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Thursday, April 24, 2014
Anesthesiology, as defined by the American Society of Anesthesiologists (ASA), is the practice of medicine dedicated to the relief of pain and total care of the surgical patient before, during and after surgery. According to the ASA, each year more than 45 million anesthetics are given to patients in the United States.
People who might need information about anesthesia include:
The article Methods of Anesthesia contains complete information on this topic. Listed below is a short summary.
General anesthesia: The type of anesthesia familiar to most people is general anesthesia. During general anesthesia the patient is unconscious and cannot be aroused, or made alert. Examples of surgery that are usually done under general anesthesia are open heart surgery, lung surgery, brain surgery and operations in the abdomen.
Sedation techniques: For smaller operations or less invasive procedures general anesthesia may not be needed, and different levels of sedation, ranging from "light" to "moderate" to "deep" sedation can be provided instead. During light sedation, patients are easily aroused, are able to breathe without help, and there is little effect on heart function or blood pressure. At deeper levels of sedation, patients can be aroused only with stimulation and may need assistance with breathing.
Regional anesthesia: Techniques in which nerves are blocked using so-called "local anesthetic" medications are called regional anesthesia. Regional anesthesia is used for a variety of major and minor surgeries. It is frequently used for orthopedic surgical procedures such as knee or hip replacements, and for cesarean sections.
Epidural anesthesia: is a form of regional anesthesia in which a narrow tube, (also called a catheter) is placed in the epidural space in your back. The epidural space is a part of the spine that is in close contact with nerves. By injecting anesthetic medication into this space, the spinal nerves are numbed. An epidural requires the insertion of a special needle into the back. The epidural needle can be inserted with very little discomfort by an experienced practitioner, using local anesthesia to numb up the skin and tissues of the back. When the needle is in place, the epidural catheter is threaded through the needle and the needle is then removed.
"Spinal" anesthetic: An alternative to the epidural technique is a "spinal" anesthetic. This technique is similar to an epidural. With a spinal anesthetic, a special needle is inserted in the lower part of the back, and anesthetic medication is injected through the needle directly into the fluid that bathes the spinal nerves. The needle is then removed.
The effects of spinal and epidural anesthesia, and of other regional anesthesia techniques, are very similar - they temporarily block nerves, so that pain is not felt. As well as blocking sensation, these anesthesia techniques also decrease the ability to move the affected part of the body. As the medication wears off, the affected parts will recover both sensation and movement.
In order to provide you with safe anesthesia and an optimal recovery from the surgery, the anesthesiologist needs to know your medical history in detail. This includes information about allergies, medications (including herbal and over-the-counter medicines), and previous anesthetics and surgeries, especially if there were any problems or complications. It is helpful to bring a list of your medications and their dosages. The anesthesiologist will also do a physical examination that focuses on the airway, heart and lungs, so it is wise to wear comfortable loose clothing.
Certain tests may need to be completed before your surgery to define problems that can affect the anesthetic and the safe conduct of the surgical procedure. Hospital records, notes from your doctor, and the results of previous tests, especially those involving the heart and lungs, may be of special value to the anesthesiologist.
The anesthesiologist will inform you of the different options for anesthesia, their risks and benefits, so that you can understand, and participate in the decision-making process.
To prepare for the visit with you anesthesiologist, NetWellness has An Online Pre-Anesthesia Interview. This survey contains questions that are commonly asked by the anesthesiologist. Feel free to print the results of this survey and take them to your anesthesiologist. The survey also contains more information about why certain questions are asked.
This article is a NetWellness exclusive.
Last Reviewed: Oct 05, 2010
Gareth S Kantor, MD
Assistant Professor of Anesthesiology
School of Medicine
Case Western Reserve University