Anesthesia Risks: Allergic Reactions and Safety Measures

Anesthesia drug issues?

Hello, Doctor! My sister underwent surgery that required general anesthesia half a month ago, but she experienced a severe allergic reaction immediately after inhaling the anesthetic, which required emergency intervention.
She was observed in the ICU for one night and then transferred to a regular ward for another day before being discharged.
I would like to ask about this situation, as I may need to have a mole removed next month, which would require local anesthesia in my leg.
Am I at the same risk? However, I underwent general anesthesia twice as a child without any allergic reactions, which suggests that I may not be allergic to anesthetics.
Does this mean I am not allergic? Additionally, is it unlikely for a local anesthesia in the leg to cause an allergic reaction severe enough to lead to shock? Should I undergo any tests beforehand? Thank you for your help!

Nìmíng, 10~19 year old female. Ask Date: 2021/08/21

Dr. Guan Siqi reply Anesthesiology

The questioner has undergone general anesthesia twice, so the risk of allergy to local anesthesia this time is very low and there is no need for excessive concern.
It is recommended to discuss and evaluate with the anesthesiologist before the procedure.
Director Kuan Sih-Chi, Department of Anesthesiology, Nantou Hospital.

Reply Date: 2021/08/21

More Info

When it comes to anesthesia, particularly general anesthesia, the risks associated with allergic reactions can be a significant concern, especially for individuals who have experienced severe reactions in the past. Your sister's experience with a severe allergic reaction to anesthesia is understandably alarming, and it's natural to have concerns about your own upcoming procedure.

Firstly, it's important to note that allergic reactions to anesthetic agents, while serious, are relatively rare. The fact that you have undergone general anesthesia twice in the past without any adverse reactions is a positive indicator. It suggests that you may not have a predisposition to allergic reactions to the anesthetic agents used during those procedures. However, it is crucial to understand that allergies can develop over time, and just because you did not experience a reaction previously does not guarantee that you will not have one in the future.

Regarding your upcoming procedure, if it involves only local anesthesia for a minor surgery such as mole removal, the risk of experiencing a severe allergic reaction is generally lower compared to general anesthesia. Local anesthetics are typically less complex and involve fewer agents than those used in general anesthesia. However, it is still possible to have an allergic reaction to local anesthetics, albeit the likelihood is lower.

To address your concerns about the risk of anaphylaxis (a severe allergic reaction that can lead to shock) during local anesthesia, it is important to communicate your medical history with your anesthesiologist or the medical team performing the procedure. They can assess your risk based on your past experiences and any other medical conditions you may have. If you have a history of allergies, particularly to medications, it may be prudent to discuss this with your healthcare provider. They might recommend allergy testing or a preoperative assessment to evaluate your risk further.

In preparation for your procedure, here are some steps you can take:
1. Consultation with Anesthesiologist: Schedule a preoperative consultation with the anesthesiologist. Discuss your sister's reaction, your previous experiences, and any concerns you have. They can provide you with detailed information about the anesthetic agents that will be used and their safety profiles.

2. Medical History Review: Ensure that your medical history is thoroughly reviewed, including any allergies, previous reactions to medications, and any other health conditions that may affect anesthesia.

3. Informed Consent: During your preoperative visit, you will likely be asked to sign an informed consent form. Make sure to ask questions and express any concerns you have about the anesthesia process.

4. Monitoring During Procedure: During the procedure, you will be closely monitored for any signs of an allergic reaction or other complications. Medical staff are trained to respond quickly to any adverse reactions.

5. Postoperative Care: After the procedure, you will be monitored in the recovery area. If you have any unusual symptoms or reactions, report them immediately to the medical staff.

In summary, while there is a risk of allergic reactions to anesthesia, the likelihood of experiencing a severe reaction to local anesthesia is generally lower than that of general anesthesia. Your previous experiences without reactions are reassuring, but it is essential to communicate openly with your healthcare team about your concerns and medical history. They will take the necessary precautions to ensure your safety during the procedure.

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