Over the years, many from the public have explained their impression of general anaesthesia to me.
The answers range from 'You give stuff like chloroform and wait for people to regain consciousness.' to 'You put a tube in the mouth and machines do everything.' to 'You give one drug and then leave the operation theater while the surgeon takes care of the patient till he wakes up.'
The truth is, even today, many aren't really aware of what anaesthesiologists do inside the operation theater. It is understandable.
You meet an anaesthesiologist often just once before the surgery and he seems to focus on your diabetic history and how much you can open your mouth rather than the reason you are here, your fractured hand (I've explained why here). You never spend that much time before the operation with us and often, even less after, if all goes well.
Yes, general anaesthesia involves loss of consciousness as most reply but that is just one part of an intricate puzzle. So what else is there?
01. Inability to feel pain
Being asleep does not mean you won't feel pain. We need to block that separately.
02. Decreased response to painful stimuli
Here's something many aren't aware of - you don't need to be awake for your body to respond to pain. I need to ensure your body, including your heart, brain, nerves and muscles, do not respond when that scalpel touches you.
03. Muscle relaxation
It would be a chore if the patient keeps moving while the surgeon has his sharp instruments inside the body, would it not? Drugs are given to literally 'take your breath away', with the anaesthesiologist taking over the key functions of your lungs and vital organs and ensuring you cannot move a muscle.
04. Loss of Consciousness
As you can imagine, it can be scary to be awake and unable to move or take breaths of your own. That is where loss (and maintenance of loss) of consciousness comes into play, ensuring you do not feel anything during a surgery.
05. Amnesia
Alongside pain killers and drugs aimed at reducing your anxiety, this helps to complete the sense of well-being both during the surgery and after.
Some surgeries require us placing a tube to secure your airway while others can be done with a mere mask over your face. Some demand deep muscle relaxation, others none at all. Some need the blood pressure to be normal, some require us to deliberately lower it.
My dosage and drugs differ based on your age, weight, present illness, chronic illness, vices... even the speed of the surgeon comes into play! You can bring me 10 people weighing 60 kilograms for 10 different operations and the kind and amount of drugs used could be different for all 10, tailored to their individual needs.
Even though we have far safer drugs than those used half a century ago and some really cool equipment to monitor and care for you, general anaesthesia still has its risks, ranging from a temporary sore throat to far worse.
We can give general anaesthesia to all age groups ranging from one day old newborns to 100 year olds but there are significant risks attached to the extremes often, due to other health factors.
There are also instances (temporary or chronic) where a person may not be fit for general anaesthesia and the benefits of doing the surgery under general anaesthesia need to be weighed with the potential complications the patient can get because of it.
That is where the training, knowledge and above all, constant vigilance of an anaesthesiologist is crucial to a case. Not just to choose the type of anaesthesia or provide ideal conditions but to anticipate and handle complications that may arise at any given moment from start to end.
The goal of general anaesthesia in the end is the same as it has been since the first documented case back in October 1846 - to provide ideal safe, reversible operating conditions for both the patient and the doctor with the aim of healing you without harming you.
Got some doubts or an experience to share? Type them in the comment section below.
The answers range from 'You give stuff like chloroform and wait for people to regain consciousness.' to 'You put a tube in the mouth and machines do everything.' to 'You give one drug and then leave the operation theater while the surgeon takes care of the patient till he wakes up.'
The truth is, even today, many aren't really aware of what anaesthesiologists do inside the operation theater. It is understandable.
You meet an anaesthesiologist often just once before the surgery and he seems to focus on your diabetic history and how much you can open your mouth rather than the reason you are here, your fractured hand (I've explained why here). You never spend that much time before the operation with us and often, even less after, if all goes well.
With that in mind, I figured I would have an 'Anaesthesia Awareness' series aimed at raising basic awareness among the general public.
Don't worry, I promise not to bore you. Today's topic is a fan favourite when it comes to misconceptions about anaesthesia - What is general anaesthesia?
Yes, general anaesthesia involves loss of consciousness as most reply but that is just one part of an intricate puzzle. So what else is there?
What are the components of general anaesthesia?
01. Inability to feel pain
Being asleep does not mean you won't feel pain. We need to block that separately.
02. Decreased response to painful stimuli
Here's something many aren't aware of - you don't need to be awake for your body to respond to pain. I need to ensure your body, including your heart, brain, nerves and muscles, do not respond when that scalpel touches you.
03. Muscle relaxation
It would be a chore if the patient keeps moving while the surgeon has his sharp instruments inside the body, would it not? Drugs are given to literally 'take your breath away', with the anaesthesiologist taking over the key functions of your lungs and vital organs and ensuring you cannot move a muscle.
As you can imagine, it can be scary to be awake and unable to move or take breaths of your own. That is where loss (and maintenance of loss) of consciousness comes into play, ensuring you do not feel anything during a surgery.
05. Amnesia
Alongside pain killers and drugs aimed at reducing your anxiety, this helps to complete the sense of well-being both during the surgery and after.
Mix-and-Match
As an anaesthesiologist, we need to ensure all these components are taken care of. There is no single drug that takes care of all this. And yes, every drug comes with its own set of pros, cons and interactions which we are aware of and are prepared for.Some surgeries require us placing a tube to secure your airway while others can be done with a mere mask over your face. Some demand deep muscle relaxation, others none at all. Some need the blood pressure to be normal, some require us to deliberately lower it.
My dosage and drugs differ based on your age, weight, present illness, chronic illness, vices... even the speed of the surgeon comes into play! You can bring me 10 people weighing 60 kilograms for 10 different operations and the kind and amount of drugs used could be different for all 10, tailored to their individual needs.
Is General Anaesthesia Risky?
A question every anaesthesiologist gets asked.Even though we have far safer drugs than those used half a century ago and some really cool equipment to monitor and care for you, general anaesthesia still has its risks, ranging from a temporary sore throat to far worse.
We can give general anaesthesia to all age groups ranging from one day old newborns to 100 year olds but there are significant risks attached to the extremes often, due to other health factors.
There are also instances (temporary or chronic) where a person may not be fit for general anaesthesia and the benefits of doing the surgery under general anaesthesia need to be weighed with the potential complications the patient can get because of it.
That is where the training, knowledge and above all, constant vigilance of an anaesthesiologist is crucial to a case. Not just to choose the type of anaesthesia or provide ideal conditions but to anticipate and handle complications that may arise at any given moment from start to end.
The goal of general anaesthesia in the end is the same as it has been since the first documented case back in October 1846 - to provide ideal safe, reversible operating conditions for both the patient and the doctor with the aim of healing you without harming you.
Got some doubts or an experience to share? Type them in the comment section below.
Want to know more about anaesthesia?
I have written articles on:
1. The Magical Origins of Anaesthesia (Featured in Huffington Post)
6. What we can learn from Dr Horace Wells' untimely failure
What are the Various Types of Anaesthesia?
Public Awareness About Anaesthesia:
What is General Anaesthesia?What are the Various Types of Anaesthesia?
This is useful info. Been under anaesthesia for my caesareans and surgery, I remember being conscious during the childbirth. I could also see the cut abdomen when my sons were shown to me. During surgery, I could hear all the doctors talks and understand it till I started feeling thirsty. I started asking for water and the anaesthesiologist promptly inserted a needle telling me that it will help me. But, alls been good so far. Would love to read more of these.
ReplyDeleteThis will most likely be spinal anaesthesia instead of general anaesthesia. I will discuss it in a future post
DeleteDuring my c-section, a junior anesthesist kept trying epidural anesthesia on me but because I was on the heavier side, she was unsuccessful despite 7 attempts. I was in so much pain that I couldn't even scream out. It was only after the gynecologist came and saw my condition that the senior anesthesist was immediately summoned and she suggested general anesthesia. I was in a dazed state that day as I slipped in and out of consciousness but I could feel the pain and burning sensation of c-section. And all this happened in the Kolkata wing of a hospital, whose Bangalore wing is where my husband worked as a critical care intensivist.
ReplyDeleteI could try to make up some defense for the student but then you will just verify it from your hubby and shoot me down :D
DeleteBut yes, in hindsight, I've also been that junior anaesthetist on many an occasion with multiple pricks and attempts to get a spinal and epidural. But to feel the pain during the C-section, I fear the spinal (I cant assume it is Ga because then feeling the pain would be even worse) may not have reached the adequate height
I can totally appreciate the miracle that anesthesia is as I experienced it personally with an epidural during my second pregnancy....boy was I relieved or what! This was a very informative post about this lesser discussed medical miracle. My cousin is an anesthetist and I know that it is literally a back-breaking work. Hats off to all you silent saviours!
ReplyDeleteThanks for the appreciation. Glad to hear about the epidural .. I plan to write on it too in the coming days.
DeleteThis is great, Doc. You sure busted some myths. I think general anaesthesia is better than local one for the fear of knowing what's happening around but not feeling a thing. I think it's better to sleep off when the doctor does her magic. :)
ReplyDeleteHaha.. Often it depends on the kind of surgery. Small minor things can be done under local.
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