Cold Symptoms and Anesthesia

You finally finished organizing everything for your surgery tomorrow and suddenly notice that you have a runny nose and sore throat. You seem to be getting a cold and wonder whether this will affect your surgery. Anesthesia may make some of your cold symptoms worse, and having a cold may increase the likelihood that you will develop breathing-related complications during or after your surgery. Your surgeon and anesthesiologist will decide whether to delay your surgery until after you have recovered.

Identifying Cold Symptoms

Establishing whether your symptoms are due to a cold will help determine how they might interact with your upcoming anesthetic. A runny or stuffy nose, sore throat, hoarseness, cough and tiredness are typical symptoms of a cold. The cough may be dry or accompanied by some phlegm. A slight fever may be present. A temperature above 100 F, muscle pains, extreme fatigue, shortness of breath, wheezing or a cough that is very frequent or producing greenish phlegm generally indicates a more serious infection such as the flu or pneumonia.

Anesthesia Can Worsen Cold Symptoms

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For most types of surgery, it is necessary to be completely asleep -- a state known as general anesthesia. General anesthesia frequently causes symptoms that are similar to a cold, so if you already have a cold, it is quite likely that anesthesia will make these symptoms worse.

• Sore throat or hoarseness: A sore throat or hoarseness after anesthesia may be caused by the dry gases breathed in during anesthesia. They may also be due to a dry throat, which commonly occurs because of the requirement to refrain from eating or drinking prior to anesthesia. A breathing tube inserted through the mouth into the throat or windpipe is another common cause of sore throat or hoarseness after anesthesia.    
  
• Coughing: Coughing can occur during and shortly after anesthesia because of the irritating effects of anesthesia gases or the breathing tube.
• Tiredness: Tiredness is common after surgery, either due to the residual effects of anesthesia medications or the use of strong pain medications. 
  

Colds May Increase Complications

Undergoing anesthesia while you have a cold may increase your likelihood of experiencing breathing-related problems. Most of these complications occur during anesthesia or just as you are waking up. They may include breath-holding; closure of the vocal cords -- known as laryngospasm; or narrowing of the airways leading into the lungs -- called bronchospasm. These can be very serious, preventing adequate amounts of oxygen from entering the body. Anesthesiologists are on the constant look-out for such complications and are able to treat them promptly if they occur. Although the only good-quality research regarding these complications has been performed in children, it is assumed that the increased likelihood observed in children with colds is applicable to adults as well.

It is also possible that a cold will increase your chances of developing a lung infection after surgery, although no good-quality studies have been published that specifically evaluated this issue. All medications used to produce general anesthesia, as well as the overall stress of surgery, are known to reduce the ability of white blood cells to combat infections. This may allow a simple cold to overwhelm the body's natural defense mechanisms and progress to a more serious infection, such as bronchitis or pneumonia.

Surgery May Be Postponed

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No major medical societies have published guidelines to help your surgeon and anesthesiologist decide whether to proceed with surgery despite your cold symptoms. Some experts, such as the authors of a chapter in "Clinical Anesthesia," recommend that elective surgery be delayed for at least 6 weeks after a cold in adults. This duration has been chosen because the airways leading to the lungs are more prone to developing bronchospasm during this time period. Other experts, including the authors of a chapter in "Miller's Anesthesia," note that postponing surgery is not always necessary if a generally healthy person has only mild cold symptoms. However, this may only be applicable for relatively minor surgery. As major surgery itself can increase the likelihood of breathing-related complications during and after anesthesia, the additional risk posed by a cold may lead to the decision to postpone the procedure.

Warnings

• Inform your surgeon and anesthesiologist if you notice any cold symptoms immediately prior to your surgery. 
• Also inform your surgeon and anesthesiologist if you have had a cold in the 6 weeks before surgery. 
• If it is determined that your surgery should proceed despite current or recent cold symptoms, inform your doctor immediately if you notice any shortness of breath, wheezing, fever or excessive coughing after your procedure.