Anesthesia (anesthesia) with this or that intervention of surgeons can be of two types:
- local - the patient is conscious, only that part of the body on which the operation will take place is anesthetized;
- general - the patient falls into a deep medical sleep.
General and local anesthesia equally find a place in modern medicine. In local anesthesia, spinal and epidural anesthesia are distinguished. In these cases, the patient is conscious, but has no control over her lower body, she becomes completely numb and loses sensation. General anesthesia is often called anesthesia.
The concept of anesthesia
Anesthesia - general anesthesia; in Greek means "numbness", "numbness". Its meaning is to, with the help of medications, 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-induced sleep.
Such a dream can not be compared with the usualdaily sleep, when a person can wake up from the slightest rustle. During medical sleep, a person, in fact, turns off for some time almost all vital systems, except for the cardiovascular system.
Premedication
Before general anesthesia, the patient must undergo special training - premedication. Almost all people tend to experience excitement or fear before the operation. Stress caused by anxiety can have an extremely negative impact on the course of surgical intervention. The patient at this moment is a huge release of adrenaline. This leads to malfunction of vital organs - the heart, kidneys, lungs, liver, which is fraught with complications during the operation and after it.
For this reason, anesthesiologists consider it necessary to calm the person before surgery. For this purpose, he is prescribed drugs of a sedative nature - this is called premedication. For operations planned in advance, sedation is carried out the day before. As for emergencies, right on the operating table.
Main stages, types and stages of general anesthesia
General anesthesia is carried out in three stages:
- Induction anesthesia, or induction - is carried out as soon as the patient is on the operating table. He is being injected with medications that provide deep sleep, complete relaxation and pain relief.
- Supportive anesthesia - the anesthesiologist must accurately calculate the amount of medication needed. During the operationall functions of the patient's body are constantly kept under control: 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 anesthesiologist must be aware of all stages of the operation and its duration, so that he can, if necessary, add or reduce the dose of drugs.
- Awakening is a way out of anesthesia. The anesthesiologist also accurately calculates the number of drugs in order to bring the patient out of deep drug sleep in time. At this stage, the medicines should finish their action, and the person slowly begins to wake up. It includes all organs and systems. The anesthetist does not leave the patient until he is fully conscious. The patient's breathing should become spontaneous, blood pressure and pulse stabilize, reflexes and muscle tone return to normal.
General anesthesia has the following stages:
- Surface anesthesia - tactile sensitivity disappears, pain threshold is not felt, but reflexes of skeletal muscles and internal organs remain.
- Light anesthesia - skeletal muscles relax, most reflexes disappear. Surgeons have the opportunity to perform light superficial operations.
- Full anesthesia - relaxation of the muscles of the skeletal muscles, almost all reflexes and systems are blocked, except for the cardiovascular. It becomes possible to carry out operations of anycomplexities.
- Super-deep anesthesia - we can say that this is a state between life and death. Almost all reflexes are blocked, the muscles of both skeletal and smooth muscles are completely relaxed.
Types of general anesthesia:
- mask;
- intravenous;
- total.
Adjustment period after general anesthesia
After the patient comes out of general anesthesia, doctors monitor his condition. Complications of general anesthesia are extremely rare. Each operation has its own indications. For example, if surgery was performed on the abdominal cavity, then you should not drink water for some time. In some cases, it is allowed. Ambiguous today is the issue of movement of the patient after surgery. It used to be that it was desirable for a person in the postoperative period to stay in bed as long as possible. Today, it is recommended to get up, 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 doctor, otherwise recovery may be delayed.
Choose the method of anesthesia
An anesthesiologist is responsible for the pain relief process. He, together with the surgeon and the patient, decides which type of anesthesia to prefer in a particular case. Many factors influence the choice of anesthesia method:
- The volume of the planned surgical intervention. For example, the removal of a mole does not require general anesthesia, but surgical intervention on the internal organs of a patient is already a serious matter and requires a deep and long medication sleep.
- The condition of the patient. If the patient is in serious condition or any complications of the operation are foreseen, then there can be no talk of local anesthesia.
- Experience and qualifications of the surgeon. The anesthesiologist knows approximately the course of the operation, especially in cases where it is not the first time working with the surgeon.
- But, of course, the anesthesiologist, given the opportunity to choose and in the absence of contraindications, will always choose the method of anesthesia that is closer to him, and in this matter it is better to rely on him. Whether it is general anesthesia or local anesthesia, the main thing is that the operation is successful.
Reminder for the patient before surgery
Before the operation, there is always communication between the patient and the anesthetist. The doctor should ask about previous operations, what kind of anesthesia was and how the patient endured it. On the part of the patient, it is very important to tell the doctor everything without missing the slightest detail, as this can later play a role during the operation.
Before the operation, the patient needs to remember about the diseases that he had to endure for the entire period of his life. This is especially true for chronic diseases. Also, the patient should tell the doctor about the medications that he is forced to take at the moment. It is possible that the physicianask a lot of additional questions in addition to all of the above. This information is necessary for him in order to exclude the slightest mistake when choosing a method of anesthesia. Serious complications of general anesthesia are extremely rare if all actions on the part of both the anesthesiologist and the patient have been performed correctly.
Local anesthesia
Local anesthesia in most cases does not require the intervention of an anesthesiologist. Surgeons can independently perform this kind of anesthesia. They simply inject the surgical site with a medication.
With local anesthesia, there is always the risk that an insufficient amount of medication is injected and the pain threshold is felt. In this case, there is no need to panic. You must ask the doctor to add the drug.
Spinal anesthesia
In spinal (spinal) anesthesia, an injection is made directly into the region of the spinal cord. The patient feels only the injection itself. After the introduction of anesthesia, the entire lower part of the body becomes numb, loses all sensitivity.
This kind of anesthesia is successfully used in operations on the legs, in urology and gynecology.
Epidural anesthesia
In epidural anesthesia, a catheter is inserted into the area between the spinal canal and the spinal cord, through which pain medication can be administered.
Epidural anesthesia is sometimes used for labor pain relief and often for long-term gynecological and urological surgeries.
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 inhalation general anesthesia, is introduced into the body through the patient's respiratory tract. With this type of anesthesia, sleep is maintained thanks to a special gas that anesthesiologists apply through a mask applied to the patient's face. 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, it is easy to put the patient to sleep, and just as easy to wake him up.
Intravenous anesthesia
During intravenous anesthesia, drugs that induce drug-induced sleep and relaxation are injected directly into a vein. This allows you to achieve a quick effect and high-quality results.
Intravenous anesthesia can be used in a variety of operations. It is the most common in classical surgery.
Multicomponent general anesthesia with muscle relaxation
Multicomponent this type of anesthesia is called 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.
Miorelaxation - relaxation of all skeletal muscles. This is a very important point during surgery.
MulticomponentAnesthesia is recommended for major and lengthy operations. Today, abdominal and chest organs are operated under such anesthesia.
General anesthesia. Contraindications
There are some contraindications to the use of general anesthesia:
- heart failure;
- severe anemia;
- myocardial infarction;
- pneumonia;
- acute kidney and liver diseases;
- bronchial asthma;
- epilepsy attacks;
- treatment with anticoagulants;
- endocrine diseases such as thyrotoxicosis, decompensated diabetes, adrenal disease;
- full stomach;
- heavy alcohol intoxication;
- lack of an anesthesiologist, necessary drugs and equipment.
General and local anesthesia are very important elements in modern surgery. Not a single operation takes place without anesthesia. In this matter, medicine must be given its due, because not every person can endure a painful shock.
