Up
to date about General anesthesia
Dr. Alisher Agzamov MD PhD
General anesthesia is a treatment that puts you
into a deep sleep so you do not feel pain during surgery. When you receive
these medications, you will not be aware of what is happening around you.
You will receive general anesthesia in a
hospital or outpatient clinic. Most times, a doctor called an anesthesiologist
will put you to sleep. The doctor will give you medication into your vein. You
may be asked to breathe in (inhale) a special gas through a mask. Once you are
asleep, the doctor may insert a tube into your windpipe (trachea) to help you
breathe and protect your lungs.
You will be watched very closely while you are
asleep. Your blood pressure, pulse, and breathing will be monitored. The Anaesthesiologist and Anaesthesia technicians taking care of you can change how
deeply asleep you are during the surgery. You will not move, feel any pain, or
have any memories of the procedure because of this medicine.
Why
the Anaesthesia Procedure is performed
General anesthesia is a safe way to stay asleep
and pain-free during anaesthesia procedures that would:
- Be too painful
- Take a long time
- Affect your ability to
breathe
- Make you uncomfortable
- Cause too much anxiety
- Has some postoperative
side effects
You may also be able to have conscious sedation for your procedure,
but sometimes it isn’t enough to make you comfortable. Children may need
general anesthesia for a medical or dental procedure to handle any pain or
anxiety they may feel.
Risks
General anesthesia is usually safe for healthy
people. The following people may have a higher risk of problems with general
anesthesia:
- Patients who abuse
alcohol or medications
- Patients with
allergies or a family history of being allergic to medicine
- Patients with heart,
lung, or kidney problems
- Smokers
Ask your Anaesthesiologist about these
complications:
- Death (rare)
- Harm to your vocal
cords
- Heart Attack
- Lung infection
- Mental confusion
(temporary)
- Stroke
- Trauma to the teeth or
tongue
- Waking during anesthesia
(rare)
Before
the Procedure
Always tell your Anaesthesiologist or nurse:
- If you could be
pregnant
- What drugs you are
taking, even drugs or herbs you bought without a prescription
During the days before the surgery:
- An anesthesiologist
will take a complete medical history to determine the type and amount of
anesthesia you need. This includes asking you about any allergies, health
conditions, medications, and history of anesthesia.
- Several days before
surgery, you may be asked to stop taking aspirin, ibuprofen, warfarin
(Coumadin), and any other drugs that make it hard for your blood to clot.
- Ask your
Anaesthesiologist which drugs you should still take on the day of your
surgery.
- Always try to stop
smoking. Your Anaesthesiologist can help.
On the day of your surgery:
- You will usually be
asked not to drink or eat anything after midnight the night before the
surgery. This is to prevent you from vomiting while you are under
anesthesia. Vomiting during anesthesia can be dangerous.
- Take the drugs your
Anaesthesiologist told you to take with a small sip of water.
- Your Anaesthesiologist
or nurse will tell you when to arrive.
After
the Procedure
You will wake up tired and groggy in the
recovery or operating room. You may also feel sick to your stomach, and have a
dry mouth, sore throat, or feel cold or restless until the anesthesia wears
off. Your nurse will monitor these side effects. They will wear off, but it may
take a few hours. Sometimes nausea and vomiting can be treated with other
medicines.
Follow your doctor's recommendations while you
recover and care for your surgical wound.
Outlook
(Prognosis)
General anesthesia is generally safe because of
modern equipment, medications, and safety standards.
Most patients recover completely and do not have
any complications.
Conscious
sedation for surgical procedures
Conscious sedation is a combination of medicines
to help you relax (a sedative) and to block pain (an anesthetic) during a
medical or dental procedure. You will probably stay awake but may not be able
to speak.
Conscious sedation lets you recover quickly and
return to your everyday activities soon after your procedure.
An Anaesthesiologist or Dentist, will give you
conscious sedation in the hospital or outpatient clinic. Most of the time, it
will not be an anesthesiologist. The medicine will wear off quickly, so it is
used for short, uncomplicated procedures.
You may receive the medicine through an
intravenous line (IV, in a vein) or a shot into a muscle. You will begin to
feel drowsy and relaxed very quickly. If your Anaesthesiologist gives you the
medicine to swallow, you will feel the effects after about 30 - 60 minutes.
Your breathing will slow down, and your blood
pressure may drop a little. Your nurse or doctor will monitor you every 3 - 5
minutes during your procedure to make sure you are okay. This person will stay
with you at all times during the procedure.
You should not need help with your breathing,
but you may receive extra oxygen through a mask or IV fluids through a catheter
(tube) into a vein.
You may fall asleep, but you will wake up easily
to respond to people in the room. You may be able to respond to verbal cues.
After conscious sedation, you may feel drowsy and not remember much about your
procedure.
Why
the Procedure is Performed?:
Conscious sedation is safe and effective for
patients who need minor surgery or a procedure to diagnose a condition.
Some of the tests and procedures conscious
sedation may be used for are:
- Breast biopsy
- Dental prosthetic or
reconstructive surgery
- Minor bone fracture
repair
- Minor foot surgery
- Minor skin surgery
- Plastic or
reconstructive surgery
- Procedures to diagnose
and treat some stomach (upper endoscopy), colon (colonoscopy),
- Lung ( bronchoscopy), and
- Bladder (cystoscopy) conditions
Risks
Conscious sedation is usually safe. However, if
you are given too much of the medicine, problems with your breathing may occur.
A doctor or nurse will be watching you during the whole procedure.
Health care providers always have special
equipment to help you with your breathing, if needed. Only certain qualified
health professionals can provide conscious sedation.
Before
the Procedure
Always tell your Anaesthesiologist or nurse:
- If you are or could be
pregnant
- What drugs you are
taking, even drugs, supplements, or herbs you bought without a
prescription
During the days before your procedure:
- Tell your Anaesthesiologist
about any allergies or health conditions you have, what medicines you are
taking, and what anesthesia or sedation you have had before.
- You may have blood or
urine tests and a physical exam.
- Arrange for a
responsible adult to drive you to and from the hospital or clinic.
- If you smoke, try to
stop. Ask your Anaesthesiologist or nurse for help quitting.
On the day of your procedure:
- You will usually be
asked not to drink or eat anything after midnight the night before your
procedure.
- Do not drink alcohol
the night before and the day of your procedure.
- Take the drugs your
doctor told you to take with a small sip of water.
- Your Anaesthesiologist
or nurse will tell you when to arrive at the hospital or clinic.
After
the Procedure
After conscious sedation, you will feel sleepy
and may have a headache or feel sick to your stomach. During recovery, your
finger will be clipped to a special device (pulse oximeter) to check the oxygen
levels in your blood. Your blood pressure will be checked with an arm cuff
about every 15 minutes.
You should be able to go home 1 to 2 hours after
your procedure.
When you are home:
- Eat a healthy meal to
restore your energy.
- You should be able to
return to your everyday activities the next day.
- Avoid driving,
operating machinery, drinking alcohol, and making legal decisions for at
least 24 hours.
- Check with your doctor
before taking any medicines or herbal supplements.
- If you had surgery,
follow your doctor's instructions for recovery and wound care.
Outlook
(Prognosis)
Conscious sedation is generally safe, and is an
option for procedures or diagnostic tests.
References
Jagannath S, Baron TH, Anderson MA, et al.
Sedation and anesthesia in GI endoscopy. Gastrointestinal Endoscopy.
Aug 2008;68(2).
Cohen NA, Stead SW. Moderate sedation for chest
physicians. Chest. June 2008;133(6).
Sherwood ER, Williams CG, Prough DS. Anesthesiology
principles, pain management, and conscious sedation. In: Townsend CM, Beauchamp
RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th
ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 18.
Sherwood ER, Williams CG, Prough DS. Anesthesiology
principles, pain management, and conscious sedation. In: Townsend CM, Beauchamp
RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th
ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 18.
