Layman's guide to anesthesia

Anesthesiology is the practice of medicine supporting the pain relief and complete care of patients before, during, and after surgery. Early anesthesia occurred in Mesopotamia around 3400 BC in the form of poppies. Arabic physicians used opium in Sumeria (modern-day Iraq) before surgery. However, nurses have a long history of delivering anesthesiology in the western hemisphere. In the United States, nurses administered anesthesia during the Civil War from 1861 to 1865.

Luckily, we’ve come a long way when it comes to surgical pain relief. Safety, efficacy, and collaboration in anesthesiology care are critical to healthcare. This article will cover pain relief, the different sedation practices, and when they are used.

Who performs anesthesia?

There are many members of the anesthesiology care team that support the anesthesia clinicians. Physicians, advanced practice nurses, and non-physician non-nurses can administer anesthesia.

What are the available anesthesia services?

Anesthesia services are diverse and can specialize in various age ranges, anesthesia types, and populations. Anesthesia services include a number of areas, such as:

What are the types of anesthesia drugs?

The route of medication that you receive will vary depending on the type of anesthesiology that you will receive:

What are the main types of anesthesia?

The anesthesia type will depend on the procedure, the patient’s health status, and the doctor’s preference. Make sure to discuss any alternative options with the anesthesiology team if you have concerns. The primary types of anesthesia available are:

  1. General
    • General anesthesia renders patients wholly unconscious and they breathe through a tube that goes into the lungs (intubation). Patients under general anesthesia inhale and exhale with the help of a ventilator and must be monitored closely by an anesthesiology provider.
    • Procedures include cardiac or brain surgery.
  2. Intravenous (IV) or Monitored anesthesia care (MAC):
    • With this type of anesthesia, you will receive sedation and comfort but remain conscious and breathe on their own. Many patients fall asleep with MAC, also known as conscious or twilight sedation, to encourage relaxation and even sleep during mild surgeries or less complex procedures where an injection of local anesthesia will not cover, but general anesthesia is not needed. It is performed in a hospital or outpatient setting like same-day surgery or an office.
    • Sedation includes:
      • Minimal: You are likely to be awake but relaxed. You will understand questions, be involved in the procedure, and able to follow directions.
      • Moderate: You may feel drowsy and fall asleep during the procedure but may or may not remember some of the procedure
      • Deep: You won’t be unconscious, but you will not recall the procedure.
    • Procedures include colonoscopy or dental work.
  3. Regional (spinals, epidurals, nerve blocks)
    • Regional anesthesia offers comfort while remaining conscious and breathing on their own. Nerve blocks prevent the sensation in a part of your body during the procedure. These drugs numb the pain without putting you (or your infant if you are pregnant) at an increased risk from medications.
    • Examples include labor epidurals, spinal for cesarean section, and nerve blocks for reducing dislocation of fractures.
  4. Local
    • Surgery can be performed while alert and awake with a local anesthetic injected to numb a small area of the body for mild procedures. You won’t feel any pain in the area but will feel pressure and pulling.
    • Examples include getting teeth pulled, a skin biopsy, receiving stitches, or repairing a deep cut.

What should I expect from anesthesiology?

What are the possible side effects or risks of anesthesiology?

The side effects vary depending on the type of anesthesia.

  1. General anesthesia:
    • Nausea and vomiting
    • Dry mouth
    • Sore throat or hoarseness
    • Chills and shivering
    • Confusion and brain fog
    • Muscle aches
    • Itching
    • Bladder problems
    • Dizziness
  2. Conscious sedation or intravenous (IV):
    • Nausea and vomiting
    • Drowsiness
    • Heaviness
    • Amnesia of procedure
    • Slow reflexes
    • Low blood pressure (hypotension)
    • Headache
  3. Regional anesthesia:
    • Hypotension
    • Itching
    • Headache
    • Allergic reaction
  4. Local anesthetic:
    • Infection
    • Bleeding
    • Nerve damage
    • Allergic reaction
    • Swelling

Anesthesiology is now a regular part of medical care. Historically, patients who did not have anesthesiology would often choose death rather than face the pain of uncomplicated surgical procedures. Anesthesiology saves lives and makes surgical procedures accessible for all. It is important for those undergoing anesthesia to feel comfortable with what it is and what to expect.

Written by on Nov 19, 2020

Caitlin Goodwin, DNP, RN, CNM, is a Board Certified Nurse-Midwife, Registered Nurse, and freelance writer. She has over twelve years of experience in nursing practice.

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