Things you shouldn’t hide from your anesthesiologist before surgery

When visiting patients before anesthesia, we will ask about their past medical history, current medical history, and medication status. Often, some patients are reluctant to answer the questions asked by the doctor. This may be because they are introverted and not good at expressing themselves, or they may be afraid that their family members may worry too much about their physical condition, or they may be afraid that too much medical history will delay the surgery... No matter what the reason is, hiding the truth from the doctor is irresponsible.

1. Concealing medical history such as hypertension, heart disease, central nervous system disease, etc.

The anesthesiologist needs to understand the patient's usual blood pressure level and drug control, whether there are complications of hypertension; the type of heart disease, the onset of the disease, whether it relies on drug intervention, the types of commonly used drugs, whether it needs to be stopped, when to stop, and the choice of alternative drugs after stopping; whether there is a history of epilepsy, depression, anxiety, Parkinson's disease, schizophrenia, what drugs are used, and whether it will affect the effect of anesthetic drugs during surgery. The anesthesiologist should formulate an anesthesia plan based on the patient's overall condition.

2. Deny food or water before surgery

Before a routine elective surgery, doctors will instruct patients to fast for 6-8 hours. Some patients think that they are not undergoing gastrointestinal surgery and do not need to be so strict. Some patients think that as long as they do not eat or drink, it is correct. As a result, they eat an egg and drink a glass of milk, and the surgery is eventually stopped. After general anesthesia, the body's pyloric sphincter relaxes, and food may flow back into the mouth. Once accidentally inhaled into the airway, it will cause suffocation and endanger life.

3. Denying a cold

Airway inflammation induced by colds can increase airway responsiveness. Stimuli such as endotracheal intubation under general anesthesia or suctioning of the airway can produce complex reactions including airway edema, increased secretions, and airway smooth muscle contraction, thereby inducing acute airway spasm or obstruction, which is life-threatening.

4. Taking blood pressure medication secretly or taking more

Due to preoperative tension, anxiety or poor rest, patients' blood pressure will rise slightly before the operation. Some patients will secretly take or increase the dosage of antihypertensive drugs without telling the doctor because they are worried that the operation will be stopped due to high blood pressure. However, after taking long-term antihypertensive drugs, anesthetic drugs are used during the operation to eliminate the factors of tension and anxiety. The synergistic effect of anesthetic drugs and antihypertensive drugs will lead to refractory hypotension and cause serious consequences.

There are many similar situations in clinical practice. In fact, doctors and patients should be comrades-in-arms who defeat the disease together. They should have a cooperative relationship of mutual trust and honesty. Only when the anesthesiologist fully understands the patient's condition and formulates a detailed anesthesia plan can the surgery be guaranteed and the patient's perioperative period be safer.

Sun Yiran, Department of Anesthesiology, Mudanjiang Cancer Hospital

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