Anesthesia

Anesthesia is used so that surgery can be performed without unnecessary pain. According to the Agency for Healthcare Research and Quality (AHRQ) of the Department of Health and Human Services, anesthesia is generally safe for most patients. It is usually administered by a specialized physician (anesthesiologist) or nurse anesthetist. Both are highly skilled and have been specially trained to give anesthesia.

Types of anesthesia

The American Society of Anesthesiologists (ASA) says there are three main types of anesthesia: general, regional and local.

• General anesthesia numbs your entire body for the entire time of the surgery. You will be unconscious if you have general anesthesia. During a major operation, such as a heart operation, the anesthesiologist will use a variety of drugs to accomplish different functions, such as stopping pain, relaxing the body's muscles, etc.
• Regional anesthesia numbs a portion of your body, for example, the lower part of your body for a few hours. You may be awake with regional anesthesia or you may be given a sedative. ASA says two of the most frequently used types of regional anesthesia are spinal anesthesia and epidural anesthesia, which are produced by injections in the appropriate areas of the back. If you are receiving regional anesthesia for outpatient surgery, the American Association of Nurse Anesthetists (AANA) says to make sure you have another adult accompany you to the health care facility, so they can drive you home and monitor your recovery.
• Local anesthesia numbs only a part of your body for a short period of time, for example, a tooth and the surrounding gum. Not all procedures done with local anesthesia are painless.

Obstetrical anesthesia

Anesthesia is also used during childbirth. Obstetrical anesthesia needs to provide enough pain relief while also allowing the woman to push when it is time to do so. AANA says anesthetics used during labor include sedatives, local anesthesia and regional anesthesia. An epidural is a regional anesthetic delivered through a tiny tube called a catheter, which is placed in the small of the back, just outside the spinal canal. A spinal is similar to an epidural, but is administered with a needle into the spinal canal so its effects are felt much faster. General anesthesia may also be used during childbirth, especially if complications arise. ASA says because of the risk of complications, you should prepare for the possibility of needing anesthesia, even if you're planning a natural childbirth. That means you shouldn't eat after you start labor, according to ASA and be prepared to tell a doctor what you've had to eat or drink in the past few hours, any respiratory problems (Read about "Respiratory System") or special medical conditions and any personal or family history of problems with anesthesia. (Read about "Healthy Pregnancy")

Before and after anesthesia

Prior to receiving anesthesia, you may be asked a number of questions about your medical and personal history. It's important to answer these questions honestly. These questions can concern any allergies (Read about "Allergies"), any chronic conditions such as diabetes, high blood pressure, etc. (Read about "Diabetes" "Hypertension"), any hard drug or alcohol usage (Read about "Alcoholism"), and past anesthetic experiences. Also, you should ask immediate family members (parents and siblings) whether they had any prior adverse reaction to anesthesia. Cigarettes, street drugs and/or alcohol consumption can affect the way anesthetic drugs work during surgery, so it is essential that you're honest about your use of these substances. Dietary supplements, including herbal supplements, can also impact the anesthesia so it is important to mention that you take them well in advance. You may be asked to refrain from taking them for a period of time before your procedure. (Read about "Herbal Precautions")

Many procedures require an empty stomach. This is to reduce the chances of your regurgitating any undigested food or liquids while under anesthesia. Therefore, you may be told to fast (no food or liquids) before surgery. Your doctor will give you specific instructions on what you can or can't eat and drink and when you should start your fast. If you require medications for chronic conditions, be sure to discuss this with your doctor.

AHRQ says if you are having surgery, you should ask to meet with or speak to the person who will give you anesthesia. Find out what his or her qualifications are. Ask what the side effects and risks of having anesthesia are in your case. Be sure to tell him or her what medical problems you have including allergies and any medications you have been taking, since they may affect your response to the anesthesia. The American Society of Anesthesiologists says that providing a detailed medical history and drug list is very important, because along with the laboratory data from your tests, it's the basis upon which the anesthesiologist will decide the best drugs for your case.

Following general anesthesia, you may feel groggy or even nauseous. Nurses at the hospital will monitor your condition carefully. If you've had regional or local anesthesia, keep in mind that your judgment may be impaired, so don't plan on driving, operating heavy equipment or making important decisions for 24 hours after your procedure. AANA says it's also essential that you ask your doctor about resuming your regular medications once the surgery is completed.

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