General anesthesia in adults during a cold

A cold typically includes coughing and rhinitis. Both affect the airways. In the case of a cold (rhinitis), the mucous membranes of the respiratory tract are inflamed and swell up, resulting in a blocked nose.

As a general rule, general anesthesia is best performed on a healthy patient. However, in the case of a mild adult cold, anaesthesia is usually not dispensed with and nowadays this is no longer a problem. There is, however, the risk that a cramp in the airways (bronchospasm) or the glottis (laryngospasm) is triggered during the insertion or withdrawal of the breathing tube (tube).

This means that the bronchial tubes contract very strongly, so that not enough air can flow through them. Not enough air can be inhaled and the organs cannot be supplied with enough oxygen. This is a life-threatening situation for the body.

However, this happens very rarely. The risk of anaesthesia is increased during a cold, as the tube has increased contact with the mucous membranes of the airways when inserting or removing it, which are swollen during a cold.Especially patients with pre-existing conditions such as bronchial asthma or COPD (chronic obstructive pulmonary disease) are at risk of developing bronchospasm because their airways are constricted from the beginning. However, if fever occurs before the planned operation, the operation should be postponed in any case.

This is because the central nervous system plays a decisive role in the development of fever. The drugs used under general anesthesia to suppress pain and cloud consciousness also act on the brain. This could then lead to complications.

Therefore, if the operation is not an emergency operation, the surgical procedure should be postponed for safety reasons in the event of a cold, in order to avoid unnecessary risks. Local anesthesia is usually still possible, as there is no effect on the central nervous system. General anesthesia can be performed in case of a mild cold, because swelling of the nasopharyngeal mucosa is relatively low.

It should be noted, however, that the consideration of whether or not an operation should be performed for a mild cold should be based on the size and severity of the operation. In the case of long and severe intestinal or heart surgery, the procedure should also be avoided in the case of a mild cold. Emergency surgery can be performed in any case.

While a slight cold usually does not pose a risk of anaesthesia, in the case of a cough it must be clarified exactly whether there is a risk. A cough without sputum and without severe swelling is in most cases not critical. As soon as the affected person has swellings in the throat, for example in the tonsils, the anesthetist must decide whether the swellings can cause respiratory problems.

Coughing with mucusy sputum can also represent an increased anaesthetic risk, as there is greater resistance in the bronchi during ventilation. In any case, these are individual case decisions in which the increased risk must be weighed against the necessity of the operation. Fever is a reaction of the body indicating that the immune system is currently fighting off a pathogen.

A slight increase in body temperature does not necessarily lead to a postponement of the operation, but an attempt should be made to find the reason for the increased temperature. Since an infection already means stress for the body and general anesthesia is always a very stressful situation, it must be carefully considered whether the operation must be performed directly. This is also a case by case decision, where risk and benefit are compared.