Expert: JM Starkman, MD - 9/2/2010

Question
I am having surgery next Tuesday. I am very afraid of anesthesia! I try to educate myself on every possible aspect pertaining to anesthesia. I know its very rare to be allergic to general anesthesia. However, I do not know my biological father and have no clue if i carry genetic Malignant Hyperthermia. How closely am i going to be monitored? What can i do to prevent this sort of risk, and how safe is anesthesia after years of advancement in medicine?  

Answer
Anesthesia for otherwise healthy people is pretty darn safe--provided you really are "otherwise healthy".  The likelihood of a major complication for elective surgeries is on the order of falling and dying in a bathtub accident, but not as high as dying while crossing the street. (Various studies do, though, have various yet similar conclusions). If you are a smoker, obese, heavy drinker, diabetic and thus NOT "otherwise healthy" your risk profile increases and the anesthesiologist you see preoperatively should make adjustments to his anesthetic plan for you to obviate those issues.  

MH is rare and will likely not apply to you.  But if you're truly concerned about MH to the point of wishing to wholely and completely avoiding being at risk for developing it, speak with the anesthesiologist well in advance of your surgery to formulate a plan acceptable to you both. A spinal, epidural or similar anesthetic may be choices, for example.