General anesthesia works to knock you out and escape pain during oral surgery, elective surgery and other complicated surgical procedures. However, anesthetic agents can be toxic and bring about serious, even fatal complications. The most shocking thing is that doctors and scientists still don’t know exactly how these medicines work in the body.
The clinical state of anaesthesia consists of multiple components that are mediated via interaction of the anaesthetic drugs with different targets on the molecular, the cellular, the network and the structural-anatomical levels.
The mechanisms by which some of these drugs induce the different components of “anaesthesia” may be rather specific: discrete mutations of single amino acids in specific proteins profoundly affect the ability of certain anaesthetics to achieve specific endpoints.
Despite this potential specificity, inhalational anaesthetics are present in the body at very high concentrations during surgical anaesthesia. Due to their lipid solubility, general anaesthetics dissolve in every membrane, penetrate into organelles and interact with numerous cellular structures in multiple ways. A priori, it is therefore not unreasonable to assume that these drugs have the potential to cause insidious changes in the body other than those acute and readily apparent ones that we routinely monitor for. Some changes may wane within a short time after removal of the drug (e.g. the suppression of immune cell function). Others may persist after complete removal of the drug and even become self-propagating.
Before anesthesia, doctors and dentists operated on patients only in extreme circumstances and largely without the use of painkillers or sedatives.
Then, in 1846, dentist William T. G. Morton demonstrated the use of ether to put patients “to sleep” during surgery. The practice soon spread, but because doctors couldn’t control the amount of ether inhaled, patients could wake up during surgery–or never wake again. Ether was also highly flammable.
The next few decades saw the introduction of less flammable anesthetic gases as well as the discovery of intravenous anesthetics with controllable dosage. Still, well into the 1950s, dangerous side effects were common and included heart rhythm abnormalities, breathing problems, lowered blood pressure, nausea and vomiting.
Today, the use of anesthesiology is still commonly regarded as a high risk activity, and it can result in life-altering injuries. To this day, there is no qualified doctor or scientist who has ever been able to scientifically demonstrate or explain the root physiological effects of anesthesia.
Serious complications from modern anesthetic techniques are rare but do happen more often than we think since they’re largely unreported by the mainstream media. For example, malignant hyperthermia affects about one in 10,000 patients some of who die within 24 hours of anesthesia.
The specialists themselves have also been accused of corruption. A prominent Massachusetts anesthesiologist allegedly fabricated 21 medical studies that claimed to show benefits from painkillers like Vioxx and Celebrex, according to the hospital where he worked.
There is considerable evidence for anaesthetic toxicity in the central nervous system, which appears to be susceptible to anaesthetic neurotoxicity.
At all ages, anaesthetics affect gene expression regulating protein synthesis in poorly understood ways. While it seems reasonable to assume that the vast majority of patients completely restore homeostasis after general anaesthesia, exposure to these drugs probably has more profound and longer-lasting effects on the brain than heretofore imagined.
By most accounts, 18-year-old Stephanie Kuleba, a sunny blonde with a beaming smile and bubbly personality, was perfect. But on March 22 2008, the high school senior, head cheerleader and honor student became another statistic of the dangers of anesthesia. It was physical imperfections — asymmetrical breasts and an inverted nipple — that brought her to a Florida plastic surgeon’s office for cosmetic surgery and a routine augmentation procedure which ultimately cost her her young, promising life. A standard pre-surgery dose of general anesthesia reportedly triggered malignant hyperthermia in Kuleba’s body, sending her heart racing and body temperature rising so rapidly she died about 24 hours after the procedure.
In a March 31, 2008 interview with Matt Lauer on NBC’s Today Show, Kuleba’s mother said that the family had done extensive research on the elective surgery and “felt confident this was the right decision.” The Kuebla family’s attorney, Roberto Stanziale appeared on the same show, claiming that Stephanie Kuleba received only a fraction of the drug that could have saved her from succumbing to malignant hyperthermia.
After the mother of Kanye West passed away from cosmetic surgery, the debate is raging in medical circles as to the public reaction to tragic results from surgery that should be routine.
Personal Risk Factors
Your age may be a risk factor. In general, the risks associated with anesthesia and surgery increase in older people.
Certain medical conditions, such as heart, circulation, or nervous system problems, increase your risk of complications from anesthesia.
Some medicines can raise your risk of problems too, especially if the anesthesiologist is unaware of the medications.
If you smoke or drink alcohol you may also be more likely to have problems from anesthesia.
Risks From Local Anesthesia
In high doses, local anesthetics can have toxic effects caused by being absorbed through the bloodstream into the rest of the body (systemic toxicity). This may significantly affect your breathing, heartbeat, blood pressure, and other body functions. Because of these potential toxic effects, equipment for emergency care must be immediately available when local anesthetics are used.
Risks From Regional Anesthesia
For regional anesthesia, an anesthetic is injected close to a nerve, a bundle of nerves, or the spinal cord. In rare cases, nerve damage can cause persistent numbness, weakness, or pain.
Regional anesthesia (regional nerve blocks, epidural and spinal anesthesia) also carries the risk of systemic toxicity if the anesthetic is absorbed through the bloodstream into the body. Other complications include heart or lung problems, and infection, swelling, or bruising (hematoma) at the injection site.
Spinal anesthesia medicine is injected into the fluid that surrounds the spinal cord (cerebrospinal fluid). The most common complication of spinal anesthesia is a headache caused by leaking of this fluid. It is more common in younger people. Up to 5% of patients who have had a spinal epidural, suffer a severe headache after the medication is given.
A blood patch is often the emergency remedy by specialists who inject a small amount of the person’s own blood into the area where the leak is most likely occurring to seal the hole and to increase pressure in the spinal canal and relieve the pull on the membranes surrounding the canal.
Risks From General Anesthesia
Because general anesthesia affects the whole body, it is more likely to cause side effects than local or regional anesthesia.
General anesthesia suppresses the normal throat reflexes that prevent aspiration, such as swallowing, coughing, or gagging. Aspiration occurs when an object or liquid is inhaled into the respiratory tract (the windpipe or the lungs).
Malignant hyperthermia can result from a severe, life-threatening reaction when anesthesia gases are inhaled or a muscle relaxant called succinylcholine is given. The patient’s temperature will rise rapidly, muscles become rigid and the body begins to break down muscle fibers. The condition is serious and can result in the death of healthy patients if doctors cannot halt or control the symptoms with medication.
Nerve damage can results from all types of anesthesia. While the cause of damage varies, it can range in severity from mildly annoying to disabling. But a small percentage of patient have lasting nerve problems.
During general anesthesia, if the patient is placed in a position that when medication if the patient is lying in a position for extended periods of time that block blood flow to the nerves. An example of this type of damage is the “pins and needles” sensation when a leg is “asleep.” A person that is awake can stand up or move to relieve the problem, but a patient who is under anesthesia does not know there is a problem and cannot move.
Anesthesia awareness happens when the medications provided to render the patient unconscious during general anesthesia are not effective but the agents used to paralyze the patient are. This means that the patient is unable to move or speak, but is wide awake, hearing and feeling the entire procedure.
The medications that are used to paralyze the muscles of the body during general anesthesia work on many areas of the body. In some patients, the muscles of the bladder become paralyzed, and the patient is unable to urinate. The ability to urinate typically returns within 24 hours, but during that time the bladder can become uncomfortably full, making a urinary catheter necessary.
The bottom line is to refrain from any type of elective or cosmetic surgery unless it is absolutely necessary to your health and well-being.
When serious problems do arise during an anesthetic state, the consequences can be life-altering. It is of little consolation to the husband who has lost his wife that deaths from anesthesia are rare. The parent who has a child with serious brain damage doesn’t care that the injury was very unlikely.
Unless surgery is for an acute or life-threatening condition, the risks of surgery, anesthesia and the long-term health risks associated are often much greater than any benefits you or your doctor deem necessary to your health.
Marco Torres is a research specialist, writer and consumer advocate for healthy lifestyles. He holds degrees in Public Health and Environmental Science and is a professional speaker on topics such as disease prevention, environmental toxins and health policy.