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What’s really dangerous about anesthesia is the general public’s ignorance of the real safety issues when it comes to sedation for surgery. I am often told by my patients that they do not want general anesthesia because they worry that they may never wake up. People want sedation that allows them to breathe on their own. The impression is that somehow this is more “natural”. I am not sure it is more “natural” ; certainly appears less invasive but in fact can be clearly more dangerous. Sedation with  or without a breathing tube affects the entire cardio-pulmonary system and is general anesthesia. We call it “sedation” when there is no breathing tube in place and general anesthesia when there is a tube.

Sedation without airway control (breathing tube) is like driving without a windshield wiper. You don’t always need it but when you do……..

Sedation is an uneven process whereby a person may receive just the right amount or ….too little (waking up in the middle of the procedure in pain) or too much (not breathing at all requiring external ventilation and possible intubation, ie: a breathing tube). Electively performing general anesthesia (requiring a breathing tube) is the safest form of sedation where there is complete control of the airway avoiding unnecessary emergencies that are not always successful. Joan Rivers is an unfortunate example of just such an emergency.

It is much more dangerous to cross a supermarket parking lot than have true general anesthesia. Supermarkets are just more familiar.