At some point, most people receive anesthesia for either a surgical procedure or even diagnostic testing. While “going under” is relatively common, it’s not altogether well-understood. It’s typical for patients to experience anxiety associated with anesthesia and misconceptions surrounding the risks.
The anesthesia used in the medical industry today is safer than ever, and the classifications of anesthesia and the different anesthetics mean that it can be adjusted to suit the patient and the type of procedure they’re having.
Here’s our guide to understanding the four main types, what they do, when they’re used, and some questions you should ask before getting them.
Understanding the Different Anesthetics
A general anesthetic is the most common type of anesthetic, and it’s likely the first thing that comes to mind when you think of surgery. While other anesthetics merely sedate you to varying degrees, general anesthesia certainly puts you “under”, lulling patients into a completely unconscious state, ensuring they don’t move or feel pain while on the operating table.
Since it can restrain breathing and lead to life-threatening complications, general anesthesia is undoubtedly the riskiest. But even though this type of anesthetic requires caution and poses risks, it’s not as bad as it’s made out to be, and serious issues rarely occur in healthy people. Deaths caused by general anesthetic are very rare, occurring in only 1 of every 100,000 or 200,000 operations. And people very rarely wake up during a procedure after the anesthetic has been administered. For this reason, health care professionals strive to use the least amount of anesthetic needed to keep patients comfortable.
General anesthesia is administered intravenously through a needle in your arm or inhaled through a mask. Routinely used for most major surgeries, including brain, heart, back, and abdominal operations – general anesthesia is used for essentially any operation that covers a large area of the body, takes a long time to perform, and/or requires the patient to be completely immobilized. After the patient goes to sleep, they might be given other medication to help the muscles relax and ensure the body is totally at ease and pain-free. When patients wake up, they won’t remember the procedure. However, typical side effects include drowsiness, nausea, and chills. And it isn’t unusual to experience a sore throat from the breathing tube used during the procedure.
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IV (intravenous) sedation is used for shorter, less complex procedures, like eye or foot operations, colonoscopies, endoscopies, and biopsies. Known by various names like conscious sedation, twilight sedation, and monitored anesthesia care – this kind of anesthesia entails injecting a pain-killing drug into a specific body part, followed by IV drugs to keep the patient sedated. This type of sedation is safer than general anesthesia, and depending on how deeply the patient needs to be sedated, they may or may not experience amnesia about the procedure. With minimal sedation, patients will be able to communicate with the surgical team during the procedure.
Nurse anesthetists often administer the anesthetic during the surgery, working under the supervision of the physician.
This kind of anesthesia blocks all feeling in specific body parts and can involve a nerve block – an injection of an anesthetic near nerves to numb a particular body part – or spinal or epidural administration. Spinal administration involves anesthetic being injected directly into the cerebrospinal fluid in your spinal cord through a tiny needle. With epidurals, anesthetic is administered through a catheter inserted into the space between the spine and its outer membrane. An advantage of using the catheter is that it can be used to give more medication during the surgery. Either way, the patient doesn’t feel anything in the area being operated on.
Nerve blocks are often used for dental work, abdominal or retinal surgery, upper or lower extremity surgery, as well as pain relief after total knee replacement. Epidurals are usually given during childbirth since they numb the lower body for labor, while a spinal is used if a Caesarean section is needed to deliver the baby. While spinals are fast-acting, epidurals last longer. Whether the patient wants to be conscious for a procedure where they use a regional anesthetic, is up to them. Headaches are a common side effect of regional anesthesia.
You typically receive local anesthetic at urgent care clinics before getting stitches or at a plastic surgeon’s office before laser surgery. This kind of anesthesia numbs only a small area, so the patient doesn’t feel any pain but leaves them fully conscious. This can be administered via a needle or applied directly to the skin.
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Questions To Ask About the Different Anesthetics
It’s always a good idea to prepare for your meeting with the anesthesia team with a list of questions you’d like to ask them. Possible questions include:
- Do I need to have general anesthesia for this procedure?
- How will I feel when I wake up after my procedure?
- What kinds of medication will I be prescribed to relieve pain after my procedure?
- Do I have any risk factors that make anesthetic risky for me?
- How can I lower my risk of having anesthesia-related complications?
How To Have Anesthesia Safely
Medical professionals need to have all the relevant information about you when planning which medications to use during your procedure. This means you will need to tell your anesthesiology team about any medications you’re currently taking and all medical issues and drug allergies you may have as well as whether you’ve had a reaction to different anesthetics before.
It’s important not to eat or drink before any surgery, which requires you to have general, IV/monitored sedation, or regional anesthesia. The general rule of thumb is not to have any solid food for eight hours before having anesthesia, or clear liquids like water or coffee for two hours prior. The reason being that food can regurgitate into your lungs after anesthesia, making it harder for oxygen to reach your lungs – this is called pulmonary aspiration, and it is a very serious risk.
As directed by your surgical team, you may be required to stop using medication and supplements before your surgery because they may thin the blood and could lead to excessive bleeding.
If you are a smoker, you should stop smoking at least 24 hours before your surgery, even if you are not trying to quit for good. Smoking can lead to breathing problems and increases your risk of complications from anesthesia both during and after surgery.
It’s also vital that you arrange for someone to pick you up and take you home after your procedure. You will not be allowed to drive if your procedure requires more than local anesthesia since you will likely be drowsy, and your reflexes will be dulled. The same goes for if you’re using opioids for pain relief.
There you have it, everything you need to know about understanding the different anesthetics, from the various classifications of anesthesia to common side effects, as well as things you need to know to prepare before your procedure. If you would like to speak to a medical professional, book a consultation through the Air Doctor app to chat to a doctor about any medical issues or questions you may have.