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How to avoid general anesthesia side effects: a practical guide

Choose the right anesthetic, prevent nausea, protect the airway, keep warm, and plan your pain.

Anesthesia side effects · 2 min read

General anesthesia is safe for millions of people and is the right choice for many operations. Its common side effects are manageable and often preventable. Here is what the published literature supports:

1. Choose the lightest anesthetic that is safe

When an operation can be done comfortably with local anesthesia and monitored sedation, you may avoid the breathing tube and its effects on the throat. See The voice after the tube.

2. Prevent nausea on purpose

A multi-drug regimen cut PONV from a published 22% to 3% in one plastic surgery cohort. See why people feel sick.

3. Keep warm

Mild hypothermia increased blood loss by about 16% in a meta-analysis.

4. Plan pain before surgery

Opioid-sparing plans reduced prescribed opioids in one outpatient plastic surgery review from about 332 to 100 morphine milligram equivalents per patient.

5. Tell the truth in the pre-op visit

Past nausea, motion sickness, reflux, medicines, supplements and GLP-1 medications all change the plan. See GLP-1 medications and anesthesia.

And an honest note: a review of 18 trials found no significant difference in delirium or cognitive dysfunction between general and regional anesthesia. Awake is a preference, not an escape from a hazard.

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References

  1. Steely RL, Collins DR, Cohen BE, Bass K. Postoperative nausea and vomiting in the plastic surgery patient. Aesthetic Plast Surg. 2004;29-32. PMID 15116276
  2. Rajagopalan S, Mascha E, Na J, Sessler DI. The effects of mild perioperative hypothermia on blood loss and transfusion requirement. Anesthesiology. 2008;71-77. PMID 18156884
  3. Straughan DM, Lindsey JT, McCarthy M, et al. Enhanced recovery after surgery protocol with ultrasound-guided regional blocks in outpatient plastic surgery patients leads to decreased opioid prescriptions and consumption. Aesthet Surg J. 2021;NP1105-NP1114. PMID 33730152
  4. Bryson GL, Wyand A. Evidence-based clinical update: general anesthesia and the risk of delirium and postoperative cognitive dysfunction. Can J Anaesth. 2006;669-677. PMID 16803914