Friday, July 21, 2006

Anaesthesia is safe

A lot of patients coming in for an operation are far more concerned about the anaesthetic than the operation itself. I can understand the fear of loss of control, the fear of unconsciousness, the unknown. But the reality is that for most people it is the operation itself that holds the greatest risk. The surgeon will open up a part of the body which was never designed to be opened, often uncertain as to what anatomical abnormality you may have inside you, and then rootle around inside before putting you back together. But many people’s prime concern is the anaesthetic.

Anaesthesia is safe because anaesthetists administer it. After the Moscow Theatre Siege journalists asked how, if an anaesthetic gas had been administered, people died. Simple really, it was released in an uncontrolled manner with no one around to monitor its effects or ensure the people were still breathing.

The quoted death rate attributable to anaesthesia is 1 in 200,000, although in fit and healthy patients it is probably considerably lower than this. To put this in perspective you are over 10 times more likely to die in a road crash travelling to the hospital than as a result of anaesthesia.

Back in the 1950s, when such statistics were first being collated, the risk was around 1 in 10,000. Before that it was even higher. A number of innovations have reduced the mortality, including improved monitoring, better training for anaesthetists and safer drugs. Anaesthesia is often compared to the airline industry, although not everyone agrees the analogy is correct.

When things go wrong, they do go wrong very fast and in an often catastrophic manner. This is why anaesthesia requires long and through training.


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