Anesthesia

Anesthesia or anaesthesia (from Greek "without sensation") is a state of

temporary induced loss of sensation or awareness. It may include analgesia
(relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss
of memory), or unconsciousness. A patient under the effects of anesthetic
drugs is referred to as being anesthetized.
Three broad categories of anaesthesia exist:
Local anesthesia is another option. It is given before minor surgeries,
such as removal of a toenail. This reduces pain sensations in a small,
focused areas of the body, but the person receiving the treatment
remains conscious.
Regional anesthesia is another type. This numbs an entire portion of the
body - the lower half, for example, during childbirth. There are two main
forms of regional anesthesia: Spinal anesthetic and epidural anesthetic.
Spinal anesthetic is used for surgeries of the lower limbs and abdomen.
This is injected into the lower back and numbs the lower body. Epidural
anesthesia is often used to reduce the pain of childbirth and lower limb
surgery. This is administered to the area around the spinal cord through a
small catheter instead of a needle injection.

Local vs. general

There are a number of reasons why general anesthesia may be chosen over
local anesthesia. In some instances, the patient is asked to choose between
general and local anesthetic.

This choice depends on age, state of health, and personal preference.

The main reasons for opting for general anesthetic are:

 The procedure is likely to take a long time.

 There is a likelihood of significant blood loss.

 Breathing may be affected, such as during a chest operation.

 The procedure will make the patient feel uncomfortable.

 The patient may be young, and they may have difficulty remaining still.
The purpose of general anesthetic is to induce:

 analgesia, or removing the natural response to pain

 amnesia, or memory loss

 immobility, or the removal of motor reflexes

 unconsciousness

 skeletal muscle relaxation

Pre-surgical evaluation

Before general anesthesia is administered, patients will have a pre-surgery

assessment to determine the most appropriate drugs to use, the quantities of
those drugs and in which combination.

Some of the factors to be explored in a pre-surgical evaluation include:

 body mass index (BMI)

 medical history

 age

 current medications

 fasting time

 alcohol or drug intake

 pharmaceutical drug use

 mouth, dental and airway inspection

 observation of neck flexibility and head extension

 Side effects of general anesthesia

 temporary confusion

 memory loss, although this is more common in the elderly

 dizziness

 difficulty passing urine

 bruising

 soreness from the IV drip

 nausea and vomiting

 shivering

 feeling cold

 sore throat, due to the breathing tube


Risk factors

Outcomes can include postoperative confusion, heart attack, pneumoniaand

stroke.

Some specific conditions increase the risk to the patient undergoing general
anesthetic, such as:

 obstructive sleep apnea, a condition where individuals stop breathing while

asleep

 seizures

 existing heart, kidney or lung conditions

 high blood pressure

 alcoholism

 smoking

 history of reactions to anesthesia

 medications that can increase bleeding - aspirin, for example

 drug allergies

 diabetes

 obesity or overweight