The risk of anesthetic related death and awakening during surgery is very small. They can be even reduced, and both the doctor and the patient have an impact on it, the anesthesiologist informs PAP.
Dr. Żaneta Jastrzębska-Stojko, the head of the team of anesthesiologists at the University Center for Ophthalmology and Oncology in Katowice emphasized in an interview with PAP that the risk of death cannot be completely eliminated. “It is determined on the basis of numerous studies. The total percentage of deaths that occur during anesthesia and surgery is 0,7%. Anesthesia alone may be responsible for 1 death in 10 people. anesthesia. As you can see, it’s really rare, although such situations do happen, ”she said.
Among the factors affecting perioperative deaths, the anaesthesiologist mentioned, inter alia, very serious condition of patients qualified for anesthesia, numerous accompanying diseases, as well as human errors.
“However, the risk of death can be reduced with a careful history before surgery, provided the patient is honest. It is also necessary to carefully observe the patient during anesthesia, and in the event of critical events – quick and accurate decisions made by the anesthesiologist ”- she emphasized.
Complications often appear in a young, healthy patient, anesthetized for a simple procedure, such as appendicitis or tooth extraction. “Such a patient, having no previous contact with the health service, does not know about his hypersensitivity to drugs. In most cases, in the event of its occurrence, we manage to control the developing anaphylactic shock, but sometimes it is electrifying and the patient dies despite the quick reaction. Therefore, during the interview and preoperative assessment, we ask the patient in detail about hypersensitivity to various substances, in particular drugs, and inform them about the course of anesthesia and the risks resulting from it “- said Dr. Jastrzębska-Stojko.
To minimize the risk of death, there are detailed procedures before, during and after surgery, as well as guidelines on the need to have efficient equipment and prevention of the most common complications. “Unfortunately, we are not able to explain a certain percentage of events and eliminate the causes effectively” – admitted the anesthesiologist.
Intraoperative awakening affects a small percentage of patients. The risk of its occurrence increases during procedures in patients in severe general condition, with failure of organs essential for metabolism and drug elimination, with concomitant diseases, as well as in women generally anesthetized for caesarean section.
“Why? All drugs used for anesthesia pass through the placenta. Choosing the right doses is an art – you need to create such conditions as not to harm the newborn and cause adequate sleep and analgesia in the obstetrician. Immediately after the removal of the child, the neonatologist assesses his viability, and the drugs we administer may interfere with these functions. If the patient wakes up during the procedure and feels pain, and additionally it is not noticed and corrected by the anesthesiologist, it is most likely related to some error “- admitted Dr. Jastrzębska-Stojko.
Even if the patient wakes up during the operation and is unable to signal it, the doctor should notice it. The stress experienced at that time is manifested by increased heart rate, increased blood pressure, sweating, lacrimation, and dilated pupils. These symptoms vary in intensity, so it is very important to observe the patient and monitored vital functions. During the operation, an anaesthesiologist and an anesthetist nurse are always present in the room, who should catch any deviations from the norm and correct them effectively.
The patient himself may have an impact on the unsuccessful course of anesthesia, without informing the doctor about all his diseases. “In our practice, there is a group of patients who do not admit during the interview that they abuse alcohol, use large doses of painkillers or sleeping pills, and drugs. Meanwhile, excessive use of drugs or stimulants causes such people to metabolize anesthetic drugs very quickly. Addictions should not be concealed, we do not ask to make a sensation, but to correctly select the doses of drugs for anesthesia, and then effective analgesic therapy “- emphasized Dr. Jastrzębska-Stojko.