Anesthesia is not just about "sleeping"

In recent years, with the advancement of medical technology, patients need to be anesthetized not only during surgery, but also in many examinations and treatments. Many people think that surgical anesthesia is as simple as letting the patient sleep. In fact, there are many forms of anesthesia. It is a very complex and sophisticated medical technology. It is not only related to the success of surgery, examination, and treatment, but also closely related to the patient's life safety. In order to deepen everyone's understanding of anesthesia, let us talk about what knowledge we have about anesthesia today?

1. What is anesthesia?

Anesthesia is actually the use of drugs or other means to temporarily make the patient lose consciousness in the whole body or part of the body so that the patient can remain painless during surgery, examination or treatment. There are many forms of anesthesia, and the specific implementation needs to be selected according to the actual situation of the patient.

2. Do all anesthesia make people fall asleep?

Not all forms of anesthesia cause a person to fall asleep, as follows:

(1) Local anesthesia

This type of anesthesia is generally suitable for minor surgeries, such as skin surgery, tooth extraction, etc. The doctor only needs to apply or inject drugs on the skin and mucous membranes to make a small part of the body unconscious, and the patient is generally awake.

(2) Regional anesthesia

In regional anesthesia, drugs are injected directly around the nerves to temporarily block the corresponding sensory or motor nerves in the arms, legs, lower limbs, etc. This allows the patient to complete the surgery while awake, and can also assist general anesthesia to reduce the patient's pain after surgery.

(3) General anesthesia

This is commonly known as "general anesthesia". The anesthesiologist administers anesthetics through intravenous or inhalation, causing the patient to lose consciousness and enter a "sleep" state until the operation is completed. In order to maintain the patient's normal breathing, a laryngeal mask or tracheal intubation may be used for the patient according to the actual situation of the operation.

3. Advantages and disadvantages of different anesthesia methods

3.1 Local anesthesia

(1) Advantages

1) Safety: Compared with other anesthesia methods, local anesthesia has lower risks and less impact on the patient's physiological functions.

2) Quick recovery: After local anesthesia, patients tend to regain consciousness quickly, with less postoperative discomfort and a shorter recovery time.

3) Low cost: The cost of drugs and equipment required for local anesthesia is not high, which reduces the cost of surgery.

(2) Insufficient

1) Limitations: Local anesthesia is mainly used in certain superficial or limited area surgeries and is not suitable for complex surgeries or surgeries that require large-scale operations.

2) Incomplete anesthetic effect: Some individual cases have shown that local anesthesia cannot completely block the pain sensation, and the patient may still feel slight discomfort after anesthesia.

3) High requirements for operating skills: High requirements for surgical skills and experience. Any slight mistake may result in unsatisfactory anesthesia effect or complications.

3.2 Nerve block anesthesia

(1) Advantages

1) Local anesthesia: Only the surgical area is anesthetized and the patient is awake.

2) Less medication: Compared with general anesthesia, the dosage of anesthetic drugs is smaller.

3) Better analgesic effect: It can provide good analgesic effect during surgery and continue to work after surgery.

(2) Insufficient

1) High technical requirements: The operation requirements are very high, otherwise complications will occur.

2) It has limitations: it is mainly targeted at specific parts (such as limbs) and is not applicable to all surgeries.

3) Individual differences: Patients may have different responses and tolerance to anesthesia, which may affect the efficacy of anesthesia.

3.3 Regional anesthesia

(1) Advantages

1) Obvious analgesic effect: Regional anesthesia can accurately block pain transmission, has good analgesic effect, and accelerates postoperative recovery.

2) Can assist in major surgeries: For some larger surgeries, regional anesthesia can reduce the risks of general anesthesia and reduce complications, and is suitable for patients who cannot tolerate general anesthesia. For elderly patients with serious illnesses or who may not be able to withstand the risks and side effects of general anesthesia, regional anesthesia may be a safe and effective option.

(2) Insufficient

1) Complications: Some complications may occur after regional anesthesia, such as local anesthetic poisoning, headache caused by spinal anesthesia, etc., but in general, these complications can be effectively controlled through the guidance of specialists.

2) High requirements for operating skills: Regional anesthesia requires doctors to have a deep understanding of the anatomical structure and master precise surgical skills to ensure that the anesthetic can accurately reach the target site and improve the anesthesia effect.

3.4 General anesthesia

(1) Advantages

1) Painlessness: General anesthesia can reduce the patient’s pain during surgery and improve the comfort of the surgery.

2) Safety: General anesthesia can suppress the patient’s respiratory and circulatory systems, making the surgical procedure safer.

3) Easy to operate and control: The drug can be administered by intravenous injection or respiratory inhalation, which is simple and quick to operate. The anesthetic effect can be controlled based on the monitoring of the patient's vital signs and the depth of anesthesia.

(2) Disadvantages

General anesthesia has certain potential risks. Since multiple drugs are required during general anesthesia, the patient may be at risk of respiratory depression or circulatory fluctuations.

4. Anesthesia process

The anesthesia process is mainly divided into three stages: anesthesia induction, anesthesia maintenance and anesthesia awakening. During the anesthesia induction period, the doctor uses anesthetic drugs to anesthetize the patient; during the anesthesia maintenance period, the doctor adjusts the dosage and concentration of anesthetic drugs according to the needs of the operation to ensure that the patient is in the best anesthesia state, minimize the risk of anesthesia surgery for the patient, and avoid the patient waking up too early after the operation; during the anesthesia awakening period, the doctor gradually reduces the amount of anesthetic drugs to allow the patient to gradually recover consciousness and body functions.

5. Recovery after anesthesia

(1) Intraoperative monitoring: After anesthesia is administered to the patient, medical staff must closely monitor the patient's heart rate, breathing, blood pressure and other vital signs to ensure the patient's safety and stability.

(2) Rest during the recovery period: Patients need to get enough rest after surgery to allow the general anesthetic to be metabolized. This can alleviate the patient's discomfort symptoms such as impaired consciousness and nausea and vomiting.

(3) Diet and water intake: Patients need to gradually start eating and drinking again under the doctor's instructions. Generally, they should eat something easily digestible first, and then slowly transition to a normal diet. This can avoid indigestion symptoms such as nausea and vomiting after anesthesia.

(4) Pain control: There may be a certain degree of pain after surgery, and the doctor needs to prescribe some painkillers according to the patient's specific situation. During the medication process, the patient needs to feedback the pain situation to the doctor so that the analgesia plan can be adjusted in time.

(5) Activity recovery: Patients need to gradually start activities under the guidance of a doctor, including gradually standing up, getting out of bed and walking, doing rehabilitation training, etc. Appropriate exercise can promote blood circulation and promote recovery, but excessive fatigue should be avoided.

Summary: Anesthesia is a complex and delicate medical operation. Different anesthesia methods have different advantages and disadvantages. They need to be selected according to the patient's condition. It is not as simple as sleeping.

Author: Zhou Liufang Zhuzhou Hospital Affiliated to Xiangya School of Medicine, Central South University