True or False: Anesthesia Myths
/Anesthesiology is crucial for providing patients with comfort and safety while they undergo a wide range of procedures and life events. It’s also a medical speciality that works with many other departments within hospitals and has impacts far beyond just the operating room.
But despite its importance, it may be among the medical world’s most misunderstood fields. As anesthesiologists, we understand why patients might feel a bit wary about what we do. After all, we are literally rendering our patients unconscious while simultaneously safely guiding them through operations and procedures.
To help clarify our speciality, we’re using our last blog post of 2023 to examine a few anesthesia-related myths. If you have a question about anesthesia you would like to hear more about in a future post, please let us know.
Anesthesiologists are medical doctors.
True! In Ontario, all anesthesiologists are medical doctors who have specialized in the field of anesthesiology, making them the experts in anesthesia.
Following medical school, most anesthesiologists have undertaken an additional five to seven years of residency training after medical school, similar to the length of training surgeons and most other medical specialties undergo. Learn more about our profession.
Anesthesia is risky.
False! Modern anesthesia is remarkably safe. In Canada, general anesthesia is administered by qualified physicians who closely monitor patients throughout their procedure and are ready in a split-second to deal with any issue that arises to ensure the patient’s safety.
“Advanced training along with advances in monitoring and medications have made anesthesia safer than it has ever been, “ explains Dr. Eric Goldszmidt, an anesthesiologist with Sinai Health in Toronto, “Patient risks are more closely related to the type of surgery and their underlying health, not to the anesthesia." In fact, the risk of death is between one in 200,000 and one in 400,000, which is likely safer than the drive to the hospital!
Undergoing anesthesia always means you’ll be unconscious/asleep.
Not necessarily. There are three main categories of anesthesia:
General anesthesia: This is the type of anesthesia that renders you unconscious using medications administered by your anesthesiologist. If you’re undergoing major surgery, you’ll likely be given a general anesthetic and will sleep through your procedure.
Regional anesthesia: Regional anesthesia refers to a technique where the nerves to a part of the body are anesthetized using local anesthetic medications so that you will not feel pain in the area. Labour epidurals are an example of regional anesthesia. Regional anesthesia can refer to freezing administered in your back or to nerves in other parts of the body, particularly nerves that go to an arm or leg. While regional anesthesia on its own won’t put you to sleep, it’s sometimes paired with sedating drugs that may cause you to fall asleep and help prevent you from remembering the procedure. This sedation can be light or deep, depending on the procedure and your individual needs. Regional anesthesia is also sometimes paired with general anesthesia to decrease the amount of opioids used and maximize and extend your pain relief after surgery.
Local Anesthesia: This is a technique where topical freezing — usually an injection of medication or an application of a medicated cream or gel — is administered for minor procedures, usually by the surgeon. Local anesthesia is commonly used in cataract surgery and for many dermatological procedures, such as removing skin lesions. This technique may also be paired with sedation, which can be light or deep.
Which type of anesthesia you'll be given depends on your procedure, medical history and personal preferences. When you come for your procedure or surgery, the anesthesiologist will provide you with more details on what type of anesthesia you’ll be receiving and whether or not there are options.
You’ll reveal your secrets while you’re under anesthesia.
Very unlikely. It’s true that sedation for anesthesia disinhibits some people. However, it’s doubtful that you’ll reveal something deeply personal. If anything, explains Dr. Rohit Kumar, an anesthesiologist with Trillium Health Partners, “Most often, patients become more chatty until they drift off to sleep.”
Every now and then, a patient will do something a little more memorable. Dr. Monica Olsen, also with Trillium Health Partners, recalls when a sedated patient sang Beatles songs, “No direct personal information was revealed unless you count that we all learned that they really liked the Beatles.”
Getting an epidural during labour will increase your risk of a c-section or other intervention and is potentially dangerous.
Mostly false. There is a lot of misinformation around epidurals and labour, but thankfully, there are also hundreds of studies that look at how this procedure impacts baby and mom. One example of that research is a 2018 Cochrane review that evaluated data from 40 trials involving 11,000 participants. It concluded that, “Epidural analgesia had no impact on the risk of caesarean section…, and did not appear to have an immediate effect on neonatal status as determined by Apgar scores or in admissions to neonatal intensive care.”
Some previous retrospective studies established an increased risk of non-caesarean section interventions (such as forceps or vacuum) following the administration of an epidural. However, this connection is likely influenced by the fact that a labour that ends up requiring those interventions is often longer and more painful, leading more patients to choose an epidural for pain relief.
Epidurals are medical procedures, and there is a risk of complications, which can include lowered blood pressure, headache and the procedure working only partially or not at all. However, serious side effects are very rare. Please speak with your anesthesiologist if you have any questions around receiving an epidural.
Getting an epidural will prolong labour.
Maybe, but not by much. The evidence here is a bit more mixed. Research such as this double-blind, randomized, placebo-controlled trial from 2017 does show that receiving an epidural had no impact on the length of the participants’ labour. However, the previously mentioned Cochrane review disagrees with that conclusion.
The good news is that if an epidural does extend labour, it’s likely not by much (and it will be much more comfortable!). As this expert review paper—co-authored by Ontario anesthesiologist Dr. Ronald George —notes, epidurals have “…been suggested to extend the first stage of labor by 30 minutes and the second stage by 15 minutes, when compared with alternative forms of analgesia.” This amount, notes Dr. Goldszmidt, “Is not clinically significant.”
You can’t get an epidural if you have a back tattoo.
False. This 2020 paper, which reviewed “…the 18 years of medical literature summarizing the so-called risks…” of epidurals concluded that, “To date, no convincing complication has ever been reported after an (epidural) through a tattoo.” If possible, the anesthesiologist will avoid placing the epidural through the tattoo itself. However, there may be situations where this cannot be done, and according to the evidence, this is a safe practice.
Do redheads require more anesthesia?
This one’s complicated. Some redheads get their hair colour from a mutation in the MC1R gene. This gene is also connected to pain regulation, which could explain a link between hair colour and how much anesthesia someone needs. However, research into red hair and anesthesia has shown mixed results. Some studies have revealed that redheads do need a little bit more, however, those studies had small samples. One more extensive study involving 319 people with red hair found no need for more anesthesia (however, it wasn’t restricted to people with the MC1R gene). Anecdotal evidence is also varied.
If you have concerns about your anesthetic, please speak to your anesthesiologist. Anesthesiologists are experts in providing the right amount of anesthesia, which varies from individual to individual, regardless of hair color.