What happens if you need general anesthetic and they can't get you intubated?

Question

What happens if you are needing general anastecia for TT, MR, and lipo and they can't get you intubated? Do the wake you back up and cancel your surgery?

J. Timothy Katzen, MD, FACS · Answer

Hello and thank you for your interesting question regarding intubation and general anesthesia.

Though technically conceivable, I’ve never seen this happen in 35 years. Most Board Certified plastic surgeons utilize Board Certified anesthesiologists to perform their anesthesia. Most intubations are generally straightforward. If the intubation is more complex, there are maneuvers and instruments that can be used to ensure intubation. Techniques such as a glide-a-scope and small catheters over which the general endotracheal tube can be threaded are typically reserved for extreme cases.

However, 99.9% of the time, general anesthesia is successfully established, and the elective plastic surgery procedures can be completed. If for some reason intubation cannot be achieved, the anesthesiologist may indeed wake you up and the surgery could be postponed until a safe intubation strategy can be implemented.

Good luck. I hope this helps answer your question regarding the intubation process for general anesthesia.

Sincerely,

J. Timothy Katzen, MD, FASMBS, FICS

Morad Askari, MD, MBA · Answer

Thank you for your question. The surgical team and anesthesiologists are trained to handle airway crises. If intubation is difficult or ineffective, they may try other approaches, such as using different types of laryngoscopes, adjusting the patient's posture, or employing specific procedures. Anesthesiologists, experts in challenging airways, may have advanced tools to assist in intubation. If they determine that intubation is not feasible, they may consult with more experienced colleagues or request additional assistance, such as a specialist airway team. The patient's safety is the top priority, so the anesthesia team may awaken the patient and reschedule the operation if they believe maintaining general anesthesia is difficult. This decision prevents issues arising from inadequate oxygenation and ventilation during surgery.

Azita Madjidi, MD, MS, FACS · Answer

Tummy tuck is an elective procedure that is best done under general anesthesia. If you are at high risk of anesthesia or have a difficult airway for intubation, it has to be done in a very controlled environment under the supervision of an experienced anesthesiologist. If the difficult intubation was not known, then yes, the tentative may be aborted to minimize the risks.

Guler Gamze Eren, MD · Answer

All of the patients are examined by an anesthesiologist prior to the surgery to determine if they have any risk. If you can't get intubated despite trying several times you will be probably waked up and the surgery will be postponed.

Ronald J. Edelson, MD · Answer

There are several ways to assist with intubation so this rarely comes up. Also there is a device called a laryngeal airway which can be used instead. This issue rarely occurs

Connie Hiers, MD, FACS · Answer

Anesthesia now has several items that can assist with complicated intubations. Just because you were difficult at one time, does not always mean you will be difficult every time. Sometimes the throat muscles spasm and tighten and surgery will be cancelled. This is uncommon in adults. I have brought patients back after spasm who had no issues at a later time. However, this is elective surgery, and your safety is the first priority. Surgery may be cancelled if needed.

Camille Cash, MD · Answer

The risk of you not being able to be intubated is very low.  Before your surgery you will meet your anesthesiologist who will review your history, interview you, and assess your risk.  If you are deemed to be at high risk your surgery could potentially be postponed.  Be sure to discuss your concerns and ask questions.

What happens if you need general anesthetic and they can't get you intubated?

Answers (7)

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