Anesthesia

Overview

Anesthesia is the practice of administering medications, referred to as anesthetics, to mitigate pain during medical procedures or surgery. These medications temporarily block sensory signals from nerves at the procedure site to the brain centers.

Various forms of anesthesia function through diverse mechanisms. Some anesthetic drugs numb specific parts of the body, while others induce unconsciousness, enabling patients to remain asleep during more complex surgical procedures.

Types of anesthesia

The choice of anesthesia administered by your doctor depends on the type and extent of the procedure. Available options may include:

• Local anesthesia: Local anesthesia targets a particular area of your body, numbing it effectively. During these procedures, you stay conscious. Doctors commonly use local anesthesia for minor procedures like cataract surgery or skin biopsy.
• Sedation (twilight sleep): Sedation induces a relaxed state where you may doze off but can still awaken if necessary to communicate. Procedures commonly carried out under sedation include wisdom teeth extraction, cardiac catheterization, and certain colonoscopies. While not fully unconscious, you’re less likely to recall the procedure.
• Regional anesthesia: Regional anesthesia involves the blocking of pain in a broader area of your body, such as a limb or everything below your chest. Examples include epidurals for alleviating childbirth pain or arm blocks for hand surgery. Doctors may combine regional anesthesia with sedation or administer it independently.
• General anesthesia: This procedure induces unconsciousness and insensitivity to pain or other stimuli. General anesthesia is typically employed for more invasive procedures or surgeries involving the head, chest, or abdomen.

Risks

The majority of anesthesia side effects are transient and typically dissipate within 24 hours, often resolving even sooner. Depending on the type of anesthesia and its administration by the doctor, you may encounter:

• Headache.
• Itching.
• Nausea and vomiting.
• Either muscular or back discomfort.
• Throat pain.
• Hypothermia.
• Having trouble urinating.
• Fatigue.
• Injection site pain, soreness, redness, or bruises.

Anesthesia carries inherent risks. Possible complications may include:

• Anesthetic awareness: For reasons not entirely clear, around 1 in 1,000 individuals undergoing general anesthesia may encounter awareness during a procedure. During this time, you may be conscious of your surroundings but unable to move or communicate.
• Atelectasis or collapsed lungs: Undergoing surgery with general anesthesia or the insertion of a breathing tube can lead to a collapsed lung. This uncommon condition arises when the air sacs within the lung deflate or become filled with fluid.
• Malignant hyperthermia (MH): Individuals with malignant hyperthermia encounter a perilous response to anesthesia. This uncommon inherited syndrome induces fever and muscle contractions during surgical procedures. It’s crucial to disclose any personal or family history of MH to your anesthesiologist before receiving anesthesia to avoid medications that can trigger this reaction.
• Nerve damage: Although uncommon, certain individuals may suffer from nerve damage resulting in temporary or permanent neuropathic pain, numbness, or weakness.
• Postoperative delirium: Elderly individuals are at a higher risk of experiencing postoperative delirium, a condition characterized by intermittent confusion lasting about a week. Some individuals may also encounter long-term memory and learning difficulties.

 Before the procedure

Please make sure to inform your doctor about all medications, vitamins, and supplements you are currently taking. Some medications may interact with anesthesia or increase the risk of complications. Additionally, adhere to the following guidelines:

• Unless instructed otherwise, refrain from eating or drinking anything for eight hours before your hospital visit.
• Stop using herbal supplements as advised by your doctor, typically one to two weeks before surgery.
• Discontinue the use of Viagra or other erectile dysfunction medications at least 24 hours prior to the surgery.
• Take certain blood pressure medications with a sip of water according to your doctor’s instructions.
• Quit smoking, even for just a day, to improve lung and heart health before the procedure. For optimal results, stop smoking at least two weeks before your consultation.

During the procedure

In the course of anesthesia, a doctor will:

• Administer one or more forms of anesthesia. They might also offer you medicine to prevent nausea.
• Keep an eye on vital signs, such as pulse rate, heart rate, blood pressure, and blood oxygen level.
• Recognize and treat conditions such as an allergic reaction or alteration in vital signs.
• Give instructions on how to handle pain following surgery.

After the procedure

Following procedures involving local anesthesia, you can typically resume work or most activities after treatment unless advised otherwise by your doctor. However, if you’ve undergone regional or general anesthesia or sedation, you’ll require additional time for recovery. You should:

• Give off alcohol for a full day.
• Don’t use machinery or drive a car for a whole day.
• Get a ride home from someone.
• Take a break and rest for the rest of the day.
• Consume only drugs and supplements that have been authorized by your doctor.
• For a whole day, refrain from making any significant or legal judgments.

Outcome

After receiving local anesthesia, you should be able to resume regular activities, pending approval from your doctor.

Anesthetic drugs can linger in your system for as long as 24 hours. If you’ve received sedation, regional, or general anesthesia, it’s recommended to refrain from returning to work or driving until the drugs have completely metabolized.