Anesthesia

Definition of Anesthesia

The word anesthesia means a loss of feeling or pain. The term, however, is more commonly used to describe a series of procedures by which medications are given to an individual to prevent feelings of pain, or sometimes awareness, during a surgery or other procedure.

Who is a candidate for the procedure?

A person who is having a painful procedure may need anesthesia. The procedure may range from getting stitches for a cut to open heart surgery.

How is the procedure performed?

There are many different types of anesthesia and ways to give the medications. Common examples include:

• general anesthesia
• epidural anesthesia
• spinal anesthesia
• topical anesthesia
• regional anesthesia
• local anesthesia
• dissociative anesthesia

General anesthesia is a type of anesthesia which puts the person to sleep. The person is made unconscious with medications that are breathed into the lungs or injected into the veins. In general anesthesia, a person is also temporarily paralyzed with medications. A person has no memory of the surgery when he or she wakes up. General anesthesia is used for most major operations.

In dissociative anesthesia, the person is not put to sleep completely, but rather the medication, in addition to controlling pain, induces a trancelike state from which the person emerges with no memory of the procedure.

Epidural anesthesia and spinal anesthesia both involve injecting medications into the spinal column. The medications act directly on the spinal cord and nerves to stop the feeling of pain. A person is generally awake during the procedure. These types of anesthesia are commonly used during childbirth and with surgeries below the waist.

Regional anesthesia, local anesthesia, and topical anesthesia involve injecting medication into the skin or rubbing it onto the skin near the site of the procedure, causing numbing. In regional anesthesia a large area, such as the entire hand or leg, is numbed. A local or topical anesthesia is used before a minor procedure, such as putting stitches into a cut.

What happens right after the procedure?

General, epidural, and spinal anesthesias require at least an hour or two of monitoring after the procedure because of the effect that they can have on breathing and blood pressure. The person is usually kept in a surgery recovery room during this time.

An individual can go home if he or she does not need to recover in the hospital, though . someone else must drive because the medications used can impair coordination and reflexes for several hours.

Local, regional, and topical anesthesias often require only brief monitoring after the procedure. The person can often go home the same day. If sedatives or other medications were given, someone else must drive the person home.

What happens later at home?

General anesthesia and a major operation can cause stress on the body. No matter what type of anesthesia is used, most people feel that they are back to normal by the next day. For some people, it may take a few days.

What are the potential complications after the procedure?

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

Other problems can occur, including:

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

Other problems depend on the type of anesthesia used. For example:

• General anesthesia may result in mouth or throat damage. This is because a tube is placed in the throat and connected to a ventilator. Other mild side effects may be nausea and vomiting.
• Epidural or spinal anesthesia may cause headaches, bleeding, or infection at the site where the needle is inserted.

Local and topical anesthesias are less likely to cause complications. Severe allergic reactions, including anaphylactic shock and seizures have occurred with some anesthesias.

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.