Anesthesia for Various Medical Needs
General anesthesia is most often initiated by injecting a drug intravenously to induce unconsciousness prior to surgery. There are a number of general anesthetic drugs—some are gases or vapors inhaled through a breathing mask or tube and others are medications introduced through a vein (a thin plastic catheter inserted into a vein, usually in the patient's forearm or hand). After a patient is asleep, a breathing tube or airway may be inserted into the windpipe to maintain proper breathing during surgery. Once the surgery is complete, the anesthesia provider ceases the anesthetic and the patient wakes up and responds to commands and is taken to the recovery room. General anesthesia temporarily establishes an unconscious state so that your brain does not perceive any pain signals from the nervous system.
Regional Anesthesia (Spinal, Epidural, Peripheral Nerve Block)
The anesthesiologist makes an injection of local anesthetic near a nerve or group of nerves to numb the area of your body that requires surgery. You will likely receive an intravenous sedative for the procedure. Regional anesthesia (spinal or epidural) is used to eliminate pain in a larger part of the body by temporarily blocking large groups of nerves or the spinal cord so that the pain signal cannot reach the brain.
- Spinal and epidural anesthesia involves medication inserted into your back through a needle while lying on your side or sitting up. It makes your body numb from the waist down. Once the medicine starts to work, you will not be able to move your legs for approximately four hours after surgery when the medicine wears off. The key difference between a spinal and an epidural is that with an epidural a catheter (small tube) may be left in place to treat your pain after surgery.
- Spinal anesthesia: spinal anesthetic is used for lower abdominal, pelvic, rectal, or lower extremity surgery. This type of anesthetic involves injecting a single dose of the anesthetic medication into the subarachnoid space, which surrounds the spinal cord. The injection is made into the lower back, below the end of the spinal cord, and causes numbness in the lower body.
- Epidural anesthesia: the epidural anesthetic is similar to a spinal anesthetic and is commonly used for surgery of the lower limbs and during labor and childbirth. This type of anesthesia involves continually infusing an anesthetic medication through a thin plastic catheter. The catheter is placed into the space that surrounds the spinal cord in the lower back (just outside the subarachnoid space), causing numbness in the lower body. Epidural anesthesia may also be used for chest surgical procedures. In this case, the anesthetic medication injected at a higher location in the back to numb the chest and abdominal areas.
- Peripheral Nerve Block: A peripheral nerve block is an injection of local anesthesia around a nerve or small group of nerves to block pain to the surgical area of the body. This nerve block causes temporary loss of sensation, numbness as well as long acting pain relief to the affected area. This can be used as the sole anesthetic but is often used in conjunction with other forms of anesthetics. In some instances a small catheter is placed next to the nerves and left in place so that a local anesthetic may be infused near the nerve for post operative pain relief.
Local anesthesia is an anesthetic agent injected to temporarily stop the sensation of pain in a particular area of the body. For minor surgery, a local anesthetic can be administered via injection to numb the area, or part of your body that is affected.
Monitored Anesthesia Care (MAC)
MAC refers to the administration of anesthesia drugs via IV to achieve sedation. The patient can be sedated to varying levels, ranging from simple relaxation to a state of slight consciousness. Because the level of sedation must be maintained, or perhaps adjusted, the process is continuously monitored by an anesthesia professional. MAC also includes an examination and evaluation of the patient by the anesthesia professional prior to the administration of anesthesia. This could occur the day of the surgery or prior.