Risks and Use of General Anesthesia
By Jennifer Whitlock
General anesthesia makes you unconscious and is used during many surgical procedures. Anesthesia is defined as a medication for preventing pain. Multiple types are available. Some allow you to be alert and oriented during a medical procedure, while others make sleep so you're blissfully unaware of what's going on.
The type of anesthesia you get depends on the nature of the procedure being performed, your age and overall health, and the preferences of the surgeon and anesthesia provider. With some procedures, you may be able to choose between different types of anesthesia, while other procedures require a specific type.
General Anesthesia Definition
General anesthesia is a combination of medications that are intended to make the patient unaware of what is happening around them, to prevent pain, and to paralyze the body during a procedure.
Typically used during surgery, general anesthesia allows a healthcare provider to provide treatments that would be extremely painful if the patient were awake and able to feel.
General anesthesia not only makes the person unaware, but it also paralyzes the muscles of the body—including the muscles that make it possible to breathe. For this reason, patients who receive general anesthesia require a ventilator to do the work of the diaphragm and other muscles that help make it possible to inhale and exhale.
Uses of General Anesthesia
General anesthesia is typically used for more serious surgeries, lengthy procedures, and procedures that would typically be very painful.This type of anesthesia not only allows a patient to undergo a procedure without pain but also allows the patient to be unconscious for the procedure.
For some surgeries, it would be very traumatic to be awake for the procedure, whether or not you were able to feel pain. Imagine having a body part such as your appendix removed, and being wide awake. While you might not feel any pain, it could still be extremely distressing.
Risks of General Anesthesia
The risks associated with anesthesia vary widely from procedure to procedure, and from person to person. Everyone has their own individual risk level, as no two people are exactly the same.
For example, a 90-year-old patient with chronic illnesses will have a completely different level of risk than a healthy 12-year-old, even if they're having the same procedure.
Some risks that may be experienced while under anesthesia include:
Anesthesia awareness: This is a condition that occurs when the patient isn’t completely unconscious during general anesthesia. This has an incidence rate of 0.2%.
Aspiration: It's possible to inhale food or fluids that may be vomited up during surgery, which is why you're told not to eat for several hours before surgery.
Pneumonia or other breathing problems: These increase with age and long surgery duration and are believed, at least in part, due to the deep muscle relaxation that occurs. Abdominal surgeries may also carry a higher risk.
Corneal abrasions: Scratches to the eye are a risk, and may occur due to a variety of causes.
Dental injury: These may be caused by laryngoscope or endotracheal tube placement.
Malignant hyperthermia: This is a potentially life-threatening condition that causes a severe reaction to anesthesia. It typically runs in families.
Cardiovascular problems: These can include heart attack, heart failure, stroke, and abnormally high or low blood pressure.
Death (rare): According to some research, nearly half of anesthesia-related deaths are due to anesthesia overdose. Most others are due to adverse reactions to the anesthetics, including malignant hyperthermia and breathing problems. The risk, while small, increases with age.
Some risks and side effects come after the procedure is over, including:
Nausea and vomiting: This is the most common issue patients face after general anesthesia. If you have a history of nausea caused by anesthesia, tell your healthcare provider. You may be able to take medications to prevent it, and preventing it is typically easier than treating it.
Shivering and chills: This typically lasts for a short time after surgery and goes away once you're awake and moving.
Muscle aches: Caused by the medication or by lying still during a procedure, this condition is typically temporary and goes away within hours or days of having surgery.
Itching: Pain medication, including anesthesia, is often to blame for itching. Painkillers you're given after surgery can cause it, as well. It typically goes away once the medication is out of your system.
Difficulty urinating: This is more common in patients who have a urinary catheter during surgery and it can take hours or even days for the bladder to return to normal.
Sore throat and hoarseness: Caused by the breathing tube, this irritation is typically minor.
Dry mouth: This is generally a minor issue that goes away when you're able to drink fluids again.
Sleepiness: This is common after surgery and resolves when the body has eliminated most of the anesthesia medications.
Confusion: This is most common in elderly people and in those who have Alzheimer’s disease, dementia, or another condition that contributes to confusion.
Ileus: This is a condition where the intestines do not wake as quickly as expected after surgery and movement is very slow or is absent.
Difficulty getting off the ventilator: Weaning from the ventilator is more challenging in very sick patients or patients who have a breathing problem.
Blood clots: This issue is more common after surgery because the patient is still for an extended period of time, which is a known risk factor for blood clots.
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