Joan Rivers’ death has prompted hospitals and surgical centers to ramp up efforts to reduce and prevent dangerous complications from anesthesia and sedation during surgery. The Wall Street
Journal reports that medical facilities are increasing emergency training for medical staff and keeping a closer eye on patients on the operating table.
Anesthesia can result in a wide range of life-threatening complications. A growing body of research is showing that chronic health conditions, such as obesity, diabetes, sleep apnea, asthma, heart disease, and genetic conditions, can put patients at higher risk for complications.
Risks are compounded by the trend toward wider use of outpatient centers for surgical procedures, with surgeons using faster-acting drugs such as propofol, experts note. Some specialists worry the facilities aren't adequately equipped to handle anesthesiology emergencies.
Rivers’ death, at a New York outpatient endoscopy center, was due to a lack of oxygen during a throat procedure while she was sedated with propofol, according to the office of the city’s medical examiner. The cause of death was described as “a predictable complication of medical therapy,” but it is not clear exactly what caused Rivers to be deprived of oxygen.
Before undergoing any procedure requiring sedation, the American Society of Anesthesiologists recommends that patients do the following:
- Check physicians’ credentials including the anesthesiologist. In some states, nurse anesthetists can provide anesthesia without direct anesthesiologist supervision.
- Discuss your medical history with your anesthesia provider and how it might affect your reaction to anesthesia.
- Check on medical staff training and certifications. Find out if an outpatient center or office is licensed and accredited to perform surgical procedures.
- Make sure you are in optimal health before any procedure. If you have medical problems, you may need clearance from your primary care physician before surgery. An anesthesiologist can help determine if this clearance is necessary.
- Find out who will monitor you during the procedure—the surgeon, a nurse or an anesthesiologist. Only a medical professional specifically trained to administer anesthesia and monitor patients should care for you throughout a procedure.
- Notify all physicians involved in your procedure of medications you are taking or recently took, including herbal remedies. Herbal remedies and other medications can interact with anesthetics and drugs you may receive for the procedure.
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