It is important to avoid driving or
engaging in activities that require
focused attention (including making
important decisions and signing legal
documents) until it is clear that the
effects of general anesthesia have com-
pletely worn off.A rare but potentially life-threatening complica-
tion of general anesthesia is malignant hyperther-
mia, in which the person’s body temperature rises
rapidly and high, muscles become rigid or SPASM,
and heart rate and blood pressure vacillate wildly
and widely. Doctors believe malignant hyperther-
mia has a genetic foundation because it occurs in
families, though the precise genetic involvement
remains unknown. Death as a complication of gen-
eral anesthesia, though possible, is very rare.
Continued advances in anesthetic agents and
administration techniques are improving the expe-
rience and safety of general anesthesia.
See also NEURON; POSTOPERATIVE PROCEDURES; PRE-
OPERATIVE PROCEDURES; SURGERY BENEFIT AND RISK
ASSESSMENT; WOUND CARE.
blood autodonation A practice in which a per-
son donates his or her own BLOODfor potential
self-use during a major OPERATIONor health emer-
gency such as major trauma. The hospital or blood
bank stores the blood for specific and sole use by
the person. The person may authorize the hospital
or blood bank to release the blood for general use
as components (such as ALBUMINand PLASMA) if he
or she does not require it, though guidelines vary
according to the procedures in place for collecting
autodonated blood. Testing procedures for
autodonated may be less stringent than for gen-
eral BLOOD DONATIONbecause only the donor will
receive the blood.
Most people who choose autodonation do so
out of concern about the potential for INFECTION
such as HEPATITISacquired from general donation
blood. Though screening procedures and tests
make the blood supply as safe as possible, the risk
of such infection remains a possibility. Autodona-
tion also eliminates the risk for transfusion reac-
tion, which may occur when donor blood carries
antibodies that activate an IMMUNE RESPONSEin the
recipient. Pretransfusion testing can detect most
but not all of these scenarios. Autodonation also
ensures the availability of blood for people who
have uncommon blood types.
See also ANTIBODY; BLOOD TRANSFUSION; BLOOD
TYPE.bloodless surgery Specialized techniques that
allow surgeons to perform major operations to
avoid the need for BLOOD TRANSFUSION. Many peo-
ple oppose BLOODtransfusion on the basis of reli-
gious beliefs and others because they have
concerns about the safety of donated blood.
Though stringent screening and testing procedures
for donated blood have minimized the risk of
acquired INFECTION from the US blood supply, a
slight risk of this remains for whole blood and cer-
tain blood products.
Performing surgery when blood transfusion is
not an option requires careful planning. When the
OPERATIONis elective (nonemergency) the person
can prepare by taking medications such as ERY-
THROPOIETIN(EPO) to boost his or her ERYTHROCYTE
(red blood cell) production and donating his or
her own blood in advance of the surgery for use if
a transfusion becomes necessary. Having more
erythrocytes means the blood can carry more oxy-
gen, which encourages HEALING. It also allows the
surgeon to administer intravenous fluids during
surgery to maintain adequate fluid volume with-
out concern for diluting the blood to the extent
that ANEMIAdevelops.
During the operation, whether elective or
emergency, the surgeon can use methods to col-
lect any blood the person loses, filter it, and return
it to the person instead of transfusing donor blood.
Surgeons also use precision techniques that mini-
mize blood loss when they perform bloodless
operations. Sometimes these techniques are time
consuming, which makes the surgery more
expensive. However, many of the surgical tech-
niques surgeons use for bloodless surgery have
become standard for all operations of the same
type because they reduce the risk for postopera-
tive infection and encourage more rapid healing
and recovery.
Emergency bloodless surgery can be more of a
challenge, particularly when there are bleeding
injuries that deplete the blood supply even beforebloodless surgery 263