For many patients, the anaesthetic worries them more than the operation itself. Some of that fear comes from films, some from stories passed between relatives, and some from practices that were once routine but have since changed. Here are five common beliefs, and what the evidence says.
Myth 1. “I might wake up during the operation”
Accidental awareness during general anaesthesia is real but rare. The Fifth National Audit Project (NAP5) of the Royal College of Anaesthetists, the largest study of its kind, found that patients reported it in about 1 in 19,000 general anaesthetics. Most episodes lasted less than five minutes, and the risk was concentrated in specific situations, particularly when muscle relaxants were used. Anaesthesiologists monitor patients continuously, and many use brain-activity monitors to guide the depth of anaesthesia in higher-risk cases.
Myth 2. “Nothing to eat or drink after midnight”
The old rule of fasting from midnight has been replaced. Guidelines from the European Society of Anaesthesiology and the American Society of Anesthesiologists allow most healthy adults to drink clear fluids, such as water, until two hours before planned surgery, and to eat a light meal up to six hours before. Long fasts can leave patients dehydrated, hungry and uncomfortable without making them any safer. Always follow your own hospital’s instructions, as timings may differ for some patients and procedures.
Myth 3. “A spinal or epidural causes lifelong back pain”
Soreness at the injection site for a few days is common. Lasting back pain is a different matter. A randomised study of women who did and did not receive an epidural in labour, followed up for about two years and published in the BMJ, found no causal link between the epidural and long-term backache. Back pain is common after pregnancy and surgery, with or without an epidural, and the cause usually lies elsewhere.
Myth 4. “The anaesthesiologist gives an injection and leaves”
The anaesthesiologist stays with the patient for the entire operation. Throughout surgery, they watch heart rhythm, blood pressure, oxygen levels and breathing, adjust drugs and fluids minute by minute, and manage blood loss and any sudden change. They also plan pain relief for recovery and are often the first doctor called if a patient’s condition changes after surgery.
Myth 5. “Anaesthesia is the same for everyone”
Every anaesthetic is planned for the individual. Age, weight, heart and lung health, sleep apnoea, allergies and current medicines all shape the choice of drugs and technique. That is why the pre-anaesthetic check-up matters. Be open about everything you take, including weight-loss injections, blood thinners, herbal and Ayurvedic remedies, alcohol and tobacco.
Anaesthesia today is among the safest parts of modern medicine, the result of decades of research, training and careful monitoring. The best way to ease the fear is to meet the anaesthesiologist before surgery and ask every question you have.
