Anesthesia

What is anesthesia?

Anesthesia is a medicine given to you to prevent you from feeling pain. The main types of anesthesia are local, regional, and general.

Local anesthesia numbs the part of your body where you will have the surgery. It is for simple procedures such as sewing up a cut or removing a skin growth.

Regional anesthesia numbs a larger area of the body. Regional anesthesia can be used for more extensive procedures than local anesthesia. Two types of regional anesthesia are spinal and epidural.

• For spinal anesthesia, you are given the anesthetic with a needle in your spine. The drug takes effect quickly and blocks pain in the lower body. It may be used for many operations below the navel, such as rectal, bladder, and prostate operations, as well as operations on the legs.
• Epidural anesthesia may be used for many of the same procedures for which spinal anesthesia is used. It is also given with a needle in the back. The dose is adjusted so that the nerves that transmit pain are blocked, but you keep the ability to move. In some cases a thin tube, or catheter, may be placed at the site of injection to treat pain for several days after surgery.

General anesthesia relaxes your muscles, puts you to sleep, and prevents you from feeling pain. It will also prevent you from remembering the operation. The anesthetic may be given intravenously (IV) or as a gas inhaled through a breathing mask or tube plus IV medicines.

When is it used?

The purpose of anesthesia is to prevent you from feeling pain during a surgical or medical procedure or delivery of a baby.

How do I prepare for anesthesia?

Preparation for anesthesia varies depending on the kind of procedure you are having. Follow the instructions your healthcare provider gives you.

Make sure your provider knows what medicines you take and about any allergies or health problems you have. An anesthesiologist or nurse anesthetist may talk with you. He or she may recommend the type of anesthetic that may work best for you and the procedure you are having.

What happens during the procedure?

Local anesthesia is usually given by injecting a specific part of your body with a medicine that numbs the nerves. It can sometimes be given as nose drops or spray.

Spinal anesthetic is injected through a small needle into the fluid-filled space surrounding your spinal cord. Epidural anesthetic is injected just outside the sac that contains your spinal fluid.

You may be given a sedative with a local or regional anesthetic to relax you and reduce anxiety. The sedative may cause you to fall asleep.

If you are having general anesthesia, drugs may be given by injection into a vein. If gas is used, it is given through a mask covering your nose and mouth, or through a breathing tube in your throat. In some cases a muscle relaxant is given in addition to the anesthesia. While you are asleep you will have a breathing tube placed through your mouth and into your throat. The tube will be removed before you wake up after the surgery. It allows the anesthetist to help you breathe and make sure you are getting enough oxygen during the procedure. Your heart rate, breathing, blood pressure, and other signs are watched carefully during the procedure. You may feel some confusion as you wake up after the surgery and your mouth may be dry.

What happens after the procedure?

Each procedure or type of surgery requires different follow-up. Check with your healthcare provider about what you need to do.

What are the benefits of anesthesia?

Anesthesia helps to relieve pain and to create numbness or a state of unconsciousness during surgery.

What are the risks of anesthesia?

Risks from local and regional anesthesia include:

• You may feel some minor discomfort because the anesthetic may not numb the area enough.
• You may have an allergic reaction to the anesthetic, causing fever, nausea, vomiting, swelling, hives, or trouble breathing.
• You may have long-term damage to the nerves.
• You may have trouble breathing because the anesthetic can affect the respiratory system.
• Rarely, you may react by having seizures, dizziness, loss of consciousness, or cardiac arrest.

Risks from general anesthesia include:

• After the anesthesia, you may have nausea and vomiting, sore throat, dry mouth, and muscle pain.
• You may have stress on the heart.
• You may have an irregular heartbeat (arrhythmia).
• You may have confusion after the anesthesia.
• In rare cases, you may have a heart attack, stroke, or brain damage, which could result in death.

The probability of the above risks is low, although serious injury can result. Because general anesthesia affects all areas of your body, such as the heart and lungs, side effects are more common than with local or regional anesthetics. Local or regional anesthesia is considered safer than general anesthesia. However, most side effects from general anesthesia do not last long and are easily relieved by the anesthesiologist or nurse anesthetist who stays with you throughout the operation.

Discuss with your healthcare provider any concerns you may have.

When should I call my healthcare provider?

Call your provider right away if:

• You develop a fever.
• You have bleeding or unusual drainage from an incision.
• You have pain that gets worse.
• You have shortness of breath or trouble breathing.

Call your provider during office hours if:

• You have questions about the procedure or its result.
• You want to make another appointment.