When it comes to
anesthesia care for surgery, keeping secrets can have dangerous consequences.
The American
Association of Nurse Anesthetists (AANA) urges patients who are preparing to
undergo surgery to leave no stones unturned when it comes to telling their
Certified Registered Nurse Anesthetist (CRNA) or anesthesiologist about their
medical background, family history, diet, and drug and alcohol use.
"Patients and
their anesthesia providers must have open communication to help avoid the
possibility of a bad reaction to an anesthetic or an anesthetic not being
effective," says AANA Past-President Jan Stewart, CRNA. CRNAs are
anesthesia specialists who administer approximately 27 million
anesthetics given to patients each year in the United States.
"While a person’s
age and weight are determinants in the type and amount of anesthetic to be used,
there are other important factors as well," said Stewart. "A family
history of diabetes, use of herbal remedies, an exotic weight-loss diet, a daily
regimen of prescribed medications, a drinking problem—all of this information
is essential for the anesthesia provider to make the right anesthetic
choices."
According to
Stewart, patients should be prepared to reveal pertinent facts during the
preoperative conference with their anesthesia provider, if not sooner. Even
confidential or personal information should be discussed. For example,
"closet" alcoholics or users of recreational drugs who conceal this
information may be putting their lives in jeopardy. "For any number of
reasons, patients are sometimes hesitant to talk about an aspect of their
lifestyle that may be relevant to their anesthesia care," said Stewart.
Other reasons why
patients fail to share relevant information with their anesthesia provider are
they forget to, they are embarrassed, or they dismiss something as unimportant.
Stewart said senior citizens are a particularly high-risk group for not sharing
information. Many seniors take a host of medications for various age-related
health problems and may forget to mention a particular medication simply due to
volume.
Senior citizens also
represent a growing market for herbal medications such as ginseng, ginkgo biloba,
and St. John’s Wort, which may react unfavorably with anesthetics. Stewart
suggests that seniors and others who take a number of different medications,
regardless of whether they are prescription or over-the-counter, maintain a list
of what they are taking and carry it with them at all times.
"If a patient
thinks something they are taking is insignificant, I say let the anesthesia
provider be the judge of that," Stewart said. "You’d be
surprised at how different herbal remedies, which are very much in vogue these
days, can react with anesthetics. And never—I repeat, never—be too
embarrassed to tell your CRNA about anything you are taking. Viagra is a good
example. Even though more than 6 million prescriptions have been written for
this drug since it came on the market, many men still attach a stigma to it and
don’t like to admit they are taking it. That could be a big mistake."
Patients derive an
additional benefit from speaking openly with their anesthesia provider prior to
surgery: the comfort and confidence in knowing they had a participatory role in
determining which anesthetics they will receive. "The need for open
communication between patient and anesthesia provider cannot be stressed
enough," said Stewart.
