What is the risk of dying from a general anaesthetic?
The risk of dying in the operating theatre under anaesthetic is extremely small. For a healthy person having planned surgery, around 1 person may die for every 100,000 general anaesthetics given. To put that into perspective, Wembley stadium is the largest in the UK, holding 90,000 people. If we gave all the people in Wembley stadium a general anaesthetic, 1 person may die. However, these statistics don't reveal the true picture - although not always the case, it is highly likely that the one person who might die has a very complex medical history or is undergoing very difficult surgery.
What else may increase the risk of dying?
There are a few reasons why an individual may have an increased risk of dying. Your anaesthetist and surgeon will be able to give you information about your individual risk. You can use this time to ask any question you might have about the operation, risks and care after the operation.
Let's look at the reasons one at a time.
Long-term medical conditions
Medical problems such as diabetes, heart disease, lung problems or kidney problems can make giving an anaesthetic more challenging, and slightly increase risk. Such conditions become more common as we age. It can be more difficult for an older person to recover from an operation than it is for a younger person.
If the person is very unwell before the operation
Even in someone who is normally well, a severe illness or surgical problem (such as bleeding or a severe infection) may make the stress and trauma of the operation too much for the body to cope with, reducing the patient's chances of recovering from the operation. In this situation, it is most likely the person will die in the immediate postoperative period in the Intensive Care Unit (ICU) or on the ward. It is most unusual for a patient to die in the operating theatre.
When a patient who is very sick needs an operation, a lot of experienced doctors (surgeons, anaesthetists and intensive care doctors) will get together and discuss the patient. They will consider the risks of having the operation versus the risks of not having the operation, or of having a smaller operation first until the patient is more stable. Sometimes, in discussion with the patient and relatives, it will be decided that the operation poses such a risk of dying or causing significant injury that it is not in the patient's best interests to go ahead with the operation.
If the surgery is on delicate structures, such as the heart, lungs, brain, major blood vessels or bowel
Every surgery has some level of risk attached to it. Sometimes the operation is extremely complicated and delicate. Certain types of surgery carry a greater risk of dying. If the patient is having major surgery it is likely that they will go to the ICU or High Dependency Unit (HDU) after the operation. The surgeon will discuss the risks of a particular operation with the patient prior to surgery.
If the surgery is being done as an emergency
This is very similar to the other situations discussed. Surgery that needs to be done as an emergency has a greater risk of complications than surgery that is planned in advance. The patient is likely to be unwell, and the surgery more complicated.
Further reading and references
Dr S White; Risks associated with your anaesthetic - Section 15: Death or brain damage Royal College of Anaesthetists, 2017
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