• General Anesthesia

    (Anesthesia, General)

    Definition

    General anesthesia puts the entire body to sleep by giving medicine. It is often used during emergency surgery. It is also commonly used if a procedure would make you uncomfortable if you were awake.
    Doctors trained in anesthesia (anesthesiologists) carefully balance the amount of anesthesia medicines given by closely monitoring the body’s functions. Medicines are used to:
    • Prevent pain
    • Relax the muscles
    • Regulate body functions

    Reasons for Procedure

    This is used so that surgery can be done without you:
    • Being aware of it
    • Feeling any pain

    Possible Complications

    Every precaution is used to prevent complications. Often, medicines are given in advance to prevent certain problems, such as nausea and vomiting. Even so, complications may occur and include:
    • Nausea and vomiting
    • Allergic reaction to anesthetic used
    • Nerve damage or skin breakdown from positioning on the operating table
    • Sore throat or damage to throat, teeth, or vocal cords
    • While rare, there is a small risk of the following complications, especially among the elderly or those with medical problems:
      • Lung infections
      • Stroke
      • Heart attack
      • Anesthesia awareness—a rare complication where the patient becomes aware during the surgery
    Factors that may increase the risk of complications include:
    • Medical conditions—heart, respiratory, kidney conditions, and diabetes
    • Certain medicines—especially those that increase bleeding (eg, aspirin)
    • Smoking
    • Alcohol use—may alter the way the liver handles anesthesia
    • Time of last food intake—a full stomach may cause food to enter the lungs
    • Adverse reactions to anesthesia in the past or family history of adverse reactions
    • Food or drug allergies
    Be sure to discuss these risks with your doctor before the procedure.

    What to Expect

    Prior to Procedure

    Unless you are having emergency surgery, you will meet with an anesthesiologist before surgery and will be asked about:
    • Your health history and your family's health history—Tell your doctor if you have had anesthesia before and your reaction to it. Tell your doctor about your family's history with anesthesia.
    • Medicines that you take, including herbs and supplements—These can have an effect on how the anesthesia works.
    Before the procedure:
    • Your height and weight will be taken.
    • You will need to fast the night before surgery.
    • You may need to take certain medicines in the morning before surgery.

    Description of the Procedure

    General anesthesia is broken down into three phases:
    • Induction phase—Medicines will be given that result in the loss of consciousness. These will be given through an IV or through gas into the lungs. A breathing tube will be placed down your windpipe. This will be attached to a machine that helps you continue to breathe normally.
    • Middle or maintenance phase—Medicines will be given based on your responses. These may keep you asleep or regulate your body functions.
    • Recovery or emergence phase—This will slowly reverse the anesthesia. The medicines given will allow you to wake up. When you are starting to awaken and are breathing on your own, the breathing tube will be removed.
    Endotracheal Intubation
    Nucleus image
    Copyright © Nucleus Medical Media, Inc.

    Immediately After Procedure

    As you wake up, you will be closely monitored. You will be given pain medicine if you need it.

    How Long Will It Take?

    This procedure takes as long as needed, depending on the surgery.

    How Much Will It Hurt?

    General anesthesia numbs all pain. Since you are asleep, your brain will not sense any pain signals.

    Average Hospital Stay

    How long you spend in the hospital depends on:
    • Type of surgery
    • Your reaction to the surgery and anesthesia

    Post-procedure Care

    Once you have recovered from anesthesia, you will be sent to a hospital room or home. For the first 24 hours or longer, avoid doing activities that require your attention, such as driving. Be sure to follow your doctor's instructions.

    Call Your Doctor

    After you leave the hospital, call your doctor if any of the following occurs:
    • Signs of infection, including fever and chills
    • Nausea and/or vomiting that you cannot control with the medicines you were given after surgery, or which last for more than two days after leaving the hospital
    • Cough, shortness of breath, or chest pain
    • Dizziness, faintness
    In case of an emergency, call for medical help right away.

    RESOURCES

    American Association of Nurse Anesthetists http://www.aana.com/

    American Society of Anesthesiologists http://www.asahq.org/

    CANADIAN RESOURCES

    Canadian Anesthesiologists Society http://www.cas.ca/

    Health Canada http://www.hc-sc.gc.ca/

    References

    Anesthesia and you. American Society of Anesthesiologists website. Available at: http://www.asahq.org/patientEducation/anesandyou.htm. Accessed July 28, 2009.

    General anesthesia. Mayo Clinic website. Available at: http://www.mayoclinic.com/health/anesthesia/MY00100. Updated June 2009. Accessed July 28, 2009.

    The Joint Commission website. Available at: http://www.jointcommission.org/. Accessed July 28, 2009.

    Pollard R, Coyle J, Gilbert R, Beck J. Intraoperative awareness in a regional medical system: A review of 3 years' data. Anesthesiology. 2007;269-274.

    Sackel DJ. Anesthesia awareness: an analysis of its incidence, the risk factors involved, and prevention. Journal of Clinical Anesthesia. 2006;18:483-485.

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