Anesthesia

Anesthesia means a loss of feeling or pain. The term anesthesia is also used todescribe medication to prevent feelings of painduring a surgery or other procedure.

Who is a candidate for the procedure?

A person who is having a painful procedure may need anesthesia. The proceduremay range from getting stitches for a cut to open heart surgery.

How is the procedure performed?

There are many different types of anesthesia and ways to give the medications.Common examples include:

general anesthesia

epidural anesthesia

spinal anesthesia

topical anesthesia

regional anesthesia

local anesthesia

dissociative anesthesia

There are other, less common, forms of anesthesia that can be used in certainsituations.

General anesthesia is a type ofanesthesia which puts the person to sleep. The person is made unconscious withmedications that are breathed into the lungs or injected into the veins. Ingeneral anesthesia, a person is also temporarily paralyzed with medications. Aperson has no memory of the surgery when he or she wakes up. General anesthesia isused for most major operations.

Epidural anesthesia and spinal anesthesia both involve injectingmedications into the spinal column. The medications act directly on the spinalcord and nerves to stop the feeling of pain. A person is generally awake duringthe procedure. These types of anesthesia are commonly used during childbirthand with surgeries below the belly button.

Regional anesthesia, local anesthesia, or topical anesthesia involve injecting medication intotheskin or rubbing it onto the skin near the site of the procedure. This causesnumbing. Regional anesthesia involves numbing a large area, such as the entirehand or leg. Local or topical anesthesias are used before small procedures,such as putting stitches into a cut.

What happens right after the procedure?

General, epidural, and spinal anesthesias require at least an hour or two ofmonitoring. This is usually done in a surgery recovery room. An individual can go home if he or she does notneed to recover in the hospital. Someone else must drive the person homebecause the medications used can impair coordination and reflexes for severalhours.

Local, regional, and topical anesthesias often require only brief monitoringafter the procedure. The person can often go home the same day. If sedatives orother medications were given, someone else must drive the person home.

What happens later at home?

General anesthesia and a major operation can cause stress on the body. No matter what anesthesia is used,most people feel that they are back to normal by the next day. For some people,it may take a few days.

What are the potential complications after the procedure?

The most feared complication of anesthesia is death. This occursin roughly 1 out of every 10,000 people who have general, epidural, or spinalanesthesias. It is not usually possible to predict who will have this severereaction.

Other problems can occur, including:

liver damage

kidney damage

seizures

low blood pressure

allergic reactions

Other problems depend on the type of anesthesia used. For example:

General anesthesia may result in mouth or throat damage. This is because atube is placed in the throat and connected to a ventilator. Other mild side effects may be nausea and vomiting.

Epidural or spinal anesthesia may cause headaches, bleeding, or infection at the site where the needle isinserted.

Local and topical anesthesias are less likely to cause a problem. Severeallergic reactions, including anaphylacticshock, and seizures haveoccurred with some anesthesias.

The American Society of Anesthesiologists recently issued a warning about thepotential side effects and interactions of herbal remedies with medications used before, during, and after surgery.The group recommends that a person stop taking all herbs at least two weeksbefore planned surgery.