What to know about

general anesthesia
 Side effects

 Risks
 Sedation vs. general anesthesia

 Types

 Local vs. general

 Stages

 How general anesthetic works

 Outlook
Doctors use general anesthesia during surgery to
ensure a person is unconscious and cannot feel
pain. Scientists do not know precisely how
anesthetics work, but they appear to act at a
number of sites in the central nervous system.

General anesthesia is a medicine that is administered intravenously (IV) or

through a tube or mask. It is performed by an anesthesiologist or nurse
anesthetist, a specially trained doctor or nurse who will also monitor a
patient’s vital signs and rate of breathing during the procedure.
Under general anesthesia, people are unable to feel pain (analgesic) and will
be unconscious. It is more commonly used for major operations and during
surgery. A person may also experience amnesia temporarily following the
anesthetic.

General anesthetics have been widely usedTrusted Source in surgery since

1842 when Crawford Long administered diethyl ether to a patient and
performed the first painless operation.

In this article, we will cover a number of topics, including the differences

between general anesthesia and sedation, potential side effects of general
anesthesia, associated risks, and some theories regarding how they work.

Fast facts on general anesthesia

 An anesthesiologist or anesthetist normally administers the general
anesthetic prior to an operation.
 There are some risks associated with taking general anesthetics, but
they are relatively safe when administered correctly.
 Very rarely, a patient may experience unintended intraoperative
awareness.
 Side effects of general anesthesia can include dizziness and nausea.
 The mechanisms by which anesthesia works are still only partially
understood.
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Side effects
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There are a number of potential side effects of general anesthesia.

Some individuals may experience no side effects, whereas others may

experience a few. None of the side effects are particularly long lasting, and
they tend to occur right after the anesthesia.

Side effects of general anesthesia can include:

 temporary confusion and memory loss, although this is more common in

older adults
 dizziness
 difficulty passing urine
 bruising or soreness from the IV drip
 nausea and vomiting
 shivering and feeling cold
 sore throat, due to the breathing tube
Risks
Overall, general anesthesia is very safe. Even particularly ill patients can be
safely anesthetized. The surgical procedure itself offers the most risk.

However, older adults and those undergoing lengthy procedures are most at
risk of negative outcomes. These outcomes can include:

 postoperative confusion
 heart attack
 pneumonia
 stroke

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

 obstructive sleep apnea, a condition in which individuals stop breathing

while asleep
 seizures
 existing heart, kidney, or lung conditions
 high blood pressure
 alcohol use disorder
 smoking
 history of reactions to anesthesia
 medications that can increase bleeding — aspirin, for example
 drug allergies
 diabetes
 obesity or overweight
Death as a result of general anesthetic does occur, but only very rarely —
roughly 1 in every 100,000.

Unintended intraoperative awareness

This refers to rare cases in which patients report a state of awareness during
an operation, after the point at which the anesthetic should have removed all
sensation. Some patients are conscious of the procedure itself, and some can
even feel pain.

Unintended intraoperative awareness is incredibly rare, affecting an

estimated 1 in every 19,000 patients undergoing general anesthesia.

Because of the muscle relaxants given alongside anesthesia, patients are

unable to signal to their surgeon or anesthetist that they are still aware of what
is happening.

Patients who experience unintended intraoperative awareness can suffer

long-term psychological problems. Most often, the awareness is short-lived,
and a person is only aware of vague sensory experiences such as sounds,
touches, or movements.

As unintended intraoperative awareness is so infrequent, it is not clear exactly

why it occurs.

The following are considered to be potential risk factors:

 heart or lung problems

 daily alcohol use
 emergency surgery
 cesarean delivery
  anesthesiologist error
 use of some additional medications
 depression

Medical teams may administer IV sedation for the following procedures:

 breast or skin biopsies
 minor surgeries or repairs, such as fractured bones
 procedures using a scope, such as a colonoscopy
 teeth extraction
 eye operations

General anesthesia is also used for more lifesaving procedures such as heart
surgeries or treatments for cancer, although it does carry some risks.

Sedation vs. general anesthesia

Sedation is administered through an IV.

There are three types of sedation, including:

 Mild: A person is awake and responsive.

 Moderate: A person may be sleepy but can wake up.
 Deep: Similar to general anesthesia, as a patient is in a deep sleep.

Sedation and general anesthesia are both forms of anesthesia, but people will
experience different effects depending on the type administered by doctors
during a procedure, including the level of consciousness, breathing support,
and possible side effects.
Sedation is generally characterized by people feeling drowsy but being in a
relaxed state of consciousness. Whereas, when people are under general
anesthesia, they have a complete loss of consciousness.

Cardiovascular function is usually maintained throughout sedation, and people

are able to breathe independently. However, this does not mean that
respiratory assistance may not be used in some instances with sedation.

On the other hand, general anesthesia usually impairs breathing, and

monitoring and breathing assistance are required.

The adverse effects that may be associated with general anesthesia are
avoided with sedation, as the recovery period from sedation is typically
quicker.

Types
Alongside general anesthetic, there are other types, including:

 Local anesthesia: This type of anesthesia is given before minor

surgeries, such as the removal of a toenail. This reduces pain in a
small, focused area of the body, but the person receiving the treatment
remains conscious.
 Regional anesthesia: This type numbs an entire portion of the body
and prevents pain sensation, such as in the lower half of the body
during childbirth.

There are two main forms of regional anesthesia:

  Spinal anesthetic: This type is used for surgeries of the lower limbs
and abdomen. The professional administering the anesthetic injects it
into the lower back and numbs the lower body.
 Epidural anesthesia: This type of anesthesia is often used to reduce
the pain of childbirth and lower limb surgery. It 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
 overall health
 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 may make the patient feel uncomfortable.
 The patient may be young, and they may have difficulty remaining still.