the body is unable to regulate its temperature) or suffered a stroke.
Both can increase their risk of malignant hyperthermia, a severe and
potentially deadly reaction to anesthesia that causes muscle rigidity
and a sudden high fever.
Have had a reaction to anesthesia. If patients have had a bad
reaction to anesthesia during previous procedures, the anes-
thetist will ask detailed questions about what happened to adjust
their anesthesia and prevent it from recurring.
Have chronic health issues. Many chronic health conditions can
have repercussions for anesthesia, including diabetes, heart dis-
ease, allergies, liver or kidney disease, asthma, high blood pressure,
obesity, and seizures or other neurological disorders.
Candid conversation
Encourage patients to discuss these issues and any other concerns when
they talk to the anesthetist before surgery. If patients are concerned
about taking opioids, the anesthetist can discuss alternatives. Explain
that the anesthetist also will ask them questions and may order tests
before surgery, such as a cognitive screen to assess their mental func-
tion, especially if they are elderly. Based on the results of those tests,
their concerns, the information they provide and their health, the anes-
thetist will adjust their anesthesia, pain management and directions for
recovery.
OSM
Dr. Mason (president@asahq.org), president of the American Society of
Anesthesiologists, is the director of pediatric anesthesiology at Loma Linda
University Medical Center and professor of anesthesiology and pediatrics at
Loma Linda (Calif.).
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