How does anesthesia work and what tests are needed before anesthesia?

Anesthesia is the process of reducing the sensitivity of the body or part of it until the complete cessation of perception of information about the environment and one's own condition. When the doctor says before surgery that you won't feel anything, be calm, it's true. You may be unconscious or awake. It depends on the type of anesthesia. Let's talk about the preparation before anesthesia: what can and cannot be done.

When anesthesia is needed?

The choice of anesthesia depends on the complexity of the doctor's manipulations: local during bandages and during simple operations, regional during dental fillings and in traumatology, general and combined with large surgical operations.


 
Each anesthesiologist has the skills, knowledge and tactics to apply any of the listed anesthesia methods. 
 
When surgery is performed under general anesthesia, the anesthesiologist takes care of the patient before, during and after the operation. That is, until the patient's condition returns to normal for further rehabilitation after surgical aggression.
 
What are the types of anesthesia?
 
General anesthesia (anesthesia) is what patients most often think about when they hear the word "anesthesia". During general anesthesia, you are unconscious and do not feel anything. Drugs used during anesthesia provide reversible suppression of the central nervous system with the shutdown of consciousness and suppression of pain perception. Inhalation, total intravenous and combined anesthesia are distinguished. The choice depends on the route of administration of the anesthetics used. With the exception of short, low—traumatic operations, during this anesthesia, prosthetics of the respiratory function is required - artificial ventilation of the lungs, since under the influence of medications, respiratory function is depressed and muscles relax, including those involved in breathing.
 
Regional anesthesia blocks pain from the peripheral nerves to the central nervous system. A solution of a local anesthetic is injected into the perineural space. After that, the area of surgery becomes insensitive to pain. Common tactics of regional anesthesia are spinal and epidural. The use of epidural or spinal anesthesia (injection of an anesthetic solution into the space surrounding the spinal cord) allows you to anesthetize extensive areas. Spinal anesthesia is more often used in operations on the extremities and lower abdominal cavity. This type of anesthesia is often combined with sedation. Sedation is the administration of drugs used in general anesthesia to eliminate anxiety in a patient or to introduce them into a shallow, controlled sleep. This requires lower doses of drugs than for general anesthesia.
 
Combined anesthesia is a combination of general anesthesia with regional anesthesia methods. It is used in operations on abdominal and thoracic organs. It allows not only to achieve the effect of anesthesia, but also to reduce the dose of drugs used for anesthesia.

Local anesthesia is a type of anesthesia that blocks nerve endings and trunks in the area of surgery. Currently, it is used only in outpatient surgery and as a component of complex effects when performing "large" operations. The patient is awake during the procedure. Preparations of local anesthetics are injected through a needle or applied in a cream format. 
 
Anesthesiological support is used, as a rule, when performing painless diagnostic interventions or manipulations. The anesthesiologist is present, monitors the progress of the procedure (respiratory and hemodynamic parameters of patients are monitored), but does not intervene until necessary. His actions are aimed at eliminating the threat or minimizing possible damage and may not be related to his own anesthesia.
 
Do I even need an anesthesiologist?
 
An anesthesiologist is a specialist engaged in anesthesiological support, as well as pain treatment in the postoperative period. Its task is to assess perioperative risks based on the patient's health status and the planned operation, to ensure safety and comfortable conditions for the patient during the operation. Also, the tasks of the anesthesiologist include coordinating the work of the operating team, monitoring and managing all vital functions of the body in the perioperative period: breathing, blood circulation, metabolism. During anesthesia, the anesthesiologist is constantly next to the patient and continuously monitors his condition, immediately reacting to the slightest changes.

Thus, the successful outcome of surgical treatment in general largely depends on the experience, knowledge and practical skills of the anesthesiologist, as well as the availability of the necessary equipment and technologies.


 
About preparation for anesthesia
 
Before the operation at Olympus Clinic, the patient is scheduled to see a surgeon and an anesthesiologist. They will talk about the preparation, stages of surgery and anesthesiological benefits, rehabilitation in the early postoperative period and at home. 
 
What questions will the anesthesiologist ask?: 
 
Tell the anesthesiologist everything about your health. For example, how physically active you are, whether you have chronic diseases: asthma, diabetes, heart disease, liver or kidney disease, allergies or any other diseases. Bad habits, injuries, previous surgeries, snoring and sleep problems — all these data should be known by an anesthesiologist in order to select the safest possible management tactics for the patient at each stage of surgery and rehabilitation. Make a list of all the prescription and over-the-counter medications, supplements, and vitamins that you take. The anesthesiologist may advise you to stop taking some of them or ask specialized specialists to adjust the prescribed therapy.
 
Should I cancel my medication?

You may have to stop taking some medications a week or more before surgery. 

If you take medications every day, ask your doctor which ones you can not cancel. If necessary, the anesthesiologist may request the advice of your specialized specialist to select dosages and medications for the duration of hospitalization and rehabilitation.
 
Do you smoke and/or drink alcohol?

These substances can affect your response to anesthesia, as well as your recovery time. Alcohol can interact with anesthetics, increasing or decreasing their effects. And nicotine slows down the healing of wounds. 
 
Have there been any adverse reactions during previous operations and anesthesia? 
 
Tell the anesthesiologist if you or a member of your family had any adverse reactions during the anesthetic treatment. Tell us about any side effects you have experienced, even if it was many years ago. 
 
Are you worried?
 
It is natural to be afraid of surgery and anesthesia. If you are worried, feel free to tell your anesthesiologist about it. The doctor will answer your questions in detail so that you feel safe.
 
Do you have any questions of your own?
 
Before the meeting, write down the questions you want to ask. And write down the answers, because it's hard to remember everything at once. If you have a consultation with an anesthesiologist before hospitalization, you can invite a friend or relative to help you take notes and ask questions that you may not even have thought about.
 
Tip: Ask about your recovery. Anesthesiologists continue to care for patients after surgery. The anesthesiologist can tell you about each stage of general anesthesia: from the moment of falling asleep to the moment of waking up, how and how you will feel at these moments when you can return to your usual lifestyle and daily routine. Tell us about the concerns during rehabilitation, the anesthesiologist will tell you about these subtleties. 
 
The list of tests before anesthesia depends on the type of operation, but the standard one consists of: 

Blood type
Coagulograms
General blood test
Biochemical blood analysis
Serological examination (HIV, Hepatitis, Syphilis)
General urine analysis
ECG
Ultrasound of the veins of the lower extremities
Fluorography/chest X-ray
The conclusion of the therapist with admission to surgical treatment
 
Food
 
You will need to stop eating and drinking at least 6-8 hours before surgery. This is due to the fact that general anesthesia relaxes the muscles, so food from a full stomach can enter the respiratory tract.
 
Clothes
 
Take a set of loose and comfortable clothes. Swelling, pain during compression in the area of surgery, a bandage over the operated area are possible inconveniences in the postoperative period. 
 
Transport
 
After the operation, you will temporarily be unable to drive a car. Ask your loved ones to pick you up from the clinic. The care of friends or family will help you to recover comfortably and quickly. 
 
 
Myths about general anesthesia
 
Anesthesia takes 5 years of life
 
This is a myth. Anesthesia does not affect life expectancy. It helps the patient not to feel pain. The drugs used by the anesthesiological team have an organoprotective function. It is aimed at protecting the patient from surgical aggression. The patient is calm during the operation, he is in a controlled sleep, and the surgical team is comfortable doing their job. 
 
I can wake up during anesthesia
 
It is not true. During the anesthesiological benefit, the anesthesiologist uses high-precision equipment to monitor all vital signs, which helps to assess the quality and depth of sleep. The equipment also signals minimal deviations from the set norms (it is selected individually for each patient), helping the anesthesiologist to react to the situation in time and adjust the necessary parameters for anesthesia.
 
Anesthesia is drugs. I will have an addiction

The anesthesiologist in his practice uses drugs included in the register of potent and narcotic drugs. But drugs are not really drugs. They have similar mechanisms of action to some of the banned narcotic substances. It is impossible to exclude their use during anesthesia, since they are responsible for anesthesia and affect the depth of sleep. Dependence cannot develop during the operation and the period of hospitalization of the patient, since dosages, frequency of administration and safe periods of use are calculated by the anesthesiologist individually for each patient. The doctor takes into account the complexity of the intervention, the area, the traumatic nature of the operation and the time of hospitalization of the patient. To reduce the impact and the possibility of addiction, narcotic drugs can be combined with other drugs from the anesthesiologist's arsenal: inhalation anesthetics or muscle relaxants, hypnotics. 
 
The anesthesiologists of Olympus Clinics are sympathetic to the concerns of patients. To be afraid of something is to be human. During the consultation, you can ask any questions to our specialists. They will be happy to answer them, dispel fears and support. 
 
How long does general anesthesia last?
 
The duration of general anesthesia depends on the duration of the operation. You will regain consciousness after the end of all manipulations, up to the application of bandages to the postoperative wound. After the operation, the anesthesiologist will monitor your vital signs and the degree of anesthesia in the early postoperative period to make sure that you are ready to be transferred to the general ward of the hospital. 
 
After recovering from anesthesia, you may feel weak and drowsy. It takes several hours for the effect of the drugs to completely disappear.
 
Are there any side effects after general anesthesia?
 
If there will be any, it will be minor and temporary. Most often, these reactions are not directly related to the anesthetic aid, but are complex in nature (stress before surgery + patient's health features + surgical intervention + anesthetic aid).
 
After surgery and anesthesia, the patient may feel:

Weakness
Confusion of consciousness
Nausea
Drowsiness
Dry mouth
Chills
Sore throat
Pain in the area of surgery
 
But you should not be afraid of these reactions, since after the operation you will continue to be monitored by the staff on duty at the Olympus Clinic hospital, which includes an anesthesiologist.

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