Consultant anaesthetist Dr Anand Chandrasegaran gives an overview of anaesthesia, the types of anaesthetics and attendant risks
ANAESTHESIA is a way to control pain during a surgery or procedure by using medicines called anaesthetics. Anaesthesia is used to relax the patient, block the pain, make him sleepy, relaxed or unconscious for a surgery.
Anaesthesia dates back to the mid-1800s. Before the discovery of anaesthesia, few surgeries could be performed. Even a condition, which by current standards is easily treated, was usually fatal.
VARIOUS TYPES
Local anaesthesia numbs a small part of the body for minor procedures. For example, the patient may get a shot of anaesthetic directly into the surgical area to block the pain and stay awake during the procedure.
Regional anaesthesia blocks pain to a larger part of the body. The patient may also be given medicine to help him relax or sleep.
Epidural and spinal anaesthesia is a shot of anaesthetic near the spinal cord and nerve roots that connect to it. It blocks pain in a region of the body, such as abdomen, hips or legs.
General anaesthesia affects the brain and the rest of the body. The anaesthetic is injected into a vein (intravenously) or the patient breathes in some anaesthetics. He will be unconscious throughout surgery.
DECIDING FACTOR
The type of anaesthesia used depends on several things, including the patient’s general health status, other surgeries he may have had, and his health problems.
Always tell your anaesthetist if you or any family members have had a serious reaction to anaesthetics or other medicines.
The type of surgery also influences the type of anaesthesia. For example, you may need general anaesthesia to ensure your comfort and safety during certain types of surgery. The results of tests, such as blood tests or electrocardiogram (ECG), may influence the decision.
Your doctor may prefer one type of anaesthesia over another for your surgery. In some cases, your doctor may let you choose which type to use. Sometimes, such as in an emergency, you don’t get to choose.
RISKS AND COMPLICATIONS
All anaesthesias have some risks, depending on the patient’s pre-existing medical condition. For example, after general anaesthesia, cardiovascular-related problems, a sore throat or vomiting can occur.
With high doses of local anaesthesia, the anaesthetic can go into the rest of the body and affect the brain or the heart, while after spinal anaesthesia, some people get headaches.
Your risk depends on the type of anaesthesia you get, your age, your health and how you respond to the medicines used. Some health problems such as heart or lung disease increases your chances of complications from anaesthesia.
Taking certain medicines, smoking, drinking alcohol and using illegal drugs, can also increase your chances of complications. Your anaesthetist will talk to you about the best approach for you and will review the risks, benefits and other choices.
THE PROCESS
Before and during surgery, an anaesthesist will take charge of your comfort and safety. He or she will give you the anaesthesia and closely monitor you. He or she will check your blood pressure, breathing, heart rate and other vital body functions throughout the surgery.
During surgery, the specialist will continue to give anaesthesia to keep you free of pain. How quickly the anaesthesia wears off depends on the anaesthetics and other medicines used, and your response to the medicines.
After surgery, you will be taken to the recovery room. A nurse will check your vital signs and any bandages, and ask your level of pain. If you are in pain, don’t be afraid to say so.
Some effects of anaesthesia may last for hours after surgery. You may experience numbness or less feeling in a certain part of your body if you have had local or regional anaesthesia.
Your muscle control and coordination may also be affected. You may experience nausea and vomiting. Most of the time, this can be treated and doesn’t last long.
You may feel cold and shiver when you first wake up. For minor surgeries, you may go home the same day. If the surgery is more complicated, you will be moved to a hospital room to continue your recovery. Your doctor or a nurse will check on your recovery and answer any questions you may have.
Before and after medical procedure or surgery
THE anaesthetist will let you know what to do the night before and on the day of your procedure. Here are some tips to help you prepare:
KNOW WHEN TO STOP EATING AND DRINKING
If you take any medicines regularly, ask your doctor or nurse about changes to your medicine routine for the day before or the day of your surgery.
STAY CALM
Many people are nervous before they undergo anaesthesia and surgery. Mental relaxation methods, such as guided imagery or meditation, can help you relax. Some medicines can also help you relax.
PLAN AHEAD FOR GOING HOME
Ask a friend or a family member to drive you home. Don’t drive home yourself. If your child is having surgery or a procedure, you can help him or her prepare. Let your child know what to expect. Be honest if he or she might feel pain. Ensure your child that you will be close by.
*The writer is a consultant anaesthetist at Columbia Asia Hospital in Taiping.