Anesthesia

Anesthesia is the administration of a drug and/or gas to numb part of your body or to create a state of unconsciousness. This is so that you don?t feel the pain or discomfort of a medical or surgical procedure or while having a baby. The main types of anesthesia are local, regional, and general.

Local anesthesia numbs part of your body while you remain conscious. It is routinely used by many doctors in their offices for simple procedures such as sewing up a cut or removing a skin growth.

Regional anesthesia is similar to local in that you remain awake. However, in many cases you may be given a sedative. Regional anesthesia numbs a larger area of the body and is usually used for more extensive procedures than local anesthesia. Two types of regional anesthesia are spinal and epidural.

Spinal anesthesia can be used for many operations below the navel, such as rectal, bladder, and prostate operations, as well as operations on the legs.

Epidural anesthesia can be used for many of the same procedures for which spinal anesthesia is used. Epidural anesthesia, unlike spinal anesthesia, allows for easy reinjection of anesthesia during longer operations. It can be used to treat pain for several days after the operation.

General anesthesia will relax your muscles and put you in a deep sleep. Anesthesia gases or drugs primarily affect the brain. General anesthesia is usually administered by an anesthesiologist (a doctor who specializes in giving anesthesia) or a nurse anesthetist.

How do I prepare for anesthesia?
Preparation for anesthesia varies depending on what kind of surgery or medical procedure you are having. Follow the directions your doctor gives you. General anesthesia or the use of conscious sedation typically mandates that you have a preoperative evaluation by your primary care physician. It is crucial that you inform your physician of ALL your allergies.

What happens during the procedure?
Local anesthesia involves directly numbing the nerves with the medication. It is usually administered in the form of a spray or injection. You remain fully conscious.

Spinal anesthetic is injected through a small needle into the fluid-filled space surrounding your spinal cord. The injection is usually painless. An epidural involves an injection just outside the sac that contains your spinal fluid.

For general anesthesia, the anesthesiologist examines your heart and lungs and decides on the type of anesthesia and dosage to be used. A premedication drug may be given to relax you before you go to the surgical area. When surgery begins, drugs are given by injection into a vein. If gas is used, it is given through a mask covering your nose and mouth, or through a breathing tube in your throat. In some cases, a muscle relaxant is given in addition to the anesthesia. Your heart rate, breathing, blood pressure, and other signs are watched carefully during the procedure.

What happens after the procedure?
Each procedure or type of surgery requires different follow-up. Check with your doctor about what you need to do.

What are the benefits of anesthesia?
The procedure helps to relieve pain and create numbness or a state of unconsciousness during surgery.

What are the risks associated with anesthesia?
Risks from local and regional anesthesia include:

• You may feel some minor discomfort because the anesthetic may not numb the area enough.
• You may feel pressure, but you shouldn?t feel pain. Let your doctor know if you are still feeling pain after the medication has been administered.
• Local infection
• Bleeding or bruising
• You may have an allergic reaction to the anesthetic, causing fever, hives, itching or nausea and vomiting.
• You may have long-term damage to the nerves.
• You may have trouble breathing because the anesthetic can affect the respiratory system.
• Rarely, you may have a severe reaction by having seizures, cardiac arrest, dizziness, or loss of consciousness.

Risks from general anesthesia include:

• After the anesthesia, you may have nausea and vomiting, sore throat, and muscle pain.
• You may have low blood pressure.
• You may have stress on the heart.
• You may have an irregular heartbeat (arrhythmia).
• In rare cases, you may have a heart attack, stroke, or brain damage, which could result in death.

The probability of serious side effects is low, although risk does increase with age and the number of medical problems a person has. Because general anesthesia affects all areas of your body, such as the heart and lungs, side effects are more common than with local or regional anesthetics. Local and regional anesthesia is considered safer than general anesthesia. However, most side effects from general anesthesia do not last long and are easily relieved by the anesthesiologist or nurse anesthetist present throughout the operation.

Discuss with your doctor any concerns you may have.

When should I call the doctor?
If you feel anything unusual while you are recovering from the procedure, tell the doctor or a nurse immediately. Call the doctor during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.