What is the difference between local and general anesthesia?
Anesthesia is a method of producing artificial sleep. It is also called general anesthesia. The general anesthesia leads to the loss of pain and awareness. It allows for large operations and examinations. In the colloquial language, however, regional anesthesia forms are sometimes referred to as the word narcosis.
Using anesthesia, patients can be put into artificial sleep. For this purpose, the competent specialist (anesthetist) uses various drugs and / or gas mixtures.
Anesthesia allows operations and certain examination procedures, which would otherwise only be feasible under severe pain.
Inhalation anesthesia is caused by inhalation of gaseous drugs, for example sevoflurane, isoflurane or nitrous oxide. These so-called volatile anesthetics, on the other hand, turn consciousness out, but also reduce the feeling of pain.
Inhalation anesthesia is the oldest form of anesthesia and is today usually combined with other procedures. A single inhalation anesthesia is sometimes used in children.
Total intravenous anesthesia
In this anesthetic procedure, the physician injects all necessary narcotic drugs into a vein. From there they reach the heart first and then into the whole blood circulation.
The balanced anesthesia combines the two mentioned procedures. Thus, at the start of the anesthesia, the patient receives mostly intravenous medication, during the operation it inhales additional anesthetic gases. This reduces many anesthetic side effects and the consumption of strong painkillers.
For some operations, it is enough only when the pain sensation in a certain area is switched off. You can find more information about local anesthesia in here: Local anesthesia
In a special form of local anesthesia, the narcotic agents are injected into the spinal canal. You can find more information about spinal anesthesia in here: Spinal anesthesia
When is anesthesia performed?
Anesthesia is always used when the patient is to prevent pain and stress. Depending on the severity of the procedure, the doctor can adjust the intensity of the anesthesia.
Anesthesia use in operations
The most common reason for anesthesia is surgery. Many interventions, for example on abdominal organs, are thus only possible at all. The reduced awareness also reduces the patient’s stress and promotes recovery after surgery.
The surgeon also receives the best possible working conditions because the patient does not move. This is, for example, very important in the case of interventions on the brain or blood vessels.
Anesthesia use in investigations
Some examination procedures also require anesthesia. For example, if the patient were not narcotized, the patient would experience severe pain and coughing in a bronchial tube (bronchoscopy) with a rigid tube over the trachea.
But infants, who have to undergo nuclear magnetic resonance imaging, are often given anesthesia to keep them quiet. The recorded pictures would be otherwise shaky and useless.
For such examinations, a short anesthesia usually suffices. In contrast to anesthesia during surgery, only one sleeping medication is given in low doses.
What is done with anesthesia?
For anesthesia, the anesthetist uses gas-air mixtures as well as various medicines. These can be divided into three groups.
- Hypnotics (sleeping pills) are primarily responsible for the awareness. One example is propofol
- Analgesics (pain relievers) suppress pain sensation. For anesthesia, there are strong analgesics from the group of opioids
- Muscle relaxants relax the muscles and make the patient motionless. Depending on the application, they do not have to be used in any anesthesia
Before an anesthesia is planned, the anesthetist clarifies the patient in a detailed conversation about the procedure for him. He also asks about pre-existing diseases and inquires about regularly taken medicines.
Thus, the doctor estimates the risk of anesthesia and selects appropriate drugs. In case of great restlessness and fear of anesthesia, he also provides a soothing agent for the patient to relax.
Before initiating anesthesia, the patient breathes pure oxygen for several minutes. This creates an oxygen reserve in the blood for the later insertion of the breathing tube (intubation).
At the same time, the doctor places the patient in a vein, for example, on the hand, over which he can inject the drugs. After a strong painkill follows a highly dosed sleeping agent, whereby the patient loses consciousness within a few seconds and stops breathing spontaneously.
The anesthetist then continues the ventilation with the aid of a close-fitting face mask and a respirator bag. If this succeeds without problems, he injects a muscle-relaxing drug. As soon as it acts, it can introduce into the air tube the breathing tube (tube) via which the patient from now on is breathed by a machine.
What are the risks of anesthesia?
General anesthesia involves the risk of many side effects. Anesthesia medications can lead, among other things, to sudden blood pressure drops or cardiac arrhythmias. The anesthetist then treats them with circulatory drugs. All drugs used can also cause severe allergic reactions.
Problems with ventilation
If patient can not be ventilated via a tube during the initiation of anesthesia, the doctor must perform a tracheotomy in the worst case. Another danger is the backflow of gastric contents into the air tube and the lungs. The acid gastric juice might cause a severe pulmonary inflammation.
A possible complication is dental damage, as the doctor uses a special instrument (Laryngoscope) to guide the tube into the trachea. Therefore, dentures are taken before the operation. The tube itself can also cause damage to the vocal chords.
Malignant hyperthermia is a feared muscular disease that can occur very suddenly during anesthesia. The entire musculature is permanently stretched, so that the body warms up in a life-threatening manner. In addition to genetic factors and certain anesthetic gases, the muscle relaxant succinylcholine is the most likely cause.
Waking conditions during anesthesia
Medical practitioners speak of intraoperative alertness when the patient suddenly awakens during anesthesia or can later recall details of the operation. Causes for this are, among other things, too low-dose sleeping pills. Patients rarely experience physical pain, but the experiences during the waking phase strongly affect the psyche.
Even after an operation, anesthesia side effects can occur. These include:
- Vomiting and nausea after anesthesia
- Tremors due to undercooling
- Just vomiting and nausea are common aftermath
What do I need to consider after an anesthesia?
It is normal if you feel a bit confused and sleepy after anesthesia. If, however, you feel pain, nausea, or feeling sick in your arms or are hoarse for a long time, you should tell your doctor. In consultation with him, you may also take some sips of water. When exactly, depends on the nature of the procedure.
If you have developed malignant hyperthermia during anesthesia, the anesthetist will give you an emergency report. You must always carry it with you, so that the anesthetists will choose the right anesthetic for you during a later operation.