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Advances in Anesthesiology Have Dramatically Reduced Risks

“What if I don’t wake up?” – it’s a common fear for anyone facing surgery under general anesthesia.

But it’s a fear with little basis in fact. Serious complications almost never occur in the absence of a preexisting medical problem. Experts estimate it’s far safer to have general anesthesia than to ride in a car. Anesthesia is 10 times safer than it was in the 1970s – and 100 times safer than in 1955. Thirty years ago, patient deaths due to anesthesia were as high as one for every 5,000 cases. With modern techniques and safety standards, that has dropped to one death per 200,000 to 300,000 cases. It must also be noted that current deaths almost always involve patients already suffering from severe illnesses that greatly increased their surgical risk.

Fast-acting medications, new monitoring devices and higher safety standards for their use are credited with reducing complications and accidental deaths during general anesthesia.

The type of anesthesia you receive during surgery depends on the procedure and your general health. Hereditary factors may affect reactions to certain anesthetics and thus determine the type of drug used. Anesthetics are delivered by inhaling the drugs through a mask or by intravenous injections. The drugs circulate throughout your bloodstream to all areas of your body, including your brain, and cause loss of consciousness. Anesthetics also control pain and relax muscles by blocking transmitters in your nervous system.

Older types of general anesthetics had unpleasant side effects such as nausea or vomiting after surgery. As outpatient surgery has evolved; new anesthesia drugs have appeared that act faster and are less likely to cause nausea and prolonged drowsiness. Some newer drugs allow members of the anesthesia team to more accurately adjust the doses of the drugs throughout the procedure. This means you awaken sooner after surgery with fewer residual effects.

Within the last two decades, the American Society of Anesthesiologists has set a variety of standards for practice. The standards include a requirement that qualified members of the anesthesia team be present throughout a procedure involving use of anesthesia. The team is required to continually monitor oxygen levels, breathing, circulation, heart rate, blood pressure, temperature and anesthetic administration. The standards extend to the use of new equipment that monitors your heart and breathing during anesthesia. The monitoring equipment must also pass standards of reliability. Most machines have safety devices to detect mechanical error and monitor medication dosages.

New monitoring devices help ensure you get adequate oxygen while under anesthesia. Their use has played a major role in making surgery safer.

Fingertip readings: By transmitting a special light through a small device attached to your finger, a pulse oximeter measures and records the amount of oxygen in your blood on a beat-by-beat basis. If your oxygen level drops too low, an alarm sounds.

Breath-by-breath monitor: A device called an end-tidal capnograph measures, analyzes and displays the amount of carbon dioxide in each breath. The display alerts members of the anesthesia team of unexpected changes in breathing.

Additional devices used include active warming blankets to maintain your body temperature while you are asleep. Sequential Compression Devises " SCDs", are wraps around your legs which gently massage your legs throughout surgery to help prevent dangerous clots.  New safety devices are being developed every year, and are being incorporated into the surgery routine.  New systems for ensuring the correct procedure and surgical equipment are present for every patient have also been developed.  These "Time Out" breaks have further helped to ensure the safety of your surgery.