Anesthesia (Greek aisthesis: perception, sensation) refers to a state of insensibility induced by pharmacological agents. In the early days of anesthesia, the drugs were nitrous oxide (laughing gas), for example. In medicine, anesthesia is used to perform invasive (surgical) diagnostic or therapeutic measures. In addition to intensive care medicine, pain therapy and, in parts, emergency medicine and palliative medicine, anesthesia is part of the medical specialty of anesthesiology, which requires a residency. The following points give a brief impression of an anesthesiologist’s scope of practice:
- Preoperative preparation of patients
- Monitoring and implementation of anesthesia
- Postoperative care of patients requiring intensive care
- Stabilization of the cardiovascular system and respiration.
- Resuscitation measures in cardiovascular and respiratory arrest.
- Pain therapy for carcinoma pain (tumor pain) or chronic pain syndromes.
Before anesthesia is performed, a thorough medical history and patient education, which is mandatory, are performed because serious complications can occur during anesthesia or anesthesia. The anesthesiologist must inquire preoperatively about a number of diseases/risk factors that may indicate possible anesthetic problems:
- Cardiovascular disease – hypertension (high blood pressure), coronary artery disease (CAD), angina pectoris (“chest tightness”; sudden pain in the heart area), myocardial infarction (heart attack), heart failure (cardiac insufficiency; severely reduced cardiac output).
- Liver disease – hepatitis (liver inflammation), cirrhosis (shrunken liver; end stage of chronic liver disease).
- Pulmonary diseases – pneumonia (pneumonia), bronchitis, bronchial asthma.
- Kidney disease – renal insufficiency (kidney weakness; loss of function of the kidney).
- Metabolic diseases – diabetes mellitus (diabetes).
- Alcohol and nicotine consumption and abuse of medicines.
- Problems with previous anesthesia
- Problems with anesthesia of relatives
- Allergies to medications, especially anesthetics.
- Dental status of the patient
- Pregnancy history
General anesthesia
General anesthesia is the conventional anesthesia or general anesthesia (Greek nàrkosi: to put to sleep). This form of anesthesia first enabled the development of today’s surgical standards. General anesthesia is defined by some basic goals:
- Extinction of consciousness and amnesia (ability to remember).
- Analgesia (painlessness)
- Muscle relaxation (drug-induced relaxation of the muscles).
- Attenuation of vegetative reflexes (blocking any reactions of the organism to the potentially harmful stimuli).
To achieve these goals, the following groups of drugs are mainly used:
- Analgesics (painkillers) or opioid analgesics (eg, morphine).
- Anesthetics e.g. inhalation narcotics.
- Muscle relaxants
- Antiemetics (anti-vomiting medications).
Preoperatively, the main goal is anxiolysis (resolution of anxiety) of the patient. During surgery, the focus is on the above goals and antiemetic prophylaxis (preventive measures against nausea). Postoperatively, analgesic therapy in particular is continued intensively and antiemetic therapy is administered. Depending on the type and duration of surgery, medication is adjusted accordingly in a patient-oriented manner.
Other forms of anesthesia
The following forms of anesthesia are presented separately in other articles:
- Peridural anesthesia (PDA).
- Spinal anesthesia
- Local anesthesia
- Regional anesthesia
