Anesthesia describes the targeted numbing of the body or certain parts of the body in order to eliminate the sensation of pain. It is necessary for most surgical procedures.
The medical term for anesthesia is anesthesia and also refers to the field of medicine , which deals with the various anesthetic procedures. It is always about turning off the sensation of pain with drugs and numbing gases and numbing the body or part of it.
Most people know the anesthetic from the visit to the dentist , but it is used in all procedures in which pain can arise. Even in diagnostic procedures, patients are sedated, either to get evaluable examination results or to spare the patient unnecessary pain.
Various anesthetic procedures
General Anesthesia
The general anesthesia is colloquially called a general anesthetic. The entire body is “paralyzed” over a certain period of time. The consciousness, the sensation of pain and the muscle tension are switched off by various medications.
The anesthetics can be administered via a breathing mask (inhalation anesthesia) or via a cannula (intravenous anesthesia). Combinations of both methods are possible. An anesthetist monitors the patient throughout the anesthesia.
This method is often used in abdominal surgery , because there are many nerves and nerve bundles and partial anesthesia could not suppress all the pain stimuli . It is also used in many other procedures where partial stunning would not be enough.
The short anesthesia is a form of general anesthesia, because the entire body is sedated, as a patient falls into a light sleep. However, it does not last as long, the required amount of narcotics is lower. The drugs are usually administered intravenously (“sleep injection”).
From the body, the funds are degraded relatively quickly, so that the burden on the organism after waking up is smaller. During short anesthesia, the most important bodily functions are also monitored. The short anesthesia is used for minor procedures that last no longer than 15 minutes, and in various examinations such as colonoscopy and gastroscopy .
Locally acting anesthesia (partial anesthesia)
In addition, there is the possibility to numb only certain body regions . The sensitivity to pain of the rest of the body and the consciousness remain in the so-called partial anesthesia preserved. Differences in local anesthesia and regional anesthesia.
In regional anesthesia, the nerve pathways that are responsible for the pain impulses in individual body regions are specifically turned off by injections. Thus, in a spinal anesthesia, the entire lower half of the body can be anesthetized. A well-known example of regional anesthesia is epidural anesthesia (PDA) during childbirth . Operations on the arms or legs or the pain therapy after such procedures are further areas of application.
In contrast, in local anesthesia, the anesthetic is injected directly into the tissue where the procedure takes place. A common field of application is dental treatment, such as root canal treatment , the removal of birthmarks or cosmetic surgery.
Preparations for anesthesia
Regardless of which anesthesia procedure is planned, the anesthesiologist will inform the patient about the method in a preliminary interview. It is also clarified whether and which drugs should still be taken before anesthesia, whether there were complications or incompatibilities in previous operations and whether there are diseases that rule out a specific method of anesthesia. The interview should also serve to clarify the procedure in order to deprive the patient of the fear of the procedure.
Those who have consumed or consumed drugs should also tell the anesthesiologist , as this may be important for proper dosage of the anesthetic. If necessary, additional examinations such as an electrocardiogram ( ECG ), a pulmonary function test or laboratory tests must be performed.
In case of general anesthesia and spinal or peridural anesthesia (colloquially “spinal cord injection”) you should not eat anything on the day of the procedure six hours before the anesthetic. Also cloudy liquids such as juice or milk may not be drunk during this period. Two hours before you should also do without drinking clear liquids. On the day of the operation should also no longer be smoked.
In a partial anesthesia No preparation is usually required – are – with the exception of spinal or epidural anesthesia.
Expiration of anesthesia
General anesthesia and more complex partial anesthesia procedures are usually performed by specialized anesthetists – the anesthesiologist – and not by the doctor who then performs the actual procedure. Local anesthesia such as during a visit to the dentist or superficial procedures on the skin is usually carried out by the attending physician.
In a planned procedure under general anesthesia, the patient is usually hours before in the clinic. Before it goes into the operating room, a soothing and pain-relieving medicine is administered. In the operating room, a sleep aid is first injected into the arm vein for general anesthesia ; children often receive it via a breathing mask.
The effect occurs after a short time and leads to a deep sleep and a paralysis of the muscles. As this also causes paralysis of the respiratory muscles, anesthetized patients are given artificial respiration using a breathing mask or a breathing tube. At the same time, an anesthetic gas is administered to maintain anesthesia. During the operation, the anesthesiologist monitors blood pressure , heart rate, heart rate and other vital signs, ensuring that the anesthesia is safe.
When the operation is over, the doctor interrupts the administration of the anesthetic. As soon as the patient is able to breathe independently, the respiratory mask or tube is removed. Upon awakening and a certain time afterwards, the patient continues to be observed.
In a partial anesthesia, the anesthetic is injected in most cases by means of a syringe at the appropriate location, which is previously disinfected. There are exceptions to this for example in the case of anesthesia of the eye, where the anesthesia can also be effected by eye drops.
Risks and side effects of anesthesia
Anesthesia, like most procedures, involves a risk of complications. The ventilation technique often causes hoarseness . General anesthesia can lead to nausea and vomiting . Above all, older people are confused after anesthesia , disoriented or even no longer recognize their own family members. This may be a so-called transit syndrome (postoperative delirium).
Especially for children, pregnant women, the elderly and people with certain illnesses, the risk of incidents, for example during ventilation , is slightly higher, but serious health problems are very rare these days.
Partial anesthesia can also lead to various complications. For example, bruising or inflammation may occur at the injection site , but again the risk of serious health consequences is very low.
Hypnosis may allow painless surgery
For minor interventions, for example with the dentist, it is sometimes possible to operate without sedation. Alternatively or in addition, awareness and sensitivity to pain in some cases can be changed by hypnosis so that a painless operation is possible.
The acupuncture can help with anesthesia. Although it has proven to be the only method of anesthesia during surgery as ineffective . However, when used in addition to the traditional pain elimination methods, fewer anesthetics may be needed. Also, pre-operative anxiety and side effects of anesthesia after waking up can be alleviated by expert needling.