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General anesthesia

Definition

General anesthesia is a treatment that puts you into a deep sleep so you do not feel pain during surgery. When you receive these medications, you will not be aware of what is happening around you.

Description

You will receive general anesthesia in a hospital or outpatient office. Most times, a doctor called an anesthesiologist will put you to sleep. Sometimes, a certified registered nurse anesthetist will take care of you.

The doctor will give you medication into your vein. You may be asked to breathe in (inhale) a special gas through a mask. Once you are asleep, the doctor may insert a tube into your windpipe (trachea) to help you breathe and protect your lungs.

You will be watched very closely while you are asleep. Your blood pressure, pulse, and breathing will be monitored. The doctor or nurse taking care of you can change how deeply asleep you are during the surgery.

You will not move, feel any pain, or have any memories of the procedure because of this medicine.

Why the Procedure Is Performed

General anesthesia is a safe way to stay asleep and pain-free during procedures that would:

• Be too painful
• Take a long time
• Affect your ability to breathe
• Make you uncomfortable
• Cause too much anxiety

You may also be able to have conscious sedation for your procedure, but sometimes it isn’t enough to make you comfortable. Children may need general anesthesia for a medical or dental procedure to handle any pain or anxiety they may feel.

Risks

General anesthesia is usually safe for healthy people. The following people may have a higher risk of problems with general anesthesia:

• People who abuse alcohol or medications
• People with allergies or a family history of being allergic to medicine
• People with heart, lung, or kidney problems
• Smokers

Ask your doctor about these complications:

• Death (rare)
• Harm to your vocal cords
• Heart attack
• Lung infection
• Mental confusion (temporary)
• Stroke
• Trauma to the teeth or tongue
• Waking during anesthesia (rare)

Before the Procedure

Always tell your doctor or nurse:

• If you could be pregnant
• What drugs you are taking, even drugs or herbs you bought without a prescription

During the days before the surgery:

• An anesthesiologist will take a complete medical history to determine the type and amount of anesthesia you need. This includes asking you about any allergies, health conditions, medications, and history of anesthesia.
• Several days before surgery, you may be asked to stop taking aspirin, ibuprofen, warfarin (Coumadin), and any other drugs that make it hard for your blood to clot.
• Ask your doctor which drugs you should still take on the day of your surgery.
• Always try to stop smoking. Your doctor can help.

On the day of your surgery:

• You will usually be asked not to drink or eat anything after midnight the night before the surgery. This is to prevent you from vomiting while you are under anesthesia. Vomiting during anesthesia can be dangerous.
• Take the drugs your doctor told you to take with a small sip of water.
• Your doctor or nurse will tell you when to arrive.

After the Procedure

You will wake up tired and groggy in the recovery or operating room. You may also feel sick to your stomach, and have a dry mouth, sore throat, or feel cold or restless until the anesthesia wears off. Your nurse will monitor these side effects. They will wear off, but it may take a few hours. Sometimes nausea and vomiting can be treated with other medicines.

Follow your doctor's recommendations while you recover and care for your surgical wound.

Outlook (Prognosis)

General anesthesia is generally safe because of modern equipment, medications, and safety standards. Most people recover completely and do not have any complications.

References

Sherwood ER, Williams CG, Prough DS. Anesthesiology principles, pain management, and conscious sedation. In: Townsend CM, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 18th ed. Philadelphia, Pa: Saunders Elsevier; 2008:chap 18.