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General Anesthesia

by Patricia Griffin Kellicker, BSN

Anatomy and Physiology
General anesthesia is used to block pain, put the body to sleep, and regulate bodily functions during surgery.

The medications used in general anesthesia can be given through an intravenous, or IV, line, or inhaled through the lungs. These medications may be given to: prevent pain, induce sleep, relax muscles, block memory, decrease anxiety.

Reasons for Procedure
General anesthesia is used for surgical operations that are extensive, those that are of uncertain duration, or when other anesthesia is not feasible. It is also used for emergency operations. Other determining factors include the type of surgery and your medical history.

General anesthesia causes you to be unconscious throughout your operation. During the operation, your anesthesiologist will closely monitor the functions of your heart, lungs, and kidneys. Once your surgery is completed, the effects of the medications will be reversed and you will regain consciousness.

Treatments
General anesthesia allows surgery to take place by blocking pain, awareness, and memory. It also allows the body's muscles to be completely relaxed, an important factor in many types of surgeries.

In contrast to general anesthesia, spinal and epidural anesthesia allow you to remain awake during the procedure. Spinal or epidural anesthesia may be an appropriate alternative to general anesthesia in procedures that require only the lower half of the body to be numb.

Procedure
In the days leading up to your procedure: Arrange for a ride to and from the hospital. The night before, eat a light meal and do not eat or drink anything after midnight. General anesthesia interferes with your normal reflexes like coughing; an empty stomach will ensure you don't choke on stomach contents. If you regularly take medications, herbs, or dietary supplements, your doctor may ask you to temporarily discontinue them. Do not start taking any new medications, herbs, or dietary supplements before consulting your doctor.

Prior to your surgery, an anesthesiologist will ask you questions to help him or her determine the best anesthesia plan for you. You will be asked about: your current health and any medical problems, medications you are taking, any allergies to food or medication, previous experience with anesthesia, bleeding problems.

You will also be asked about: smoking or alcohol habits, snoring tendencies, dental problems like loose teeth, bridges, or crowns, if you are a woman, the possibility of pregnancy.

Before surgery, an IV line will be placed in your arm to deliver fluid and medications. You may receive some medication before surgery to help you relax.

Next you will be wheeled into the operating room on a stretcher and moved to the operating table. You will be given an anesthetic agent, either through your IV or a mask, which will cause you to drift off to sleep.

Depending on the type of surgery you are having, you may have a breathing tube inserted through your mouth and into your windpipe, or trachea. This tube will be connected to a respirator that gives you oxygen and anesthetic gases. If a breathing tube is unnecessary, a mask will be used to deliver oxygen and medications.

You will be connected to various monitors that track your blood pressure, heart rate, and the oxygen content in your blood. You may also be connected to equipment that controls your breathing and a catheter may be placed in your bladder to collect urine.

The anesthesiologist will continue to give you medications through your lungs or IV to keep you asleep. You may also receive medications to regulate your heart rate, blood pressure, breathing, temperature, and body fluid balance.

The anesthesiologist will constantly monitor and regulate all of your body functions as they respond to the surgery. A fine balance is maintained during anesthesia that takes into consideration your body's reactions, the amount of anesthesia needed, and the length of surgery.

Risks and Benefits
Possible complications of general anesthesia include: nausea and vomiting, lung infections, allergic reaction to anesthetic used, nerve damage, skin ulcers, sore throat, damage to the throat, lips, tongue, teeth, or vocal cords, stroke or heart attack, death.

Benefits of general anesthesia include: its quick onset, complete control of body functions, no memory of the surgery, its use in surgeries with unpredictable durations, ability to perform surgeries in different parts of the body at the same time.

In general anesthesia, or any other procedure, you and your doctor must carefully weigh the risks and benefits to determine whether it's the most appropriate procedure for you.

After the Procedure
Once the procedure is complete, the anesthesiologist will give you medications to reverse the anesthesia. If you had a breathing tube in place, he or she will remove it as soon as you can safely breathe on your own. You will wake up in a recovery room where you will be closely monitored and given pain medication as needed. Once you are stable, you will be sent to a hospital room or home.

Once you are home, contact your doctor immediately if you experience any of the following: signs of infection, such as fever or chills, difficulty breathing, worsening mouth or throat pain, and/or other worrisome symptoms either related to your anesthesia or surgery.

Sources:

  • American Society of Anesthesiologists. Anesthesia and You. Available at: http://www.asahq.org/patientEducation/anesandyou.htm. Accessed June 22,2004.
  • Mayoclinic.com. Anesthesia:Options and considerations. Available at: http://www.mayoclinic.com. Accessed June 22,2004.
  • S. Rashiq. Anesthesia, General. Emedicine website. Available at: www.emedicine.com/plastic/topic110.htm. Accessed July 2, 2004.
  • U.S. National Library of Medicine and the National Institutes of Health. General Anesthesia. Available at: http://www.nlm.nih.gov/medlineplus/tutorials/generalanesthesia.html Accessed June 29, 2004.


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