“How will I know if I am allergic to anesthesia?”

The best place to have allergic reaction is in the operating room where they have immediate access to life saving drugs and other modalities, where you are under constant vigil and monitoring.

No. The chances are very small, 1 in 250,000.

The only true allergic response to volatile general anesthetics occurs in patients who have an inherited genetic mutation that makes them susceptible to a condition called malignant hyperthermia. If you have received general anesthesia in the past without difficulty, and none of your close relatives developed malignant hyperthermia after receiving general anesthesia, then you do not have this mutation, and you are not allergic to anesthesia.

No routine tests are peformed due to the rather low and unusual incidence of anesthesia drug allergies. More commonly would be an allergy to the antibiotic or blood product administered should they be administered.

Only after you have a reaction.

There isn't really a thing about being allergic to anesthesia in general. Anesthesia is generally putting you into a certain stage of consciousness or unconsciousness. To do so, we use a wide variety of different medications to achieve that state, but we also might give medications that affect your heart rate, your blood pressure, etc. You might be allergic to one of these specific types of medications. When we do your pre anesthetic assessment, we ask you about any drug or non drug allergies you might have. This allows us to avoid drugs you might have an allergy or a sensitivity toward. We obviously can't predict what drug you might be allergic to that you had not received in the past, but that is part of why we monitor your vital signs every step of the way. If you were to develop an allergic reaction after receiving any medication we give you, we would be able to recognize that you're having some type of reaction to it and intervene immediately.

A true allergy to anesthesia is a very rare phenomenon. It’s genetically linked and occurs in a bout 1:400,000 adults. It is called malignant hyperthermia. If no one in your family has ever experienced it under anesthesia, then the chances are, that you don’t have it.

Dr Ketch

Hello, and thanks for asking a great question.
As with all medications, there is the possibility of an allergic reaction to one or more agents used during anesthesia. Anesthesia is divided into two broad categories, General (where you are fully asleep) and Conduction (where pain impulses are blocked from reaching the brain). Each of these categories has variations on its theme: General, ranges from slight sedation to the fully asleep version, and Conduction, blocking small nerves near the site of surgery to larger nerves near the center of the body, the spinal cord.
A medical history is the primary method to determine allergies to medications and anesthesia. If you have family members who have had a reaction to an anesthetic or allergies to certain medications, many of these are used in modern anesthesia. Some allergies follow family heredity and some are patient specific. Even allergies to certain foods can give us a hint as to a potential drug allergy in anesthesia. Most anesthesia agents and medications are well proven with millions of successful anesthetics administered every year.
If during a surgery, a patient shows signs of an allergic reaction, the medication or agent is stopped and another used in its stead. Anesthesia providers are very diligent about observing patients under anesthesia. Possible drug reactions or allergies are always watched for during an anesthetic.
If no allergy was discovered in the history, the only alternative to find out before the surgery would be, allergy testing for the major classes of medications used in anesthesia.
Thanks again for your question.

“Allergy” to general anesthesia is very rare. “Allergy” to some older types of “local” anesthesia which causes numbness, is a little more frequent. However allergy to the modern “amide-linked” local anesthetics is almost unheard of.
If you have ever had a life-threatening allergic reation, be sure to tell your anesthesia provider this fact. Anesthesia providers commonly treat the much more common early stages of allergic reactions to antibiotics, latex, and other substances so that the reaction does not result in any lasting harm.

Short answer is, you can't know. If you have preexisting allergies to certain medications or foods, let your anesthesiologist know. Otherwise, there is no true allergy to anesthesia, but there can be to medicines used during anesthesia.

Boris Yaguda, M.D.