General Anesthesia

General anesthesia is the most powerful form of anesthesia. It is usually reserved for major surgery, such as surgery inside the skull, neck, chest, abdomen, and pelvis. General anesthesia may be used for other procedures if the person is unable or unwilling to cooperate during types of anesthesia that leave him or her awake.

General anesthesia uses medication to make a person unconscious. Medications are commonly breathed into the lungs or injected into the veins through an intravenous line inserted into the vein of the hand or arm.

An individual may also be temporarily paralyzed with other medications to prevent movement during the surgery. A ventilator, or artificial breathing machine, breathes for the person during the procedure because the chest muscles are paralyzed. A ventilator requires a tube to be put through the mouth into the windpipe, known as endotracheal intubation. Oxygen and inhaled medication can then be delivered to the lungs.

The person is watched closely using very sophisticated electronic devices during the procedure. The oxygen levels in the blood, pulse, blood pressure and other functions are monitored. Fluids are usually given through an intravenous line to prevent dehydration and low blood pressure.

The individual is totally asleep and unable to feel pain during the surgery. When the procedure is complete, the medication is turned off. The person will have no memory of the surgery when he or she wakes up.

The person is taken to an area called the surgery recovery room after the procedure. When the person can breathe independently, the ventilator is turned off. It may take several minutes for the person to wake up and he or she may feel groggy at first. Healthcare professionals monitor the person in the recovery room. Pain medications are given as needed.

Gradually, the person wakes up and begins the recovery process. The person may need to stay in the hospital for a few days to recover from the procedure. Often the person can go home after a few hours. The person must be stable and feel well enough to go home, and someone must be available to drive the person home because the medications cause coordination problems and slowed reflexes for several hours after surgery.

After getting home, the person should rest for the remainder of the day. By the next day, the anesthesia is usually out of the system. The following day, the pain from the surgery usually causes more problems than the anesthesia. A person should not drive for at least 12 hours after the procedure. Some people may take a few days to feel that they are back to normal.

The most feared complication of general anesthesia is sudden death. This occurs in roughly 1 out of every 10,000 people. It is not possible to predict who will have this type of severe reaction.

The medications used in general anesthesia can cause severe reactions. These include:

• liver damage
• kidney damage
• seizures
• low blood pressure
• allergic reactions

Nausea is relatively common for a few hours after the procedure. Additional side effects may occur as well, depending on the medications used. Other complications are possible, such as damage to the mouth or throat from the breathing tube. The surgery itself may also have complications.

The American Society of Anesthesiologists recently issued a warning about the potential side effects and interactions of herbal remedies with medications used before, during, and after surgery. The group recommends that a person stop taking all herbs at least two weeks before planned surgery.