Imagine a world without anesthesia: Only those who can tolerate pain would consider cosmetic surgery. However, thanks to the development of anesthesia, anyone can now consider cosmetic surgery without fear of pain. Anesthesia is generally given to ensure that the patient is comfortable and painless during the surgical procedure. There are different types of anesthesia and they are given in a variety of ways. How a person receives anesthesia depends on factors such as their health condition, the type of anesthesia, and their preferences. This section of Dalili Medical introduces the different types of anesthesia, the advantages and disadvantages of each type, and answers some frequently asked questions that many people who are about to undergo cosmetic surgery ask.

How long does anesthesia last?

 

Anesthesia can last for any number of hours, but the risk of complications increases if it lasts longer than six hours.

Does anesthesia shorten life expectancy?

 

No, there is no convincing evidence that anesthesia shortens life expectancy.

Does general anesthesia cause urination?

 

General anesthesia paralyzes the bladder muscles. This can make urination difficult and affect the ability to recognize the need to urinate. Many procedures also involve the use of a Foley catheter, a tube inserted into the body to drain urine from the bladder.

Does general anesthesia stop the heart?

 

General anesthesia suppresses much of the body’s normal autonomic nervous system activity. This includes breathing, heartbeat, circulation (such as blood pressure), and digestive system movements. The heart does not stop, but its function is suppressed.

How long does anesthesia stay in the body?

 

After surgery, most patients wake up in the recovery room but remain asleep for several hours. It can take up to a week for the anesthesia to leave the body completely, but most people will not feel much of a change after 24 hours.

What happens if anesthesia is stopped during surgery?

 

Anaphylactic shock (a life-threatening allergic reaction to the anesthesia) and unexpected awakening during surgery are all serious risks and complications that can occur during surgery. However, anesthesia is closely monitored to prevent these outcomes. Death is relatively rare.

Do you dream during anesthesia?

 

No lucid dreaming occurs during anesthesia. It is not wise to confuse general anesthesia with natural sleep.

Why are the eyes taped shut during surgery?

 

Tape or ointment helps protect the cornea during general anesthesia. Negative locks, hypoallergenic tape, hypoallergenic eye patches, and saline compresses are used to keep the eyelids closed.

Can I talk during general anesthesia?

 

You cannot talk while the anesthesia is in place, but it is not uncommon to talk when you wake up.

Can I wake up from anesthesia?

 

With regular anesthesia, patients recover within a few minutes, but conditions known as delays can occur. Delays in the operating room and increased overall costs are associated with this problem.

What medications do doctors use for anesthesia?

 

Sedative-hypnotic drugs such as etomidate, propofol, ketamine, opioids, lidocaine, and midazolam are commonly used to induce general anesthesia. Adjuvants are often used to increase the effects of the main sedative-hypnotic induction drug.

Types of Anesthesia?

 

There are 3 types of anesthesia:

General anesthesia: A medically induced state of complete unconsciousness. Examples of general anesthesia are ketamine (ketamine), propofol (propofol), etomidate (etomidate), isoflurane (isoflurane) and sevoflurane (sevoflurane).

Local anesthesia: It is given in cases of minor surgery, such as the removal of men's nails, or in cases such as the patient being given by a dentist. The advantage of this type of anesthesia is that the patient is alert during the medical procedure and thus reduces the sensation of pain in a specific area of ​​focus without affecting the patient's consciousness. Examples of the item benzocaine are: benzocaine (benzocaine), lidocaine (lidocaine), novocaine (novocaine).

Local anesthesia: Anesthesia that belongs to this type numbs the whole body (for example, the lower half during childbirth) - There are basically 2 types of local anesthesia:

Spinal anesthesia (English: Spinal anesthesia): It is used for surgery in the lower extremities and abdomen. The injection is made in the lower back area, which paralyzes the lower part of the body.

Epidural anesthesia: It is often used to relieve pain during childbirth and lower extremity surgery. It is given to the area around the spinal cord through a tube (catheter) instead of injecting it with a needle.

Stages of anesthesia?

 

According to the Gödel classification, anesthesia has 4 stages and was adopted by the scientist Arthur Ernst Gödel in 1937.

Stage 1: Induction This stage occurs while the anesthesia is given to the patient and loss of consciousness. The patient moves from a state of sedation without amnesia to a state of sedation without amnesia.

Phase 2: Excitement Phase In the period following the patient's loss of consciousness, characterized by excitement and delirium, breathing and heart rate may become irregular, nausea and pupil dilation may occur, and respiratory arrest may occur. The risk of suffocation may arise due to irregular breathing and the risk of provocation. Therefore, rapid-acting anesthesia aims to reduce the time spent in phase 2 of anesthesia.

Phase 3: Surgical anesthesia In this phase, the patient is ready for surgery if the muscles are relaxed, empty, the respiratory rate decreases, and eye movement slows down and then stops.

Phase 4: Overdose In this phase, the patient is given too much anesthetic medication that leads to depression of the brain stem or bone marrow. This leads to deterioration of breathing and the cardiovascular system.

The anesthesiologist's priority is to transfer the patient to phase 3 of anesthesia as soon as possible and to remain there for the durationOperation.

Indications for general anesthesia?

 

General anesthesia is recommended for patients who:

The operation takes a long time.

Breathing is affected.

It is performed on a large area of ​​the body.

It involves major organs of the body, such as the heart or brain.

It causes severe bleeding in the body.

It is very painful.

It causes severe stress for the patient.

If the operation is short or is performed on a small part of the body, the doctor is unlikely to recommend general anesthesia and a different type of anesthesia may be used. The type of general anesthesia depends on the type of surgery.

Indications for general anesthesia?

 

General anesthesia is indicated when surgery is performed under general anesthesia:

The operation takes a long time.

It affects breathing.

It is performed on a large area of ​​the body.

It involves major organs of the body, such as the heart or brain.

It causes severe bleeding in the body.

It is very painful.

It causes severe stress for the patient.

If the procedure is short or is being performed on a small part of the body, your doctor is unlikely to recommend general anesthesia and a different type of anesthesia may be used. The type of general anesthesia depends on the type of surgery.

General anesthesia medications?

 

Some names for general anesthesia medications are:

Methohexital

Propofol

Phosbupropofol

Thiopental

Ketamine

Etomidate

Isoflurane

Sevoflurane

Desflurane

Stages of general anesthesia?

 

There are four stages of general anesthesia detailed below:

Stage 1: Initiation of anesthesia. This stage occurs between the administration of general anesthesia and loss of consciousness, during which the patient goes from anesthesia without amnesia to anesthesia with amnesia.

Stage 2: Awakening. During this stage, breathing and heart rate become irregular and nausea, dilated pupils, and shortness of breath may occur.

Because breathing becomes irregular and there is a risk of vomiting, there is a possibility of choking during this stage. Modern fast-acting general anesthesia medications aim to reduce the time spent in the second stage of general anesthesia.

Stage 3 Surgical anesthesia. Muscles relax, vomiting stops, breathing is controlled, eye movements slow down and eventually stop, and the patient is ready for surgery. The anesthesiologist’s priority is to get the patient into this stage of general anesthesia as quickly as possible and maintain it throughout the procedure.

Stage 4: Overdose. Overdose of general anesthesia causes depression of the brain stem and medulla, leading to respiratory and cardiovascular collapse.

Side effects of general anesthesia?

 

There are many side effects caused by general anesthesia, but patients’ bodies react differently to general anesthesia, with some patients experiencing no side effects while others experience some side effects. It is worth noting that the side effects of general anesthesia are not permanent and begin immediately after anesthesia and disappear quickly.

After waking up from general anesthesia, patients may experience fatigue. The following side effects are also associated:

Temporary disorientation, which is more common in older people, as the aging brain does not recover as easily from anesthesia. This condition may last for several days after surgery and is called delirium, and usually goes away within a week after surgery.

Temporary memory loss. More common in people with heart disease, lung disease, Alzheimer's disease, and Parkinson's disease.

Dizziness.

Difficulty urinating.

Bruising or pain at the site of the drip.

Vomiting and nausea: usually begins soon after general anesthesia.

Shivering and chills that last for a short time.

Sore throat due to the breathing tube.

Dry mouth.

Muscle pain.

Itchy skin.

Problems with the mouth and teeth, such as cracked gums or lips.

Pelvic inflammatory disease (delayed return to normal bowel movements after surgery, with slow or no bowel movements).

Difficulty weaning patients from mechanical ventilation (especially those with breathing difficulties).

Blood clots.

Risks and complications of general anesthesia and its complications?

 

Complications of general anesthesia include the following:

Aspiration: Doctors ask patients not to eat or drink for several hours before surgery, as vomiting food or liquids can cause them to choke during surgery.

Pneumonia and other breathing problems: Older patients are more likely to develop pneumonia and breathing problems after surgery, and the risk increases with age, length of surgery, and abdominal surgery.

If the larynx is closed in patients with obstructive sleep apnea during surgery, it is difficult for them to regain consciousness at the end of the surgery and breathing problems occur during surgery.

Corneal problems: In cases of general anesthesia, corneal erosions can occur due to the anesthetic entering the eye, leading to loss of vision or even blindness.

Oral and dental problems

Malignant hyperthermia: A life-threatening condition in which an acute reaction to anesthetic drugs causes a rapid rise in body temperature and severe muscle spasms. This condition is likely to be hereditary.

Cardiovascular problems: General anesthesia can cause heart attacks, heart failure, strokes, and sudden increases or decreases in blood pressure.

Unintended awakening during surgery: This is a rare condition. The patient is conscious and alert during surgery, despite being given an anesthetic that is supposed to make the patient unconscious.

Death: This is a rare condition, and is usually the result of an overdose of anesthesia or any of the complications listed above.

What are the possible short-term side effects?

 

Most side effects of general anesthesia occur immediately after the operation and do not last long. After the operation is over and the anesthesia medication is stopped, the patient slowly awakens in the operating room or recovery room. The patient may feel groggy or confused and the patient may experience these common side effects:Nausea. It usually occurs immediately after the procedure, but some people continue to feel nauseous for a day or two. Anti-nausea medications help with this.

Dry mouth. The patient may feel thirsty when they wake up. Drinking water helps with oral hygiene.

Sore throat or hoarseness. The tube that is placed in the mouth to help with breathing during the procedure may cause a sore throat after it is removed.

Chills and shaking. It is common for the temperature to drop during general anesthesia. The medical team will work to prevent the temperature from dropping too low during the procedure, but the patient may wake up feeling chills and shaking. This may last from a few minutes to hours.

Confusion and fuzzy thinking. After waking up from the anesthesia, the patient may feel restless, sleepy, and have blurred vision. This usually lasts for a few hours, but in older people, the disturbance may last for days or weeks.

Muscle pain. Muscle relaxants used during the procedure may cause pain afterwards.

Itching. This occurs if narcotic medications are used during or after the procedure. This side effect is common for this group of medications

Bladder problems. You may have difficulty urinating for a short time after general anesthesia.

Dizziness. You may feel dizzy after standing up. Drinking enough fluids can help.

What are the possible long-term side effects?

 

Most people do not experience long-term side effects. However, older people may experience side effects that may last for more than a couple of days.

These include:

Postoperative delirium: Some people feel confused, disoriented, and may have difficulty remembering things after surgery. The confusion usually goes away after about a week.

Postoperative cognitive dysfunction (POCD): Some people may experience persistent memory problems or other types of cognitive impairment after surgery. This is unlikely to be due to the anesthesia, but it may be due to the surgery itself.

Some factors that increase the risk of postoperative cognitive dysfunction include:

Having a stroke.

Heart disease.

Lung disease.

Alzheimer's disease.

Parkinson's disease.

Some research suggests that cognitive impairment after surgery is more likely in people over the age of 60.

What are the short-term side effects?

 

Most side effects of general anesthesia occur immediately after surgery and do not last long. After the procedure is over and the anaesthetic wears off, patients may wake up slowly in the operating room or recovery room and feel dizzy or unconscious and experience common side effects, such as vomiting and nausea. Vomiting usually occurs immediately after surgery, but some people continue to vomit for a day or two. Anti-nausea medications can help.

Thirst. You may feel thirsty when you wake up, and drinking water can help to keep your mouth moist.

Sore throat and hoarseness. The tube that is placed in your mouth to help you breathe during surgery can cause a sore throat after it is removed.

Chills and shaking. It is common for your body temperature to drop during general anesthesia, and although your medical team will ensure that your body temperature does not drop too low during the procedure, you may wake up with chills and shaking that can last from minutes to hours.

Confusion and disoriented thinking. After waking up from anesthesia, patients may feel confused, sleepy, and have blurred vision. This usually lasts for several hours, but older people may experience disorientation for days or weeks.

Muscle pain. Muscle relaxants used during surgery may cause pain afterwards.

Itching. This occurs when anesthetic drugs are used during or after surgery. This is a common side effect of this group of medications.

Bladder problems. This may cause difficulty urinating for some time after general anesthesia.

Dizziness. You may feel dizzy after standing up. Drinking enough fluids can help improve this.

What are the long-term side effects?

 

Most people do not experience any long-term side effects. However, older people may experience side effects that last for more than two or three days.

These effects include:

Postoperative delirium: Some patients may feel confused or disoriented after surgery or have trouble remembering things. The confusion usually goes away after a week or so.

Cognitive impairment after surgery (POCD) Postoperative cognitive impairment (POCD): Some people may experience persistent memory loss or other types of cognitive impairment after surgery. This is unlikely to be an effect of the anesthesia, but may be an effect of the surgery itself.

Factors that may increase the risk of developing cognitive impairment after surgery include:

Stroke.

Heart disease.

Lung disease.

Alzheimer's disease.

Parkinson's disease.

Cognitive impairment after surgery Cognitive impairment is more likely to occur in people over the age of 60.

What increases the risk of side effects?

 

In most cases, general anesthesia is very safe, but it is the procedure itself that puts patients at risk. People at greatest risk are older adults and those undergoing lengthy surgery.

Patients should tell their doctor if they have any of the following factors that may affect their condition during and after surgery:

Family history of side effects from general anesthesia.

Sleep apnea.

Epilepsy.

Obesity.

High blood pressure.

Diabetes.

Heart disease.

Lung disease.

Kidney disease.

Drug allergy.

You should also tell your doctor:

If you are a smoker.

If you drink large amounts of alcohol.

If you are taking blood thinners or anticoagulants.