I have had a few surgeries in my lifetime. My most recent surgery was open heart surgery – a triple bypass. I remember before each surgery I was introduced to the anesthesiologist and he told me his procedure and the risks. Before each surgery, I always had to sign a consent form giving him permission to administer anesthesia to me knowing the risks.
I must say that aside from knowing its risks, I never gave the anesthesia much thought.
Below is very helpful information about anesthesia.
What is anesthesia?
Anesthesia is medicine to keep a patient comfortable and unaware of any pain during a procedure, or surgery.
How is anesthesia administered?
The anesthesia medicine will be given in the patient’s IV, through a face mask, or through a tube in your nose or throat. It can also be given as a shot in your back, or as a shot in the area where you need the procedure or the surgery done. How it is administered depends on the type of anesthesia needed.
When is anesthesia administered?
All anesthesia is administered a short time before the actual procedure or surgery begins to allow the anesthesia time to numb the areas which are being worked on and to make sure the patient will be relaxed or asleep during the surgery.
Why are there different types of anesthesia?
A person’s medical history such as if he, or she has diabetes, heart disease or heart problems, abnormal test results, and/or if he, or she has had a previous allergic reaction to a specific type of anesthesia will prevent an anesthesiologist from using one type of anesthesia and the anesthesiologist will have to choose another type.
A person’s current medical condition and age may also determine what type of anesthesia will be administered by the anesthesiologist.
The type of procedure or surgery a patient is having will determine if local (regional) anesthesia is needed, or general anesthesia.
What types of anesthesia are there?
There are 3 major types of anesthesia. They are:
1. Local Anesthesia is where a numbing drug is injected directly into the surgical area and around the surgical area to block pain sensations. This medicine can also sometimes be given as an ointment or a spray. Local anesthesia is best used for tests, procedures, or surgeries where a lot of pain is not expected. Local anesthesia can only be used for minor procedures on a limited part of the body, such as a hernia, breast biopsy, or skin procedures. Usually the patient is awake during the procedure and might also be given a relaxant to help the patient relax to relieve anxiety and any discomfort, or to even fall sleep.
Procedural sedation is a limited type of anesthesia which combines the use of local anesthesia with small doses of sedatives or painkillers to relax the patient.
2. Regional Anesthesia is where a local numbing drug is injected around major nerves or the spinal cord to block pain from a larger but still limited part of the body. It numbs the nerves running down to the lower part of the body. This type of anesthesia can be chosen for a variety of major surgical procedures, such as those performed on the legs and lower abdomen. Most likely another medication will be given to help the patient relax comfortably and even sleep during the surgery.
There are 2 major types of Regional Anesthesia which are:
A). Peripheral Nerve Blocks in which a local anesthetic is injected near a specific nerve or group of nerves to block pain from the area of the body supplied by the nerve. This type of anesthesia can also be given in the patient’s armpit which is called an axillary block. Nerve blocks are most commonly used for procedures on the hands, arms, feet, legs, or face. Surgery on the upper extremity can be performed using nerve blocks on the arm. With this type of regional anesthesia the area remains numb for 4 to 18 hours depending on the type of medicine used. The patient may be awake during the surgery or may be given medication to make them sleepy.
B). Epidural and Spinal Anesthesia in which a local anesthetic is injected near the spinal cord and nerves that connect to the spinal cord to block pain from an entire region of the body, such as the abdomen, hips, or legs. This type of regional anesthesia is used for procedures or surgeries performed on the lower abdominal area, pelvic area, rectal, or other lower extremity areas. In some situations, such as a prolonged procedure, spinal anesthesia may be given continuously throughout the surgery. If this were the case, a thin catheter tube is left in place so the anesthesiologist can continuously inject the numbing medication.
Spinal and Epidural Anesthesia is commonly used for surgery below the waist – of the lower limbs and during labor and childbirth. When women hear the word ‘epidural’ they immediately associate it with easing labor pains.
This type of anesthesia also involves continually administering an anesthetic medication through a thin catheter tube. As the patient lies on his, or her side or is sitting up, the catheter is placed into the space that surrounds the spinal cord in the lower back causing numbness in the lower body. The needle is then taken out but the catheter is left in place to give the patient more medicine if needed. The patient is awake during surgery but may be given medicine in their IV so that he or she is sleepy. The patient’s lower body is numb and he or she may be able to move their legs but should not feel pain. Full feeling returns in the legs after the medication is stopped and wears off – usually in 1 to 4 hours. How high the numbness goes depends on where the surgery will be performed.
Epidural anesthesia may also be used for chest surgical procedures. In this case, the anesthetic medication is injected at a higher location in the back to numb the chest and abdominal areas.
One advantage of spinal or epidural anesthesia is that long-acting medications can be placed near the spinal cord to give pain relief for an extended period after the operation.
Epidural anesthesia can give longer lasting pain relief than spinal anesthesia.
3. General Anesthesia is administered into a vein (IV) usually in the patient’s arm or is inhaled through a breathing mask, or a tube. It affects the brain as well as the entire body. Its purpose is to put the patient in an unconscious state during surgery. The patient is completely unaware and does not feel pain during the surgery. A breathing tube may be inserted into the patient’s windpipe to administer oxygen for continuous proper breathing during surgery and to administer aesthetic gases to keep the patient asleep. Once the surgery is complete, the anesthesiologist stops the anesthetic, including the gases and the patient wakes up in the recovery room. For shorter procedures and surgeries, the tube in the windpipe is not used, and the patient can simply breathe through a mask during the whole operation.
General anesthesia may often cause forgetfulness right after surgery. I remember before I had my heart surgery, as I was waiting in the operating room one of the resident doctors said to me, “Look around because you are not going to remember any of this afterwards.
Along with all of the different types of anesthesia, a patient may also be given a muscle relaxant which blocks the transmission of nerve impulses to the muscles and temporarily relaxes the muscle tone.
References:
WebMD Medical Reference from Healthwise (2008, February)
http://www.webmd.com/pain-management/tc/anesthesia-types-of-anesthesia?page=2
Drugs.com (2010, May) http://www.drugs.com/cg/types-of-anesthesia.html
