Anesthesia Isn't Risk-Free
Safety Of Anesthesia Is Questioned After Death
(CBS) In early January,
best-selling author Olivia Goldsmith died from complications of anesthesia
during plastic surgery, according to her literary agent.
The 54-year-old Goldsmith, who wrote "First Wives Club," was undergoing an
elective cosmetic procedure to remove loose skin from her chin. Her death raises
serious questions about the safety of anesthesia.
The Saturday Early Show's Dr. Mallika Marshall says there are a
few things a patient should know before going under the knife.
Marshall explains that deaths due to anesthesia are not common. Each year, more
than six million Americans undergo cosmetic surgery, and millions more have
procedures that require anesthesia.
The vast majority of people who have anesthesia make it through without any
problems. But, Marshall warns, anesthesia isn't risk-free. However, there are
some things you can do to reduce that risk.
There are several types of anesthesia:
Local anesthesia is used when only a small area of the body needs to be numbed.
It may be administered for a cut that requires stitches or a cavity that needs
to be filled. The medicine is introduced around the area being worked on, and
the patient remains completely awake.
Regional anesthesia involves a larger part of the body. Again, the patient
remains awake. An example is the epidural, which many pregnant women receive to
reduce the pain of childbirth.
Conscious sedation is also known as "twilight sedation." It's used to provide
sedation and pain relief during a procedure. The patient is usually groggy and
often doesn't remember much after the surgery. But patients under this kind of
sedation are conscious enough to communicate with the doctor and able to breathe
completely on their own. Conscious sedation is often used for wisdom tooth
extraction, colonoscopies and balloon angioplasty.
With general anesthesia, a person is so unconscious that they need a ventilator
to assist in breathing. General anesthesia is used in longer and more difficult
procedures such as abdominal or open heart surgery.
Marshall says there are guidelines for doctors to use in choosing which type of
anesthesia to use. For example, if a patient is having open heart surgery or
open abdominal surgery, they must be completely unconscious. In some minor
cases, patients may be given a choice of having conscious sedation or general
anesthesia. In these situations, Marshall recommends that patients have a frank
discussion with their doctor about the pros and cons of each option.
People who are at the highest risk of having a complication with anesthesia are
older individuals and people who have serious underlying medical conditions,
such as heart or lung disease.
With local anesthesia, side effects are rare. But, some people do get allergic
reactions to the anesthetic. Regional anesthesia can, in rare cases, cause nerve
damage. General anesthesia, however, carries the highest risk, because it
affects the entire body. It can cause fluctuations in blood pressure and an
irregular heartbeat -- and in extreme cases can lead to heart attack or stroke.
But again, these serious complications are rare, and occur in fewer than 1 in
10,000 people undergoing general anesthesia.
Marshall says patients can do a few things to prevent side effects. First, she
recommends that patient share their entire medical history with the
anesthesiologist and surgeon who will be present during the surgery. The doctors
need to know about all the medical conditions a patient may have and all the
medications that a patient is taking, because they could interfere with the
anesthetics being used.
For elective surgery, Marshall says patients should make sure they choose
reputable doctors at a reputable medical institution.