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Anesthesia - Types of Anesthesia

Anesthesiainvolves the use of medicines to block pain sensations (analgesia) during surgery andother medical procedures. Anesthesia also reduces many of your body's normalstress reactions

to surgery.

The type of anesthesia used for your surgery depends on:

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Yourmedical history, including other surgeries you have had and any conditions youhave (such as diabetes). You will also be asked whether you have had anyallergicreactionsto any anesthetics or medicines or whether any family members have had

reactions to anesthetics.

The results of yourphysical exam. A physical exam will be done to evaluate your currenthealth and identify any potential risks or complications that may affect your anesthesiacare.

Tests such as blood tests or anelectrocardiogram(EKG, ECG), if needed. The type of surgery that you are having.

o You need to be able to lie still and remain calm during surgery done withlocal orregional anesthesia.

o Young children usually cannot stay still during surgery and need generalanesthesia.

o Adults who are extremely anxious, in pain, or have muscle disorders also mayhave difficulty remaining relaxed and cooperative.

o Some surgical procedures require specific positions that may be uncomfortablefor long periods if you are awake.

o Some procedures require the use of medicines that cause muscle relaxation andaffect your ability to breathe on your own. In such cases, your breathing can bestbe supported if general anesthesia is used.

Based on your medical condition, your anesthesia specialist may prefer one type of anesthesia

over another for your surgery. When the risks and benefits of different anesthesia options are

equal, your anesthesia specialist may let you choose the type of anesthesia.

Anesthesia methods

There are several ways that anesthesia can be given.

Local anesthesiainvolves injection of a local anesthetic (numbing agent) directly into thesurgical area to block pain sensations. It is used only for minor procedures on a limited

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part of the body. You may remain awake, though you will likely receive medicine to help

you relax or sleep during the surgery.

Regional anesthesiainvolves injection of a local anesthetic (numbing agent) aroundmajor nerves or the spinal cord to block pain from a larger but still limited part of the

body. You will likely receive medicine to help you relax or sleep during surgery. Major

types of regional anesthesia include:o Peripheral nerve blocks. A local anesthetic is injected near a specific nerve or

group of nerves to block pain from the area of the body supplied by the nerve.

Nerve blocks are most commonly used for procedures on the hands, arms, feet,legs, or face.

o Epidural and spinal anesthesia. A local anesthetic is injected near the spinal cordand nerves that connect to the spinal cord to block pain from an entire region ofthe body, such as the belly, hips, or legs.

General anesthesiais given into a vein (intravenously) or is inhaled. It affects the brain aswell as the entire body. You are completely unaware and do not feel pain during the

surgery. Also, general anesthesia often causes forgetfulness (amnesia) right after surgery

(postoperative period).

For some minor procedures, a qualified health professional who is not an anesthesia specialistmay give some limited types of anesthesia, such asprocedural sedation. Procedural sedation

combines the use of local anesthesia with small doses of sedative or analgesic agents

(painkillers) to relax you.

Medicines used for anesthesia

A wide variety of medicines are used to provide anesthesia. Their effects can be complex. And

they can interact with other medicines to cause different effects than when they are used alone.

Anyone receiving anesthesia-even procedural sedation-must be monitored continuously toprotect and maintain vital body functions. The complex task of managing the delivery of

anesthesia medicines as well as monitoring your vital functions is done byanesthesia specialists.

Medicines used for anesthesia help you relax, help relieve pain, induce sleepiness or

forgetfulness, or make you unconscious. Anesthesia medicines include:

Local anesthetics, such as bupivacaine or lidocaine, that are injected directly into thebody area involved in the surgery.

Intravenous (IV) anesthetics, such as fentanyl, propofol, or sodium thiopental, that aregiven through a vein.

Inhalation anesthetics, such as isoflurane and nitrous oxide, that you breathe through amask.

Other medicines that are often used during anesthesia include:

Muscle relaxants, which block transmission of nerve impulses to the muscles. They areused during anesthesia to temporarily relax muscle tone as needed.

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Reversal agents, which are given to counteract or reverse the effects of other medicinessuch as muscle relaxants or sedatives given during anesthesia. Reversal agents may beused to reduce the time it takes to recover from anesthesia.

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