By Kim Tae-jong
A woman in her 30s, who underwent plastic surgery at a local clinic three years ago, sustained severe brain damage due to adverse side effects from intravenous drugs used in managed anesthesia care (MAC).
She was unconsciousness during the operation when her heart suddenly stopped and a lack of oxygen to the brain over several minutes led to paralysis, and almost caused the loss of her eyesight.
Like her, an increasing number of patients choose MAC rather than undergo a general anesthetic, as they believe it is very simple yet safe. Many of them simply think they will just go to sleep while undergoing short surgical procedures, without being properly informed of the possible risks.
General physicians and surgeons also prefer to use intravenous injections, as they are faster and easier to administrate, compared to inhalational anesthetic substances.
But experts say patients should know about the procedure and anesthesiologists should be present during operations to cope with possible emergencies.
“A lot of patients simply ask for MAC because of fears about pain,” said Kong Myoung-hoon, an official of the Korean Society of Anesthesiologists. “But few people seem to know about the harmful side effects.”
According to data police obtained from the Korean Medical Association, a total of 23 fatalities involving general anesthetics have occurred. Of them, 18 people died ― 14 during plastic surgery and four others during endoscopies ― five others sustained severe brain damage or were paralyzed.
There are various kinds of drugs used in the process of general anesthesia. One such medication is propofol, one of the most widely-used intravenous drugs employed to induce and maintain general anesthesia.
Propofol was designated as a narcotic last year to limit access and prevent the drug from being abused as various side effects had been reported. Misuse of propofol was a contributing factor in the death of Michael Jackson in 2009.
But Kong, who is also an anesthesiologist at the Korea University Medical Center, said a more serious problem is that surgeons, physicians and dentists administer intravenous drugs used to induce anesthesia without the presence of anesthesiologists.
“General anesthesia by intravenous drugs should be induced by trained professionals in a controlled environment for safety reasons. But many untrained surgeons and physicians now use it, and they may be unable to cope with emergency situations in which patients stop breathing,” Kong said.
He said people should not confuse anesthesia with sleep.
“When patients are in induced unconsciousness, anesthesiologists carefully and continuously monitor their condition and adjust drugs to make it as safe as possible, while surgeons and physicians do their job,” he said.
But he added that out of approximately 1.8 million operations conducted under general anesthesia annually about 500,000 of them are undertaken without the presence of anesthesiologists.
“Also, there are a total of 3,300 hospitals and clinics capable of surgery but only 30 percent of them have full-time anesthesiologists. That means the majority of surgery is performed without anesthesiologists,” he said.