Patients that experience unintended intraoperative awareness can suffer long-term psychological problems. Most often, the awareness is short-lived and of sounds only, and occurs prior to the procedure.
According to a recent large-scale investigation of the phenomenon, patients experienced tugging, stitching, pain, paralysis, and choking, among other sensations. Because unintended intraoperative awareness is so infrequent, it is not clear exactly why it occurs. 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. 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. However, using general anesthetic poses a higher risk of complications than local anesthesia. If the surgery is more minor, an individual may choose local as a result, especially if they have a underlying condition, such as sleep apnea.
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. It is essential that these questions are answered accurately. For instance, if a history of alcohol or drug use is not mentioned, an inadequate amount of anesthesia might be given which could lead to dangerously high blood pressure or unintended intraoperative awareness.
Modern anesthetics and updated delivery methods have improved the speed of onset, general safety, and recovery, but the four stages remain essentially the same:. Stage 1, or induction: This phase occurs between the administration of the drug and the loss of consciousness. In fact, your risk of complications is more closely related to the type of procedure you're undergoing and your general physical health, rather than to the type of anesthesia.
Older adults, or those with serious medical problems, particularly those undergoing more extensive procedures, may be at increased risk of postoperative confusion, pneumonia, or even stroke and heart attack.
Specific conditions that can increase your risk of complications during surgery include:. Estimates vary, but about 1 or 2 people in every 1, may be partially awake during general anesthesia and experience what is called unintended intraoperative awareness. It is even rarer to experience pain, but this can occur as well.
Because of the muscle relaxants given before surgery, people are unable to move or speak to let doctors know that they are awake or experiencing pain. For some patients, this may cause long-term psychological problems, similar to post-traumatic stress disorder. This phenomenon is so rare that it's difficult to make clear connections. Some factors that may be involved include:. General anesthesia relaxes the muscles in your digestive tract and airway that keep food and acid from passing from your stomach into your lungs.
Always follow your doctor's instructions about avoiding food and drink before surgery. Fasting is usually necessary starting about six hours before your surgery. You may be able to drink clear fluids until a few hours prior. Your doctor may tell you to take some of your regular medications with a small sip of water during your fasting time. Discuss your medications with your doctor. You may need to avoid some medications, such as aspirin and some other over-the-counter blood thinners, for at least a week before your procedure.
These medications may cause complications during surgery. Some vitamins and herbal remedies, such as ginseng, garlic, Ginkgo biloba, St. John's wort, kava and others, may cause complications during surgery. Discuss the types of dietary supplements you take with your doctor before your surgery. If you have diabetes, talk with your doctor about any changes to your medications during the fasting period.
Usually you won't take oral diabetes medication the morning of your surgery. If you take insulin, your doctor may recommend a reduced dose. While anesthesia is very safe, it can cause side effects both during and after the procedure. Most side effects of anesthesia are minor and temporary, though there are some more serious effects to be aware of and prepare for in advance. The most important thing you can do to prevent anesthesia side effects is make sure a physician anesthesiologist is involved in your care.
A physician anesthesiologist is a medical doctor who specializes in anesthesia, pain management, and critical care medicine. Before your surgery, meet with the physician anesthesiologist to discuss your medical history, health habits, and lifestyle. This information will help the physician anesthesiologist know how you might react to anesthesia and take steps to lower your risk of side effects.
This meeting is also a good time for you to ask questions and learn what to expect. There are four main types of anesthesia used during medical procedures and surgery, and the potential risks vary with each. The types of anesthesia include the following:. General anesthesia. General anesthesia causes you to lose consciousness. This type of anesthesia, while very safe, is the type most likely to cause side effects. Page last reviewed: 21 June Next review due: 21 June General anaesthesia.
How general anaesthetics are given Before having an operation, you'll meet a specialist doctor called an anaesthetist to discuss which anaesthetic is most suitable for you. This is called a preoperative assessment, when the anaesthetist will: discuss the type or types of anaesthetic that are suitable for you explain the risks of anaesthesia agree a plan with you for your anaesthetic and pain control afterwards The anaesthetist will look at your medical history and ask whether anyone in your family has had problems with anaesthesia.
They'll also ask about your general health and lifestyle, including whether you: have any allergies smoke or drink alcohol are taking any other medicine The anaesthetist can answer any questions you have.
Before and during your operation Just before you have surgery, you'll usually be taken to a room where your anaesthetist will give you the general anaesthetic. It will either be given as a: liquid that's injected into your veins through a cannula a thin, plastic tube that feeds into a vein, usually on the back of your hand gas that you breathe in through a mask The anaesthetic should take effect very quickly.
Recovery After your operation, the anaesthetist will stop the anaesthetic and you'll gradually wake up. Side effects General anaesthetics have some common side effects. Possible serious complications and risks include: a serious allergic reaction to the anaesthetic anaphylaxis waking up during your operation accidental awareness , although the amount of anaesthetic given will be continuously monitored to help ensure this does not happen death — this is very rare Serious problems are more likely if you're having major or emergency surgery, you have any other illnesses, you smoke, or you're overweight.
Other types of anaesthetic As well as general anaesthetic, there are several other types of anaesthetic, which can be used for certain procedures. They include: local anaesthetic epidural anaesthetic spinal anaesthetic nerve blocks Page last reviewed: 21 June Next review due: 21 June
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