A combination of drugs that place you in a sleep-like condition prior to surgery or other medical procedure is general anesthesia. You can not experience discomfort under general anesthesia because you are absolutely unconscious.
A mixture of intravenous medications and inhaled gases is typically used for general anesthesia (anesthetics).
General anesthesia is more than just being unconscious, though it’s definitely going to make you feel that way. But the anesthetized brain does not respond to the signs or reflexes of pain.
A specially qualified doctor who specializes in anesthesia is an anesthesiologist. The anesthesiologist controls the vital functions of the body when you are under anesthesia and regulates your breathing.
An anesthesiologist and a licensed registered nurse anesthetist (CRNA) work together in many hospitals during a procedure.
Why it’s done
Depending on the type of procedure you are having, your general health, and your individual preferences, your anesthesiologist or nurse anesthetist, along with your doctor, will prescribe the best anesthesia choice for you. Your team can suggest a general anesthesia for some procedures.
There are some procedures that may:
- Expose you to a cold environment
- Take a long time
- Result in significant blood loss
- Affect your breathing (especially chest or upper abdominal surgery)
Other forms of anesthesia may not be ideal for more involved procedures, such as light sedation combined with local anesthesia (for a small area) or regional anesthesia (for a larger part of your body).
Overall, general anesthesia can be very safe; most people are able to undergo general anesthesia themselves without serious complications, particularly those with severe health conditions.
In fact, the risk of complications, rather than the type of anesthesia, is more closely related to the type of operation you are undertaking and your general physical health.
There may be an increased risk of postoperative confusion, pneumonia, or even stroke and heart attack in older adults or those with serious medical conditions, particularly those undergoing more extensive procedures.
Relevant conditions that can increase the risk during surgery for complications include:
- Drug allergies
- Obstructive sleep apnea
- High blood pressure
- Other medical conditions involving your kidneys heart, or lungs
- Medications, such as aspirin that can boost bleeding
- History of heavy alcohol use
- History of adverse reactions to anesthesia
These risks are more generally more associated to the surgery itself rather than the anesthesia.
Estimates differ, but during general anesthesia, around 1 or 2 individuals in every 1,000 can be partially awake and experience what is called unintentional intraoperative consciousness. Experiencing pain is much rarer, but this can also happen.
Patients are unable to move or speak to let doctors know they are awake or feeling pain because of the muscle relaxants provided before surgery. This can cause long-term psychological issues for some patients, similar to post-traumatic stress disorder.
This phenomenon is so unusual that simple correlations are hard to establish. Any variables that can be involved include:
- Emergency surgery
- Cesarean delivery
- Lower anesthesia doses than the required dose used during the procedure
- Use of certain medications
- Heart or lung problems
- Daily alcohol use
- Mistakes by the anesthesiologist, such as not monitoring the patient or not measuring the amount of anesthesia in the patient’s system throughout the procedure
How you prepare?
In your digestive tract and airway, general anesthesia relaxes the muscles that prevent food and acid from getting through your lungs from your stomach. Before surgery, patients are advised to always follow the doctor’s advice on avoiding food and drink.
Starting around six hours before your surgery, fasting is normally mandatory. You will be able to drink clear liquids until a couple of hours before that. Your doctor might tell you to take some of your daily medications with a small sip of water during your fasting time. Discuss with your doctor about your drugs.
For at least a week before your operation, you might need to avoid certain drugs, such as aspirin and some other over-the-counter blood thinners. During surgery, these drugs can cause complications.
Complications during surgery can be caused by some vitamins and herbal remedies, such as ginseng, garlic, Ginkgo biloba, St. John’s wort, kava, and others. Before your surgery, clarify the types of dietary supplements you are taking with your doctor.
If you have diabetes, check with your doctor for any changes to your medications during the fasting process. Usually, you won’t take oral diabetes medicine on the morning of your surgery.
If you take insulin, your doctor will prescribe a reduced dose. Discuss your condition with your doctor if you have sleep apnea. During and after the surgery, the anesthesiologist or anesthetist will need to closely control your breathing.
What you can expect?
Before the procedure
Your anesthesiologist may speak with you before you undergo general anesthesia and can ask questions about:
- Health history of yours
- Your prescription medicines, over-the-counter drugs, and herbal supplements
- Allergies and Allergies
- Your previous anesthesia encounters
This will help the anesthesiologist select the medicines that are most secure for you.
During the procedure
Usually, through an intravenous line in your arm, the anesthesiologist delivers the anesthesia medications. The gas you breathe out of a mask will also be administered to you. In order to go to sleep, children can need to have a mask.
The anesthesiologist can insert a tube into your mouth and down your windpipe once you’re asleep. The tube protects your lungs as well as ensure that you get enough oxygen. Before doctors insert the tube to relax the muscles in your windpipe, you’ll be given muscle relaxants.
Other solutions, including a laryngeal airway mask, can be used by your doctor to help control your breathing during surgery. You are constantly watched as you sleep by someone from the anesthesia treatment team.
Your medicines, ventilation, temperature, fluids, and blood pressure will be changed as appropriate. With extra drugs, fluids, and occasionally blood transfusions, any complications that arise during the procedure are correct.
After the procedure
The anesthesiologist reverses the drugs to wake you up when the surgery is complete. Slowly, you wake up in the operating room or in the recovery room. When you first wake up, you’ll probably feel groggy and a little confused.
You might experience side effects that are normal, such as:
- Dry mouth
- Sore throat
- Muscle aches
- Mild hoarseness
After waking from anesthesia, you can also experience other side effects, such as discomfort. You will be asked about your pain and other side effects by your anesthesia care team.
Side effects depend on the kind of surgery and your particular condition. After your operation, your doctor can give you medications to reduce pain and nausea.
- General anesthesia: Mayo Clinic