Under general anesthesia, the patient is unable to feel pain and may also have amnesia. General anesthetics have been widely used in surgery since , when Crawford Long administered diethyl ether to a patient and performed the first painless operation. In this article, we will cover a number of topics, including the potential side effects of general anesthesia, associated risks and some theories regarding their mode of action.
Some individuals may experience none, others a few. None of the side effects are particularly long-lasting and tend to occur straight after the anesthesia.
Overall, general anesthesia is very safe. Even particularly ill patients can be safely anesthetized. It is the surgical procedure itself which offers the most risk. However, older adults and those undergoing lengthy procedures are most at risk of negative outcomes. These outcomes can include postoperative confusion, heart attack , pneumonia and stroke.
Some specific conditions increase the risk to the patient undergoing general anesthetic, such as:. Death as a result of general anesthetic does occur, but only very rarely — roughly 1 in every , to , This refers to rare cases where patients report a state of awareness during an operation, after the point at which the anesthetic should have removed all sensation. Some patients are conscious of the procedure itself and some can even feel pain. Unintended intraoperative awareness is incredibly rare, affecting an estimated 1 in every 19, patients undergoing general anesthetic.
Because of the muscle relaxants given alongside anesthesia, patients are unable to signal to their surgeon or anesthetist that they are still aware of what is happening. Patients that experience unintended intraoperative awareness can suffer long-term psychological problems.
Most often, the awareness is short-lived and of sounds only, and occurs prior to the procedure. According to a recent large-scale investigation of the phenomenon, patients experienced tugging, stitching, pain, paralysis, and choking, among other sensations. Because unintended intraoperative awareness is so infrequent, it is not clear exactly why it occurs. Local anesthesia is another option. It is given before minor surgeries, such as removal of a toenail.
This reduces pain sensations in a small, focused areas of the body, but the person receiving the treatment remains conscious. Regional anesthesia is another type. This numbs an entire portion of the body — the lower half, for example, during childbirth.
There are two main forms of regional anesthesia: Spinal anesthetic and epidural anesthetic. Spinal anesthetic is used for surgeries of the lower limbs and abdomen.
This is injected into the lower back and numbs the lower body. Epidural anesthesia is often used to reduce the pain of childbirth and lower limb surgery. This is administered to the area around the spinal cord through a small catheter instead of a needle injection.
A breathing tube may be inserted into the windpipe to maintain proper breathing during surgery. Once the surgery is complete, the anesthesiologist ceases the anesthetic and you are taken to the recovery room for further monitoring. Anesthesiologists are the doctors trained to administer and manage anesthesia given during a surgical procedure. They are also responsible for managing and treating changes in your critical life functions--breathing, heart rate, and blood pressure--as they are affected by the surgery being performed.
Further, they diagnose and treat any medical problems that might arise during and immediately after surgery. Before surgery, the anesthesiologist will evaluate your medical condition and formulate an anesthetic plan that takes your physical condition into account. It is vital that the anesthesiologist knows as much about your medical history, lifestyle, and medicines, including over-the-counter and herbal supplements, as possible.
Some particularly important information he or she needs to know includes the following:. Reactions to previous anesthetics. If you have ever had a bad reaction to an anesthetic agent, you need to be able to describe exactly what the reaction was and what your specific symptoms were.
Give the anesthesiologist as much detail as possible, such as you felt nauseated when you woke up or the amount of time it took you to wake up. Current herbal supplements. Certain herbal products, commonly taken by millions of Americans, may cause changes in heart rate and blood pressure, and may increase bleeding in some patients.
The popular herbs gingko biloba, garlic, ginger, and ginseng may lead to excess blood loss by preventing blood clots from forming. In addition, St. John's wort, and kava kava, may prolong the sedative effect of the anesthetic. The American Society of Anesthesiologists advises anyone planning to have surgery to stop taking all herbal supplements at least 2 to 3 weeks before surgery to rid the body of these substances.
Any known allergies. Discussing any known allergies with the anesthesiologist is very important, as some anesthetic drugs trigger cross-allergies, particularly in people who have allergies to eggs and soy products.
Allergies to both foods and drugs should be identified. All recent and current prescription and over-the-counter medicines. It is also important to let your surgeon and anesthesiologist know about both prescription medicines and over-the-counter medicines you are taking, or have recently taken. Certain prescription medicines, such as coumadin, a blood thinner, must be discontinued for some time before surgery. In addition, as many people take a daily aspirin to prevent heart attack, and certain dietary supplements, doctors need to be aware of these habits, as they can prolong bleeding and interfere with medicines used by anesthesiologists.
Cigarette smoking and drinking alcohol. Cigarette smoking and alcohol can affect your body just as strongly and sometimes more strongly than many prescription medicines you may be taking.
Because of the way cigarettes and alcohol affect the lungs, heart, liver, and blood, these substances can change the way an anesthetic drug works during surgery. It is important to let your surgeon and anesthesiologist know about your past, recent, and current consumption of these substances before surgery. Undergoing surgery can be a good motivator to quit smoking.
Most hospitals are smoke-free and doctors, nurses, and other health professionals will be there to give you support. Patients deserve the same high standard of care in these facilities that they receive in the hospital setting. Anesthesiologists are working with federal and state legislators and agencies and collaborating with other physicians and accrediting bodies to establish safety standards for such facilities.
For more information on ambulatory surgery, click here. In addition to providing patient care, the anesthesiologist often is responsible for managing the resources of the operating suite, including the efficient use of operating rooms, supplies, equipment and personnel.
Unlike most surgeons, who spend much of their time seeing patients in private offices, anesthesiologists work in the operating suite every day.
Their continuous presence, along with their wide-based appreciation for the needs of surgeons and other physicians who perform procedures requiring anesthesia, uniquely qualifies anesthesiologists for leadership positions in operating room administration and management. All rights reserved. Reprinted with permission. Toggle navigation. Intraoperative Care It is estimated that nearly 40 million anesthetics are administered each year in the United States.
Anesthesia Outside the Operating Room As medical technology has advanced, so has the need for anesthesiologists to become involved in caring for patients during uncomfortable or prolonged procedures in locations outside the traditional operating suite.
Pain Medicine Because of their specialty training and vast experience in controlling pain during surgery, anesthesiologists are uniquely qualified to prescribe and administer drug therapies or perform special techniques for acute, chronic and cancer pain. Chronic and Cancer Pain Management Anesthesiologists are the vanguard of those who are developing new therapies for chronic pain syndromes and cancer-related pain.
Anesthesiologists who specialize in the treatment of chronic pain often dedicate their practices exclusively to a multidisciplinary approach to pain medicine, working collaboratively with other medical specialists in a pain clinic.
For more information about anesthesia and pain management, click here Obstetric Anesthesia It is very common for anesthesiologists to provide expectant mothers with pain relief during labor and delivery. For more information on ambulatory surgery, click here Operating Room Management In addition to providing patient care, the anesthesiologist often is responsible for managing the resources of the operating suite, including the efficient use of operating rooms, supplies, equipment and personnel.
Anesthesia research at the clinical and basic science levels has been completed almost exclusively by anesthesiologists or Ph.
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