Charles A. Bertrand, M.D., FACP, DIM-CD (Ret.)
Associate Clinical Professor of Medicine at New York Medical College
and at the Medical University of South Carolina


How do you feel when you're about to be put "put under?" Do you fear having to "take" an anesthetic? Well, you should feel a lot better because of the remarkable improvements that have occurred during the past decade.

An anesthetic death is one that is caused by the anesthetic agent or the improper administration of the anesthesia. Can you imagine that there are about 250 million surgical procedures done each year that require anesthesia to be given? There are different types of anesthesia, suhc as local anesthesia- for example, a dental extraction. Regional anesthesia is a second type and a good example would be spinal anesthesia. General anesthesia is a third type wherein the patient needs to be unconscious because of a more extensive procedure - such as a heart operation. The patient may be "put to sleep" with general anesthesia administered either by an intravenous injection or by inhalation anesthetic (or both).

Remarkable improvement in patient safety has occurred during the past decade. The February issue of the Mayo Clinic Health Letter has an article discussing patient safety with regard to anesthesia. THere has been a 25-fold decrease in anesthestic deaths. Presently, it is estimated that there is about one death for two hundred and fifthy thousand anesthetics. Or, this may also be expressed as four deaths per one million anesthetics administered. Why has such a dramatic improvement occurred?

Well, here are some of the reasons. Better monitoring equipment is one - for example, the patient has a small finger gadget applied called a pulse oximeter which measures the percent of oxygen in the blood in a non-invasive manner. FOrtunately, if the patient is not receiving enough oxygen, this can be detected in a matter of seconds and corrected.

New and safer medicines are now available, thus further providing for patient safety. Many of the anesthetic agents that were used 10 to 20 years ago are no longer given, having been replaced by better ones.

Better training of anesthesiologists also contributes to the success rate. And the use of guidelines and standards has become more prevalent. This, too, ads to patient safety.

At a recent meeting of the Anerican Society of Anesthesiologists held in Dallas, Texas in October 1999, there were 63 presentations regarding patient safety. Patient safety has been a most important consideration for many years, and this effort yields greater dividends.

And, finally, how should you relate to the anesthesiologist and what should you tell him or her? Medicines that you take, use of alcohol and drugs, prior illnesses, allergies that you have and prior experiences with anesthesia for starters. A good relationship with your doctor is essential - and this is particularly important with the surgeon and the anesthesiologist about to operate on you.

The advice provided on this website is intended to be general in nature and should not be relied upon for specific treatment. If you need personal medical attention please contact your physician.

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