The Healthy Geezer: Anesthesia is risky, but safe for all ages

By Fred Cicetti

Q: I’m a senior who’s having surgery, and the one thing that scares me more than anything else is the anesthesia. Can you tell me anything to reduce my fear?

A: There are probably several sources for your fear. The first is that you’re older and wonder if you’re at greater risk than someone younger. The second is that anesthesia can be dangerous to anyone. The third is that you’ll lose total control when you’re under. I hope some of the facts about anesthesia will help with all of your fears.

Anesthesia is risky, but today it is safer than ever for all age groups. Your age is not as important a risk factor as your medical condition and the type of surgery you are having. 

Safer drugs and major advances in the monitoring equipment doctors use in surgery have reduced anesthesia complications. In the last decade alone, deaths caused by anesthesia have dropped 25-fold, to 1 in 250,000.

In addition, shorter-acting drugs, more specific drugs and new intravenous drugs can minimize the nausea and vomiting that sometimes occur after anesthesia.

There are three main types of anesthesia: general, regional and local.

General anesthesia makes a person unconscious so that the entire body is pain free. Regional anesthesia is used to block sensation in one area of your body. Local anesthesia numbs a small part of your body.

General anesthesia is used for extensive surgeries. The drugs used in general anesthesia are given intravenously or are inhaled. They act as hypnotics, painkillers and muscle relaxants, and they block your memory of the surgery. 

Regional anesthesia is injected around a single nerve or a network of nerves that branches out and serves an area. For example, spinal, epidural and caudal anesthesia are injected into or near the spinal fluid, effectively numbing nerves that serve the lower half of your body. 

Local anesthesia may be used to numb only a small area of nerves at the site where the surgeon plans to operate, such as for cataract surgery. Local anesthesia is also used for minor procedures such as skin biopsies and stitching a cut.

During local and regional anesthesia, patients often receive intravenous drugs for sedation so they can be comfortably drowsy during surgery and remember little of their time in the operating room. 

Before your surgery, you can also expect questions from your doctors regarding your anesthesia. The following have to be considered: medical problems you might have, medications you take, whether you smoke or drink alcohol, any allergies you have, previous negative experience with anesthesia, and adverse reactions to anesthesia by other family members. 

The information collected by your doctors guides them in their treatment. For example, smoking or alcohol consumption can influence the way an anesthetic works in your body during surgery. Knowing whether you smoke or drink alcohol allows your anesthesiologist to choose anesthetics that are suited to you. 

And some anesthetics include components of certain foods, such as albumin from eggs. Discussing food and drug allergies beforehand helps your anesthesiologist make important drug choices.