While there are many types and levels of anesthesia — medication to keep you from feeling pain during surgery — general anesthesia is most commonly used for major operations, such as knee and hip replacements, heart surgeries, and many types of surgical procedures to treat cancer. Many of these surgeries are lifesaving or life-changing and would not be possible without general anesthesia.
How does general anesthesia work?
General anesthesia is medicine that is administered by a physician anesthesiologist through a mask or an IV placed in the vein. While the anesthesia is working, you will be unconscious, and many of your body’s functions will slow down or need help to work effectively. A tube may be placed in your throat to help you breathe. During surgery or the procedure, the physician anesthesiologist will monitor your heart rate, blood pressure, breathing, and other vital signs to make sure they are normal and steady while you remain unconscious and free of pain.
During surgery, the physician anesthesiologist will monitor your vital signs to make sure they are normal and steady while you remain unconscious and free of pain.
Once your surgery is complete, your physician anesthesiologist will reverse the medication and be with you as you return to consciousness, continually monitoring your breathing, circulation, and oxygen levels. Some patients feel fine as they wake up; others experience symptoms such as nausea, vomiting, or chills. Your throat may be sore from the breathing tube. Your physician anesthesiologist will help you manage these symptoms.
Because you’ve had major surgery, you probably will have pain and discomfort from the procedure as you recover, which might get worse as the effects of the general anesthesia wear off. Your physician anesthesiologist will advise you about how to manage your pain during recovery in the hospital and at home.
If you are able to go home the day of surgery, you will not be able to drive after having general anesthesia — so make sure someone can take you home. It may take a day or two for the anesthesia medication to completely leave your system, so you may be sleepy, and your reflexes and judgment may be affected.
Today, physicians have many ways to make sure their patients are as comfortable as possible during surgery or procedures for diagnosing medical conditions. One common type of pain control is called sedation, which relaxes you and sometimes makes you fall asleep. Sedation, also known as monitored anesthesia care, conscious sedation, or twilight sedation, typically is used for minor surgeries or for shorter, less complex procedures, when an injection of local anesthetic isn’t sufficient but deeper general anesthesia isn’t necessary. These procedures might include some types of biopsies or involve the use of a scope to examine the throat or colon to find and treat medical conditions such as cancer.
An analgesic is a medication used to achieve analgesia, or pain relief, and is often combined with sedation. Procedures using sedation and analgesics may be performed in a hospital or in an outpatient setting, such as a same-day surgery center, your physician’s office, or a dentist’s offic
How do sedation and analgesia work?
Sedation and analgesics are usually provided through an IV placed in a vein. Depending on the procedure, the level of sedation may range from minimal (you’ll feel drowsy but able to talk) to deep (you probably won’t remember the procedure). Moderate or deep sedation may slow your breathing, and in some cases, you may be given oxygen. Analgesia may also contribute to drowsiness. But even with deep sedation, you won’t be unconscious, as you would be with general anesthesia.
Most patients wake up quickly once the procedure is over and the medications are stopped. Possible side effects include headache, nausea, and drowsiness, but you will likely experience fewer effects than you would from general anesthesia — and you’ll probably recover faster and go home sooner.
Sometimes IV sedation and analgesics will be combined with other types of pain control — such as local anesthesia, which involves one or more injections to numb a small area of the body, or regional anesthesia, which numbs a larger part of the body, such as from the waist down.
What are the levels of sedation?
The level of sedation a patient experiences depends on several factors, including the type of procedure you’re having and how your body responds to anesthesia. Your age, medical condition, and health habits may also affect the type of anesthesia you’ll receive. Regardless of the level of sedation, it’s important that a physician anesthesiologist be involved in your anesthesia care. A physician anesthesiologist is a medical doctor who specializes in anesthesia, pain management, and critical care medicine.
The main levels of sedation are:
- Minimal – Minimal sedation will help you relax, but you will likely be awake. You’ll understand questions your doctor is asking and be able to answer as well as follow directions. This level of sedation is typically used when your doctor needs you to be involved in the procedure.
- Moderate – You will feel drowsy and may even fall asleep during the procedure. You may or may not remember some of the procedure.
- Deep – You won’t actually be unconscious, but you’ll sleep through the procedure and probably will have little or no memory of it.
Regional anesthesia is a type of pain management for surgery that numbs a large part of the body, such as from the waist down. The medication is delivered through an injection or small tube called a catheter and is used when a simple injection of local anesthetic is not enough, and when it’s better for the patient to be awake.
This type of anesthesia, including spinal blocks and epidurals, is often used for childbirth. In fact, an epidural is the most common type of pain control used for labor and delivery. It allows the mother to be awake and able to push when it’s time to deliver the baby, but numbs the pain. Another type of regional anesthesia — a spinal block — is stronger and is used during procedures such as cesarean deliveries, also known as C-sections. Spinal blocks and epidurals allow the doctor to surgically deliver the baby without causing pain to the mother, and without subjecting the baby to sedating drugs that might be harmful.
Regional anesthesia is very safe and doesn’t involve the potential complications and side effects that can happen with sedation and general anesthesia. But it does carry some risks, and it’s important that it be provided and monitored by a physician anesthesiologist.
Today, many types of surgery can be safely and painlessly performed while you are awake. Local anesthesia, also called local anesthetic, is usually a one-time injection of medicine that numbs a small area of the body. It is used for procedures such as performing a skin biopsy or breast biopsy, repairing a broken bone, or stitching a deep cut. You will be awake and alert, and you may feel some pressure, but you won’t feel pain in the area being treated.
When is local anesthesia used?
Local anesthetics have made it possible to perform many surgical procedures quickly, with less preparation and a shorter recovery time. General anesthesia and anesthesia that sedates you can cause side effects such as nausea, and a physician anesthesiologist must monitor you if you are administered these types of anesthesia — during the procedure and for a time afterward. However, with local anesthesia, side effects and complications are rare and usually minor. For example, you may experience some soreness where the medication was injected. In rare cases, you could have an allergic reaction to the anesthetic.
There are some procedures that can’t be performed without general anesthesia or sedation. Other procedures may require an anesthetic that numbs a larger part of the body, such as from the waist down. This is called regional anesthesia and is used for procedures such as a cesarean delivery, also called a C-section.
But for many procedures, your doctor will recommend a local anesthetic. For others, you may have a choice. If you prefer not to be sedated, ask your surgeon or the physician anesthesiologist if your procedure can be performed safely and comfortably with local anesthesia. Not only will you recover and get home faster, but the procedure may be less expensive.
Sometimes local anesthesia is combined with sedation.
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