Anaesthesia for a gastroscopy
Even in the case of a gastroscopy, general anesthesia is not absolutely necessary. As an alternative, the patient can be given a strong sedative and the throat is numbed with a spray. For very anxious patients or people who cannot cooperate properly, such as children, a general anaesthetic may be useful or even necessary. Here too, the risks of general anesthesia must be weighed up against the advantages individually.
Anesthesia and pill
In principle, there are no dangers of the pill under general anesthesia, but many medications have an influence on the effectiveness of the pill. Since many different medications are used under general anesthesia, this question cannot be answered in a generalized way. Since safe contraception may not be guaranteed, additional contraceptive measures should be used in the first weeks after the anaesthetic. In order to clarify the individual case, the attending physician should be consulted.
Anaesthesia despite a cold
A slight cold is usually no obstacle to general anesthesia, but this must be decided by the anesthesiologist in each individual case. In the case of a cough, it must be clarified whether ventilation can be ensured during anesthesia. It must be weighed up whether the increased risk during ventilation is more serious than postponing the operation.
A slight increase in body temperature is not automatically an obstacle, but the cause of the temperature increase must be sought. Here, too, it must be considered whether the body can withstand the additional stress of general anesthesia and whether postponing the surgery makes sense. In case of fever, only operations that cannot be postponed should be performed, as the body is already under severe stress. In the case of a cold, the question of whether a postponement is necessary is therefore always an individual case decision.
Pregnancy
During pregnancy, anesthesia should only be considered for absolutely necessary and urgent procedures. The responsible anaesthetist must be informed about a possible or existing pregnancy during every anaesthetic procedure and the patient must be fully informed about risks and possible complications. A basic distinction is made between the necessity of anaesthesia for gynaecological operations, such as in obstetrics, and for non-gynaecological operations due to existing pre-existing conditions.
With the exception of the first 2-3 weeks of pregnancy (SSW), the use of anaesthetics is considered particularly critical for the child until the 16th SSW. In the case of a pregnant patient, some physical changes must be taken into account with regard to the anaesthetic procedure. For example, a pregnant woman is never considered fasting, which is why ventilation can only take place via intubation tube and not via a ventilation mask to prevent swallowing of vomit (aspiration).
It should also be noted that anaesthetic drugs begin to work earlier and lose their effect more quickly when the anaesthetic is removed. Airway protection can be more difficult because the mucous membranes of pregnant women are better supplied with blood and minor injuries cause more severe bleeding. An adequate oxygen supply is also essential for mother and child, although an oversupply can also be harmful as it impairs the delivery of oxygen to the child.
In addition, the coagulability of the blood is increased, which increases the risk of thrombosis or embolism. The child is also exposed to anaesthetics in the womb, as these enter the foetus’ bloodstream via the placenta and the umbilical cord. General anesthesia slightly increases the risk of complications during pregnancy, such as miscarriage or premature birth, while an epidural (epidural), which is used frequently for painless delivery, is usually well tolerated. Complications that can occur during an epidural include a sudden drop in blood pressure, fever or headaches in the days following delivery due to irritation of the meninges in the spinal canal. The drop in blood pressure can be counteracted by infusions that increase the blood volume in the circulation.Vasoconstrictive substances (vasopressors) should be avoided, as they reduce the blood flow in the uterus and can therefore harm the child.
