General anesthesia: types and contraindications

Anesthesia (anesthesia) with one or another intervention of surgeons can be of two types:

• local - the patient is conscious, only that part of the body where the operation will take place is anesthetized;
• general - the patient is immersed in a deep medication sleep.

General and local anesthesia equally find a place in modern medicine. In local anesthesia, spinal and epidural anesthesia are isolated . In these cases, the patient is conscious, but does not own his lower body, she is completely numb and loses sensitivity. General anesthesia is often called anesthesia.

The concept of anesthesia

Narcosis - general anesthesia; translated from Greek means "numbness", "numbness." Its meaning is to use the medications to have an effect on the central nervous system and completely block the nerve impulses that it transmits. As a result, all human reactions are inhibited, and he plunges into the so-called drug sleep.

Such a dream can not be compared with the usual daily dream, when a person can wake up from the slightest rustle. With medical sleep, a person, in fact, turns off for some time almost all vital systems, except for the cardiovascular system.

Premedication

Before conducting general anesthesia, the patient must undergo special training - premedication. Almost all people tend to experience excitement or fear of surgery. Stress caused by excitement can have an extremely negative effect on the course of surgery. The patient at this moment has a huge surge of adrenaline. This leads to malfunctioning of vital organs - the heart, kidneys, lungs, liver, which is fraught with complications during and after the operation.

For this reason, anesthetists consider it necessary to reassure a person before surgery. For this purpose, sedatives are prescribed to him - this is called premedication. In operations planned in advance, premedication is carried out the day before. As for emergency cases - then right on the operating table.

The main stages, types and stages of general anesthesia

General anesthesia is carried out in three stages:

• Induction anesthesia, or induction, is performed as soon as the patient is on the operating table. He is injected with medications that provide deep sleep, complete relaxation and anesthesia.
• Maintenance Anesthesia - The anesthetist must accurately calculate the amount of medication needed. During the operation, all functions of the patient’s body are constantly monitored: blood pressure is measured, pulse rate and respiration are monitored. An important indicator in this situation is the work of the heart and the amount of oxygen and carbon dioxide in the blood. The anesthetist should be aware of all stages of the operation and its duration, so that he can add or reduce the dose of drugs if necessary.
• Awakening is a way out of anesthesia. An anesthetist conducts an accurate calculation of the number of drugs also with the aim to promptly remove the patient from deep drug sleep. At this stage, the medications should finish their action, and the person begins to awaken smoothly. It includes all the organs and systems. The anesthetist does not leave the patient until he comes fully into consciousness. The patient’s breathing should become independent, blood pressure and pulse should be stabilized, reflexes and muscle tone fully normal.

General anesthesia has the following stages:

• Superficial anesthesia - the tactile sensitivity disappears , the pain threshold is not felt , but the reflexes of skeletal muscles and internal organs remain.
• Light anesthesia - the skeletal muscles relax, most of the reflexes disappear. Surgeons have the opportunity to carry out light superficial operations.
• Complete anesthesia - relaxation of the muscles of the skeletal muscles, almost all reflexes and systems are blocked, except for the cardiovascular. There is the possibility of conducting operations of any complexity.
• Ultra-deep anesthesia - we can say that this is a state between life and death. Almost all reflexes are blocked, muscles of both skeletal and smooth muscles are completely relaxed.

Types of general anesthesia:

• mask;
• intravenous;
• common.

Adaptation period after general anesthesia

After the patient exits general anesthesia, his condition is monitored by doctors. Complications of general anesthesia are extremely rare. After each operation, there are indications. For example, if the surgery was performed on the abdominal cavity, then you can not drink water for some time. In some cases, it is allowed. A controversial issue today is the issue of patient movement after surgery. Previously, it was believed that a person in the postoperative period, it is desirable to stay in bed as long as possible. Today, it is recommended to get up, to move independently after a fairly short period of time after the operation. It is believed that this contributes to a quick recovery.

In any case, the patient should listen to the recommendations of his attending physician, otherwise the recovery may be delayed.

Choosing an anesthetic method

The anesthetist is responsible for the anesthesia process. He, together with the surgeon and the patient, decides what type of anesthesia to give preference in a particular case. The choice of anesthesia method is influenced by many factors:

• The scope of the planned surgical intervention. For example, the removal of a mole does not require general anesthesia, but surgical intervention on the patient’s internal organs is a serious matter and requires a deep and prolonged medical sleep.
• Patient status. If the patient is in serious condition or any complications of the operation are expected, then there can be no talk of local anesthesia.
• Experience and qualifications of a surgeon. An anesthesiologist roughly knows the progress of the operation, especially in those cases if it is not the first time he has worked with a surgeon.
• But, of course, the anesthesiologist, with the possibility of choice and in the absence of contraindications, will always choose the method of pain relief that is closer to him, and in this matter it is better to rely on him. Whether it is general or local anesthesia, the main thing is that the operation is successful.

Reminder for patient before surgery

Before surgery, there is always communication between the patient and the anesthetist. The doctor should ask about previous operations, what anesthesia was and how the patient suffered it. On the part of the patient, it is very important to tell the doctor everything, without missing a single detail, since this can later play a role in the course of the operation.

Before surgery, the patient needs to recall the diseases that had to be transferred for the entire period of life. This is especially true for chronic diseases. Also, the patient should tell the doctor about medications that he is forced to take at the moment. It is possible that the doctor may ask many more additional questions besides all of the above. This information is necessary for him in order to exclude the slightest mistake when choosing an anesthesia method. Serious complications of general anesthesia are extremely rare if all the actions both on the part of the anesthesiologist and on the part of the patient were performed correctly.

Local anesthesia

Local anesthesia in most cases does not require the intervention of an anesthetist. Surgeons can independently carry out this kind of anesthesia. They just chop off the site of the surgical intervention with a medical preparation.

With local anesthesia, there is always a risk that an insufficient amount of medication is introduced and the pain threshold is felt. In this case, do not panic. You must ask your doctor to add the drug.

Spinal anesthesia

With spinal (spinal) anesthesia, the injection is done directly into the spinal cord. The patient only feels the injection. After the introduction of anesthesia, the entire lower body becomes numb, loses all sensitivity.

This kind of anesthesia is successfully used in operations on the legs, in urology and gynecology.

Epidural anesthesia

With epidural anesthesia, a catheter is inserted into the area between the spinal canal and the spinal cord, through which painkillers can be administered .

Epidural anesthesia is sometimes used to anesthetize labor and often for prolonged operations in the field of gynecology and urology.

Which is better, epidural anesthesia or general anesthesia? This is a very controversial issue today. Everyone has their own arguments about this.

Mask anesthesia

Mask anesthesia, or inhaled general anesthesia, is injected into the body through the patient’s respiratory tract. With this type of anesthesia, sleep is maintained thanks to a special gas, which anesthetists supply through a mask applied to the patient's face. It is used for light short-term operations.

If mask anesthesia is used, the main thing for the patient is to listen to the doctor: breathe as he asks, do what he says, answer the questions asked by him. With mask anesthesia, the patient is easy to enter into sleep, and just as easy to wake him up.

Intravenous anesthesia

With intravenous anesthesia, drugs that cause medical sleep and relaxation are injected directly into a vein. This allows you to achieve a quick effect and high-quality result.

Intravenous anesthesia can be used in a variety of operations. He is the most common in classical surgery.

Multicomponent general anesthesia with muscle relaxation

This type of anesthesia is called multicomponent because it combines mask and intravenous anesthesia. That is, the components of general anesthesia are administered in the form of drugs intravenously, and in the form of gases through the respiratory system. This type of anesthesia allows you to achieve maximum results.

Muscle relaxation - relaxation of all skeletal muscles. This is a very important point during surgery.

Multicomponent anesthesia is recommended for serious and lengthy operations. Today, under such anesthesia, organs of the abdominal cavity and chest are operated on.

General anesthesia Contraindications

There are some contraindications to the use of general anesthesia:

• cardiovascular failure;
• severe anemia;
• myocardial infarction;
• pneumonia;
• acute diseases of the kidneys and liver;
• bronchial asthma;
• epilepsy attacks;
• anticoagulant treatment;
• endocrine diseases such as thyrotoxicosis, decompensated diabetes, adrenal gland diseases;
• full stomach;
• heavy intoxication;
• lack of an anesthetist, the necessary drugs and equipment.

General and local anesthesia are very important elements in modern surgery. Not a single operation goes without pain relief. In this matter, medicine must be given credit, because not every person can endure pain shock.