnant women and fetuses vary, depending on the type of drug. In general, giving large amounts of general anesthetics to the mother during labor and delivery may make the baby sluggish after delivery. Pregnant women should discuss the use of anesthetics during labor and delivery with their doctors. Pregnant women who may be given general anesthesia for other medical procedures should ensure that the treating physician is informed about the pregnancy.

BREASTFEEDING. Some general anesthetics pass into breast milk, but they have not been reported to cause problems in nursing babies whose mothers were given the drugs.

OTHER MEDICAL CONDITIONS. Before being given a general anesthetic, a patient who has any of the following conditions should inform his or her doctor:

• neurological conditions, such as epilepsy or stroke
• problems with the stomach or esophagus, such as ulcers or heartburn
• eating disorders
• loose teeth, dentures, bridgework
• heart disease or family history of heart problems
• lung diseases, such as emphysema or asthma
• history of smoking
• immune system diseases
• arthritis or any other conditions that affect movement
• diseases of the endocrine system, such as diabetes or thyroid problems

— Jennifer Sisk