Is it necessary to shave beard before a general anesthesia?

Question

Hello doctor,

I am scheduled next week for outpatient surgery to have a malignant tumor removed from my bladder via a catheter inserted into my urethra. Before that, the anesthesiologist will administer a general anesthetic as well as a muscle relaxant to keep me from kicking in when under anesthesia. The procedure also involves the administration of something. I am not clear whether it is anesthetic or just oxygen via face mask.

My question. I have invested the past couple of years in growing a full, bushy beard. The RN assigned by my HMO told me I would have to shave, or trim down (way down), my beard in order to get a good seal for the mask. Is this really necessary? Is it possible that the nurse was speaking on the basis of a hygienic or even aesthetic concern about my beard rather than on the basis of a sincere concern about the possibility of a little gas (be it anesthetic or oxygen) escaping out the side of the mask? I mean, if the concern is really a hygienic one, I will be happy to shampoo the beard the night before as I had planned to do anyway.

Thank you.

Answer 1

Hi,

Welcome to icliniq.com.

That is worth a concern for both your anesthesiologist and you too. Let me elaborate on it for you.

General anesthesia involves making a person unconscious and making him totally relaxed by giving a medication called muscle relaxant. With unconsciousness and muscle relaxation, a person cannot breathe by himself under general anesthesia so he has to be administered oxygen with the help of a bag and mask ventilation supplying positive airway pressure so that his lungs expand during controlled inspiration and relax during passive expiration. Hence, this procedure requires a good mask fit on your face so that your anesthesiologist is able to ventilate your lungs with life-sustaining oxygen.

Also, as I read in your history (attachments removed to protect patient identity), you weigh 215 pounds, with a BMI of 41.99. You are considerably overweight, which means you would require more concentration of oxygen during general anesthesia. So, an overweight patient with a bushy beard is always a challenge for an anesthesiologist. To achieve a good mask fit in such a patient is always difficult in order to provide oxygen and other inhalational anesthetic agents effectively.

So, it is not that hygiene is a concern but it is a safe administration of general anesthesia a major concern in your case. I would suggest, consulting your anesthesiologist for spinal anesthesia which involves anesthetizing the lower half of your body in which bladder tumor surgery can be performed. This would avoid general anesthesia and would also save your beard.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.