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Anesthesia Risks
Park Ridge, Ill.—Two popular forms of self-expression today are tattoos and piercings. But unlike other fashion statements, body ornamentation such as lower-back tattoos and pierced tongues may carry health risks should the wearer need anesthesia care, according to the American Association of Nurse Anesthetists (AANA).
A tattoo is a permanent mark or design made on the body with pigment injected into the dermal layer of the skin through ruptures in the skin’s top layer. A small needle punctures the skin repeatedly—an action resembling that of a sewing machine—and inserts tiny ink droplets with each puncture. Theoretically, inserting a needle through the pigment of a tattoo may result in a tissue core that contains pigment, leading to possible neurological complications later on.
"The AANA is not opposed to tattoos and respects peoples’ rights to adorn their body however they please," said Sandra Tunajek, CRNA, ND, director of Practice for the AANA. "However, since the jury is still out on whether injecting a needle through a tattoo poses a significant health risk, we caution anyone interested in obtaining a tattoo to give strong consideration to where it is placed on their body."
For example, Tunajek pointed out that a popular tattoo location among young women is the lower back. These women don’t necessarily consider that someday they might need an epidural during labor and delivery, and may encounter subsequent problems if the needle has to pass through a tattoo, said Tunajek. "At this point, the risk of infection is still unknown," she added.
A study conducted by the Canadian Journal of Anesthesia to test the ramifications of women receiving epidural anesthesia in a tattooed area encountered a patient whose tattoo covered her entire back, making it impossible for the anesthesia provider to locate a lumbar interspace that did not have tattoo pigment in the overlying skin. Aside from the difficulty in locating a suitable area to insert the epidural, the woman received the epidural without incident. Other studies conducted on this matter have shown no adverse affects on the patient or anesthesia process. However, possible long-term implications from depositing a pigmented tissue core into these areas are unknown.
Another anesthesia risk associated with body ornamentation involves pierced tongues.
"If a patient who is scheduled to have surgery has a pierced tongue, then the tongue ring is removed prior to the procedure. That’s simple enough," said Tunajek. The potential for trouble arises in emergency situations when the patient needs to be intubated—that is, have a breathing tube inserted down his or her throat—to receive urgent care.
"A pierced tongue isn’t typically the first thing on the anesthesia provider’s mind while they’re preparing the patient for surgical or some other emergency care," said Tunajek. "The instrument used to insert the breathing tube may catch on the tongue ring, tearing the tongue or knocking the ring down the patient’s throat."
"It’s unlikely that people who get their tongue pierced consider this sort of associated health risk," said Tunajek. "But as the popularity of this type of piercing grows, people need to be aware of all possible ramifications."
Public Service Announcement: Tattoos and Anesthesia (:30)
See text for PSA.
Public Service Announcement: Health Alert (:30)
See text for PSA.
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