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What is Anesthesia? |
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For
the convenience and the safety of
the patient undergoing surgery; patient
should not feel any pain during the
procedure. There are two types of
Anaesthesia:
- Regional
Anesthesia - Patient remains conscious
- General
Anesthesia - Patient is unconscious
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Who gives Anaesthesia? |
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Anesthesiologist
is a doctor, who is trained for minimum
period of two years after MBBS. The
training involves knowledge of medicine,
special instruments and techniques.
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What are the prerequisites for anaesthesia
on part of the patient before any elective
(planned) surgery? |
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The patient should be in his optimal
health before undergoing any elective
surgery
- He
should not be suffering from any
acute illnesses e.g. Fever, severe
upper respiratory tract infection,
conjunctivitis etc.
- Chronic
illnesses should be treated to optimize
conditions; e.g. Asthma, diabetes,
hyper -hypo thyroidism
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Preoperative assessment and investigations |
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- Patient
should be assessed by Anaesthesiologists
before surgery. (by one week if
possible)
- Routine
investigations should be done: Hemoglobin,
urine routine, Blood counts, X ray
chest, ECG above age of 45 or in
diabetic patient
- Specific
Investigations are done: For specific
diseases like diabetes, ischemic
heart disease, liver disease etc.
and when Anesthesiologist feels
it is required
- Any
consultation required for the patient
as advised by anaesthesiologist.
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Pre operative Fasting |
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Minimum 6 hrs for adult patients
- For
children 4 hrs ( Mothers' milk)
2 hrs (Any clear fluid)
This required to prevent vomiting
and aspiration (entering of stomach
contents in windpipe) during anaesthesia
and post operative period
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What is regional anaesthesia? |
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This
means a region of body is made numb
without unconsciousness! It ranges
from
- Field
block
- Local
nerve block
- Plexus
block
- Spinal
or Epidural Anaesthesia
- IV
regional Anaesthesia
Field
block -
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Local anaesthetic agent can be injected
in the superficial and deep layers
of the body for operation e.g. Abdominal
field block for Caesarian section
- Disadvantage
: Large amount drug required causing
side effects, patchy anaesthesia
Local
nerve block -
- Surgery
on the terminal organ can be performed
by using local nerve block to it
e.g. Surgery on finger nail,circumcision,
dental extractions
Plexus
block -
-
Brachial plexus block can be given
for any surgery on hand
Spinal
or Epidural Anaesthesia-
- It
is used for mainly lower abdominal
and lower limb surgery.
- Epidural
route is also used for pain relief
techniques e.g. Labour analgesia,
cancer pain relief, Post operative
pain relief.
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What is general anesthesia? |
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It involves three components unconsciousness,
pain relief and muscle relaxation.
This technique also involves multiple
drug administration and instrumentation
to secure the airway of the patient.
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Which technique of anesthesia is
better regional or general? |
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There
are advantages and disadvantages of
each technique. The use depends on the
site and duration of surgery
| Regional |
General |
| Patient
remains conscious |
Patient
remains unconscious |
| Patients'
protective airway reflexes are
intact |
Patient
has to be protected by the Anesthesiologist |
| Depending
on the drug used it takes some
time to recover sensations &
movement of the affected part |
Patient
recovers the sensations immediately
after anaesthesia is reversed |
The
patient should discuss the choice of
anaesthesia in consultation with his
anaesthesiologist. |
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Consent from the patient is necessary
for any surgery with or without anaesthesia. |
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It
is the permission given by the patient
or his legal representatives for the
procedure. It may be a combined consent
or separate for surgery and anaesthesia.
It implies that patient has understood
the risk involved in the anaesthesia
and has agreed to it! For children and
mentally retarded patients, parents/
guardian have to give consent. |
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What are the risks involved in Anesthesia?
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Common
Post operative complications are:
- Nausea,
vomiting
- Drowsiness
- Headache,
backache in case of spinal anaesthesia
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The risk of anesthesia comes from patients'
reaction to drugs and techniques used during
anesthesia. It also may arise from the injury
caused by operation. Patient may have diseases
like blood pressure, heart disease, Diabetes
etc. This may contribute to the complications!
Experienced anesthetist reduces such problems
by preparing the patient in advance. In emergency
this is not possible. Thus emergency procedures
increase the risk.
Patient must give all the information about
existing diseases, medications, previous operations
to the doctor. Following the doctor's advice
properly is necessary to reduce the risk.
Credits to Dr Shubha Mohite
Email : shubha
_mohite@hotmail.com
You
can find more information on our national
website at:
http://www.isa-india.org/patientsmain.html
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