Having surgery is never a trivial matter and is to be taken seriously. In addition, surgery requires anesthesia which also carries risk. Below are listed known risks that are typically discussed with you in preparation for surgery and/or anesthesia. If you have any questions about any of the listed items, please ask your surgeon, anesthesia provider or nurse before surgery.
Bleeding and need for transfusion of blood and/or blood products
Major Adverse Cardiac Events such as heart attack, heart failure, lethal arrhythmia
Major Pulmonary Events such as respiratory failure, aspiration, pneumonia requiring prolonged endotracheal intubation and ventilator support in the ICU
Perioperative Nausea and Vomiting as a result of medications given or ‘nerves’. Vomiting is a major risk factor for pulmonary aspiration that can lead to respiratory failure and death.
Falling as a result of your particular surgery, effects of anesthesia or medications that make you unsteady.
Uncontrolled Pain as a result of medications that you are now taking, illicit drugs that you are using or previous history of alcohol or substance abuse.
Addiction to pain medicine following surgery is real and a discussion between you and your doctor must take place regarding any issues that you may have or expect to have with addictive pain medication. While your anesthesia provider will work very hard to address your severe surgery related pain during and immediately following surgery, you will experience ongoing pain for a while as part of the healing process.
Coughing and Shortness of Breath as a result of smoking or vaping of any kind which can lead to respiratory failure and death.
Smoking cigarettes, cigars or pipe smoking is a major cause of mortality in the US.
Smoking and vaping also places you at risk for major complications during surgery and anesthesia regardless of what you smoke/vape, how much you smoke or for how many years.
If you have ever considered stopping smoking/vaping, please contact your PCP or surgeon today for medical and clinical assistance. You can stop. But if you need help, there are lots of people and resources that are ready to assist you in this life-saving goal.
Obstructed Breathing/Stopped Breathing as a result of diagnosed/undiagnosed Sleep Apnea. If you have Sleep Apnea or have been told that you are at risk for sleep apnea because of snoring, obesity, daytime sleepiness or other reasons, PLEASE see your PCP or surgeon for a referral for Sleep Apnea evaluation and treatment. Sleep Apnea is a significant risk factor for major respiratory complications that can lead to death in surgical patients.
Surgery Related Complications are adverse outcomes that are well-known and related to your planned surgery. These are things that your surgeon discusses with you in the office while planning your surgery.
Weakness or Numbness can happen for a variety of reasons such as an IV placement to a nerve block for surgical pain. However, the most common reason is due to positioning of your arms and legs during surgery. Great care is given to this in properly placing and padding your extremities and body during surgery. Generally this is only temporary and will resolve on its own.
Allergic Reaction to medications, antibiotics, tape or bandage material, surgical supplies and materials
Dental Injury can happen in the course of surgery as a result of a procedure but more commonly as you wake up, sometimes patients clench their jaws tightly and can break or loosen teeth or dental implants/bridgework.
Eye Injury can occur during the course of your surgery during positioning or as a complication of the procedure that is happening in or around the face and neck. Most commonly this is due to the patient scratching their eyes unknowingly while emerging from anesthesia sedation. Great care is exercised during this phase of recovery but can still occur. These injuries are usually infrequent and minor and resolve spontaneously. However, they cause discomfort and concern and may require that an ophthalmologist evaluate the extent of the injury and for treatment.
Delirium is a distressing complication of the stresses of surgery and effects of anesthesia that can happen. The older you are, the more likely that you may experience delirium following surgery. This is usually brief and mild but may be more severe and debilitating and can last for weeks. In some rare and extreme cases, the patient may not recover their full preoperative level of cognition.
There is a link between known dementia preoperatively and a permanent loss of cognition following surgery.
There is also a link between some forms of mental illness, diagnosed or not, and post-operative delirium, combativeness, emotional lability, angry outbursts and personality changes. It is very likely that these changes are temporary but still can be very distressing for patients and their families/loved ones.
Wrong Site Surgery is when the operation expected and planned is not the surgery that was done as a result of a mistake or a series of mistakes made by all the personnel involved in your case including the surgeon. This is a terrible outcome that all surgery department personnel work hard to avoid. This explains why you, the patient are asked the same questions over and over again. This is the one thing that happens on the day of surgery that is proven to prevent such mistakes. However, these stories may still be found in the news from time to time.
Surgery Cancellation occurs when the surgeon determines that your surgery should be delayed or to not occur at all. This could happen for many different reasons. The most common is that you become ill right before your day of surgery. In the case of illness, your surgery should wait until you are well to avoid complications. Other reasons include things like eating food on the day of surgery, taking drugs or alcohol on the day of surgery, being on blood thinner medications before surgery, and finding out that you are pregnant.
If you have serious medical conditions involving your heart, lungs, brain, liver, blood or kidneys, then your primary care physician must determine that you are fit for surgery and anesthesia. This may involve blood testing, heart tests, Xrays and perhaps a specialist referral to evaluate you for surgery. Once this information is assembled, it is generally reviewed by an anesthesia provider for completeness.