Your brief but meaningful relationship with your anesthesiologist – a relationship you’ll probably sleep through – begins with the give and take of information that helps your anesthesiologist provide better care and avoid pitfalls.
Here are five details of your health history and lifestyle to share in the preoperative interview:
1. Share any previous reaction or complication you or your blood relatives have had, even if it seems minor.
One life-threatening reaction to anesthesia, called malignant hyperthermia, runs in families and is triggered by certain medications your anesthesiologist can easily avoid.
Discuss any postoperative nausea and vomiting you’ve had. Avoiding some common anesthesia drugs and giving medications will minimize your upset stomach.
Mention postoperative weakness, too. Weakness, like malignant hyperthermia, may be an inherited inability to metabolize muscle relaxants used during surgery. Avoiding the culprit drugs solves the problem.
If you’ve suffered from an extremely sore throat, difficulty swallowing, or a swollen uvula (the little hanging down thing in the back of your throat) after surgery, let your anesthesiologist know. It’s a sign that placing a breathing tube in your windpipe (to help you breathe during some procedures) was tough to do.
Please pass along any history of postoperative memory loss or worsening forgetfulness in your preoperative visit.
The final complication to share is any awareness you’ve had under general anesthesia -recalling conversations, feeling pain, or being awake but unable to move. If you’ve ever had this traumatic experience, please let your anesthesiologist know. The chance of it happening again is higher and your anesthesiologist will take extra steps to prevent it happening again.
2. Inform your anesthesiologist if you have obstructive sleep apnea. If you’ve never been diagnosed, but your spouse says you sound like a freight train or even worse, you have pauses in your breathing, tell your anesthesiologist. You’ll need extra monitoring after surgery since many medications used to keep you asleep and treat your pain worsen apnea.
3. Share any supplements you take. Some can affect your surgery and anesthesia (see sidebar).
Now for the confessions:
4. If you remembered you were supposed to fast before surgery right after you polished off a Krispy Kreme donut, let your anesthesiologist know. During general anesthesia, any food in your stomach may end up in your lungs. It’s a life-threatening condition and the reason for a period of fasting before surgery.
5. You and your anesthesiologist both want the same things: for you to sail through your surgery, wake up like you just had the best sleep of your life, and get back to your life as soon as possible.
No judgment here with any of these substances. But it’s important to confess any narcotic use, as this increases your need for more narcotics during and after surgery.
Fess up if you smoke tobacco or marijuana. Both make you more prone to wheezing and coughing when you awaken.
Finally, let your anesthesiologist know how much and how often you drink alcohol. If just a whiff of mezcal has you dancing the Mambo both in – and on – the bar, your anesthesiologist will be more judicious with your medications. On the flip side, if you can still walk in a straight line and have an intellectual conversation when you’ve gotten down to the worm, let your anesthesiologist know that, too. You’ll need higher doses than the bar-top dancer.
You and your anesthesiologist both want the same things: for you to sail through your surgery, wake up like you just had the best sleep of your life, and get back to your life as soon as possible. Passing along these important pieces of your medical history and lifestyle will help you both reach these goals.
Supplements That Affect Surgery and Anesthesia
- Black Cohosh – lowers blood pressure
- Echinacea – can cause liver damage
- Ephedra – irregular heartbeat
- Feverfew – risk of bleeding
- Garlic – blood pressure changes, risk of bleeding
- Ginger – sedation, risk of bleeding
- Gingko biloba – risk of bleeding
- Ginseng – risk of bleeding
- Hoodia – blood sugar changes, irregular heartbeat
- Kava – sedation, can cause liver damage
- St. John’s Wort – causes sedation, prolongs the effects of anesthesia
- Valerian – sedation