General anesthesia: types and contraindications

Anesthesia (anesthesia) with this or that intervention of surgeons, can be of two kinds:

• Local - the patient is conscious, only the part of the body on which the operation will be anesthetized is anesthetized;
• General - the patient is immersed in deep medication sleep.

General and local anesthesia equally find a place in modern medicine. In local anesthesia, spinal and epidural anesthesia is isolated. In these cases, the patient is conscious, but does not own his lower body, it is completely numb and loses sensitivity. Anesthesia common is often called anesthesia.

Concept of anesthesia

Anesthesia - general anesthesia; In translation from Greek means "numbness", "stupor". Its meaning is to use the medications to exert an effect on the central nervous system and completely block the nerve impulses that it transmits. As a result, all human reactions are inhibited, and he plunges into the so-called drug - induced sleep.

Such a dream can not be compared with the usual daily sleep, when a person can awaken from the slightest rustle. In the case of a medical dream, in fact, virtually all vital systems, in addition to the cardiovascular system, are disconnected for a certain period of time.

Premedication

Before the general anesthesia, the patient must undergo special training - premedication. Virtually all people tend to experience excitement or fear of the operation. Stress caused by anxiety can have a very negative impact on the course of surgical intervention. At this moment a huge adrenaline rush occurs . This leads to disruptions in the functioning of vital organs - the heart, kidneys, lungs, liver, which is fraught with complications during the operation and after its completion.

For this reason anesthesiologists consider it necessary to calm a person before surgery. To this end, he is prescribed sedatives - this is called premedication. With operations planned in advance, premedication is carried out the day before. As for emergency cases, it's right on the operating table.

The main stages, types and stages of general anesthesia

Anesthesia is conducted in three stages:

• Introductory anesthesia, or induction, is performed as soon as the patient is on the operating table. He is administered medications that provide deep sleep, complete relaxation and anesthesia.
• Supportive anesthesia - an anesthesiologist must accurately calculate the number of necessary medications. During the operation, all the functions of the patient's body are kept under control: blood pressure is measured, pulse rate and breathing are monitored. An important indicator in this situation is the work of the heart and the amount of oxygen and carbon dioxide in the blood. An anesthesiologist should be aware of all stages of the operation and its duration, so that he can add or reduce the dose of drugs if necessary.
• Awakening is a way out of anesthesia. An anesthesiologist leads an accurate calculation of the amount of drugs also for the purpose of removing the patient from a deep medication sleep in time. At this stage, the medicines must finish their action, and the person begins to wake up smoothly. It includes all organs and systems. An anesthesiologist does not leave the patient until he comes fully conscious. The patient's breathing should become independent, blood pressure and pulse stabilize, reflexes and muscle tone completely come to normal.

Anesthesia common has such stages:

• Superficial anesthesia - tactile sensitivity disappears, pain threshold is not felt , but there are reflexes of skeletal muscles and internal organs.
• Easy anesthesia - skeletal muscle relaxes, most reflexes disappear. Surgeons have the opportunity to carry out light surface operations.
• Complete anesthesia - relaxation of muscles of skeletal muscles, virtually all reflexes and systems, except cardiovascular, are blocked. There is the possibility of carrying out operations of any complexity.
• Super-deep anesthesia - we can say that this is the state between life and death. Almost all reflexes are blocked, the muscles of both skeletal and smooth musculature are completely relaxed.

Types of general anesthesia:

• Masked;
• Intravenous;
• Common.

Adaptation period after general anesthesia

After the patient leaves the general anesthesia, his condition is observed by the doctors. Complications of general anesthesia are extremely rare. After each operation, there are testimonies. For example, if surgery was performed on the abdominal cavity, then some time you can not drink water. In some cases, it is allowed. Ambiguous for today is the issue of movement of the patient after the operation. Previously it was believed that a person in the postoperative period is desirable as long as possible to be in bed. Today it is recommended to get up, move independently after a short time after the operation. It is believed that this contributes to a rapid recovery.

In any case, the patient should listen to the recommendations of his doctor, otherwise the recovery may be delayed.

The choice of method of anesthesia

Anesthesiologist is responsible for the process of anesthesia. He, together with the surgeon and the patient, decides what kind of anesthesia to give preference in this or that case. The choice of the method of anesthesia is affected by many factors:

• The amount of planned surgical intervention. For example, the removal of a birthmark does not require general anesthesia, but surgical intervention on the patient's internal organs is a serious matter and requires a deep and prolonged medical sleep.
• Patient status. If the patient is in serious condition or any complications of the operation are anticipated, then there can be no talk of local anesthesia.
• Experience and qualification of the surgeon. An anesthesiologist knows about the course of the operation, especially in cases when he is working with a surgeon for the first time.
• But, of course, an anesthesiologist, if possible, and in the absence of contraindications, will always choose the method of anesthesia that is closer to him, and in this matter it is better to rely on him. Whether an anesthesia is common or local - the main thing is that the operation is successful.

Memo for the patient before surgery

Before the operation, there is always communication between the patient and the anesthesiologist. The doctor should ask about the previous operations, which was anesthesia and how the patient suffered it. It is very important for the patient to tell the doctor everything, not missing the slightest detail, as this can later play a role in the course of the operation.

Before the operation, the patient needs to remember the diseases that had to be carried over the entire period of his life. This is especially true of chronic diseases. Also, the patient should tell the doctor about the medications that he is compelled to take at the moment. It is possible that the doctor can ask many more additional questions besides all the above. This information is necessary to him in order to exclude the slightest mistake in choosing the method of anesthesia. Serious complications of general anesthesia are extremely rare if all the actions of both the anesthesiologist and the patient have been performed correctly.

Local anesthesia

Local anesthesia in most cases does not require the intervention of an anesthesiologist. Surgeons can independently carry out this kind of anesthesia. They just cut the place of the surgical intervention with a medical product.

With local anesthesia, there is always the risk that an insufficient amount of medication is administered and the pain threshold is felt. In that case, do not panic. It is necessary to ask the doctor to add the drug.

Spinal anesthesia

With spinal (spinal) anesthesia, the injection is made directly into the region of the spinal cord. The patient feels only the injection itself. After the introduction of anesthesia, the entire lower body becomes numb, loses all sensitivity.

This kind of anesthesia is successfully used for operations on the legs, in urology and gynecology.

Epidural anesthesia

With epidural anesthesia, a catheter is inserted into the area between the vertebral canal and the spinal cord, through which pain medications can be administered .

Epidural anesthesia is sometimes used to anesthetize labor and often - with prolonged operations in the field of gynecology and urology.

What is better, epidural anesthesia or general anesthesia? This is a very controversial issue to date. Everyone has his own arguments about this.

Masque anesthesia

Mask anesthesia, or inhalation general anesthesia, is introduced into the body through the patient's airways. With this kind of anesthesia, sleep is maintained by a special gas, which anesthetists are fed through a mask attached to the patient's face. It is used for light short-term operations.

If mask anesthesia is used, the main thing for the patient is to listen to the doctor: to breathe as he asks, to do what he says, to answer the questions asked by him. When masking a patient's anesthesia, it is easy to enter into sleep, and it is just as easy to awaken him.

Intravenous anesthesia

With intravenous anesthesia, medications that cause drug-induced sleep and relaxation are injected directly into the vein. This allows you to achieve a quick effect and a qualitative result.

Intravenous anesthesia can be used for a variety of operations. It is the most common in classical surgery.

General anesthesia multicomponent with muscle relaxation

Multicomponent this type of anesthesia is called because it combines a mask and intravenous anesthesia. That is, the components of general anesthesia are administered in the form of drugs intravenously, and in the form of gases through the respiratory system. This type of anesthesia allows you to achieve maximum results.

Miorelaxation is the relaxation of all skeletal muscles. This is a very important point in the conduct of surgical intervention.

Multicomponent anesthesia is recommended for serious and long-term operations. Today under such an anesthesia operate organs of the abdominal cavity, thorax.

General anesthesia. Contraindications

There are some contraindications to the use of general anesthesia:

• Cardiovascular failure;
• Severe anemia;
• Myocardial infarction;
• pneumonia;
• Acute kidney and liver diseases;
• bronchial asthma;
• Seizures of epilepsy;
• Treatment with anticoagulants;
• Endocrine diseases such as thyrotoxicosis, decompensated diabetes, adrenal diseases;
• Full stomach;
• Heavy alcohol intoxication;
• The absence of an anesthesiologist, the necessary drugs and equipment.

General and local anesthesia are very important elements in modern surgery. No operation passes without anesthesia. In this matter, medicine must be given due, because not everyone can suffer a pain shock.