Anesthesia: How Real Are the Risks?

Authored by: Kanae Funabiki

Art by: Ariana Desai

Public consciousness surrounding anesthesia is formed by rare yet devastating events. A botched epidural taking a pregnant woman’s life, a patient feeling pain while being given a paralytic [1][2]… Michael Jackson overdosed on propofol, which is actually a common anesthetic used in surgery. In a sense, anesthesia related deaths are similar to plane crashes; accidents rarely happen, but when they do, they are drastic. Whether for a quick dental procedure or a life-threatening surgery, nearly 60,000 patients receive general anesthesia daily in the United States, and it is estimated that 60% of people in England undergo surgery at some point in their lifetime [3][4].

The risks and methods of anesthesia differ based on the type of case as well as the hospital. Currently, anesthetic methods can broadly be separated into three groups: general, local, and regional. General anesthesia is what people usually imagine from TV shows and movies—being completely unconscious during surgery. However, there is still no objectively agreed upon definition of general anesthesia, as a low concentration of anesthetic may lead to symptoms such as amnesia, the inability to feel pain, and excitation, while a high concentration leads to other effects such as deep sedation and muscle relaxation [5]. Usually, general anesthesia during surgery guarantees that the patient does not wake up during the procedure. However, it is the most invasive method, as it requires a breathing tube inserted into the trachea. Potential complications include myocardial infarctions (interference with lung mechanics), acute renal impairment (decreased kidney function), and vomiting [6].

Regional anesthesia, on the other hand, is a specific technique that targets peripheral nerves with an anesthetic agent to block the transmission of pain. In short, it only numbs a specific area. It is commonly used for orthopedic surgeries and C-sections to relieve pain. In this case, anesthesiologists inject lower concentrations of medications compared to general anesthesia, resulting in fewer side effects and faster recovery. One main type of regional anesthesia is a nerve block, where medications are injected in very close proximity to nerves. Potential complications from nerve blocks include nerve injury, infections, and bleeding [7].

Local anesthesia is the lightest form of anesthetic, administered either via injection or topical cream [8]. It provides pain relief but only for limited procedures, such as sewing deep cuts or filling dental cavities. Additionally, it is sometimes injected at the end of surgical procedures to provide extra relief during recovery. Possible complications include pain at the injection site, sensory disorders, and, very rarely, nerve damage [9].

So how significant are the risks of anesthesia? In 2011, anesthesia related mortality rates were reported to be as low as 0.4 per 100,000, largely due to improvements in safety standards and enhanced training [10]. The rise of regional anesthesia has also improved outcomes for major surgical procedures. Of all anesthesia-related deaths, 46.6% were connected to anesthesia overdose, 42.5% were due to adverse effects of anesthetics, and 3.6% were related to pregnancy care. Anesthesia continues to make significant progress, with ongoing innovations in nerve blocks and the development of faster-acting drugs. Although tragic cases capture headlines, the reality is that anesthesia is remarkably safe and continues to improve each year.

References:

1. Goldstein, J. (2023, January 23). A deadly epidural, delivered by a doctor with a history of mistakes. The New York Times. https://www.nytimes.com/2023/01/23/nyregion/anesthesiologist-brooklyn-deaths.html 

2. NBC News. (2007, April 10). Family sues after man gets wide-awake surgery. NBC News. https://www.nbcnews.com/id/18040894/ns/health-health_care/t/family-sues-after-man-gets-wide-awake-surgery/

3.  Watson, S.-L., Fowler, A. J., Pearse, R. M., Abbott, T. E. F., et al. (2024). The lifetime risk of surgery in England: A nationwide observational cohort study. British Journal of Anaesthesia, 133(4), 768–775. https://doi.org/10.1016/j.bja.2024.06.028

4. Way, C. S., & Hill, A. D. (2012). Anaesthesia mortality: A review of current understanding and outcomes. British Journal of Anaesthesia, 109(Supplement 1), i29–i38. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162622/

5. Son Y. (2010). Molecular mechanisms of general anesthesia. Korean journal of anesthesiology, 59(1), 3–8. https://doi.org/10.4097/kjae.2010.59.1.3

6. Harris, M., & Chung, F. (2013). Complications of general anesthesia. Clinics in plastic surgery, 40(4), 503–513. https://doi.org/10.1016/j.cps.2013.07.001

7. Folino, T. B., & Mahboobi, S. K. (2023). Regional anesthetic blocks. In StatPearls. StatPearls Publishing. Retrieved January 29, 2023, from https://www.ncbi.nlm.nih.gov/books/NBK563238/

8. UCLA Health. Types of anesthesia. UCLA Health. Retrieved March 2, 2026, from https://www.uclahealth.org/medical-services/anesthesiology/types-anesthesia

9. Ghafoor, H., Haroon, S., Atique, S., Ul Huda, A., Ahmed, O., Bel Khair, A. O. M., & Abdus Samad, A. (2023). Neurological Complications of Local Anesthesia in Dentistry: A Review. Cureus, 15(12), e50790. https://doi.org/10.7759/cureus.50790 

10. Gottschalk, A., Van Aken, H., Zenz, M., & Standl, T. (2011). Is anesthesia dangerous?. Deutsches Arzteblatt international, 108(27), 469–474. https://doi.org/10.3238/arztebl.2011.0469