Many patients, going for surgery, wait with horror to emerge from anesthesia. Side effects after medical anesthesia are not uncommon, and patients may experience disturbances in the functioning of the central nervous system and brain. Not all drugs have the same effect, so it is impossible to say exactly how anesthesia will affect the body in a particular case. But it is reliably known that the abuse of anesthesia is unsafe, so treatment without pain should not be regular. Temporary switching off of consciousness should be used only for medical reasons.
Clinical Application
An anesthesiologist works with drugs that affect the central nervous system, and the concept of anesthesia includes manipulations aimed at introducing a person into an unconscious state. General anesthesia is necessary for surgery and other procedures that require desensitization.
Medication-induced sleep makes it possible to perform complex operations that require prolonged pain relief. Large-scale disorders in which many organs are involved (mainly injuries after road accidents, falls from heights and natural disasters) are treated surgically only when consciousness is turned off.
Medication-induced sleep will not cause harm if the drugs are selected correctly and the dosage does not exceed the norm. The doctor is obliged to monitor the patient’s condition at all stages of the operation, as well as after recovery from anesthesia.
Spinal pain after surgery
During spinal anesthesia, pain can be caused by a traumatic factor, so if you experience pain in the lumbar or any other part of the spine, tell your doctor. This is especially important in cases where back pain is combined with paresis or plegia of the limb (limited mobility).
The above case is a very rare complication. Most often, the back hurts because a person has been lying on a fairly hard surface of the operating table for some time, which, in combination with osteochondrosis, gives pain.
Lower back pain and other muscle pain are the result of using Ditilin
Classification
According to the standard classification, appropriate forms of anesthesia are required for different stages of the operation. The introductory stage requires rapid euthanasia, during the treatment stage maintenance anesthesia is necessary, and basic anesthesia involves a superficial shutdown, during which the amount of the main drug is reduced.
During surgical interventions, anesthesia is selected taking into account sensitivity, intensity of action and the required duration of sleep. In this regard, the following are highlighted:
- mononarcosis – one medication is required to induce sleep;
- mixed - implies the use of at least two medications of similar action;
- combined – involves the use of drugs from different groups. It is considered complex and is called multicomponent anesthesia.
A little bit of history
The first method of pain relief was used by Avicenna; he cooled the limbs until they lost sensitivity. Amroise Paré compressed blood vessels and nerves. In Ancient Egypt, they used sleepy tubes that were soaked in narcotic herbs.
The real anesthetic began to be used at the end of the nineteenth century, it was cocaine hydrochloride. But the drug was very toxic and led to high mortality; its use was abandoned.
They were made to faint by bleeding. This method was cruel and was not developed. During the period of hostilities, they even used alcohol until they were in a strong state of intoxication.
Kinds
General anesthesia varies depending on the method of drug administration:
- inhalation – has several varieties. Typically, the inhaled drug is administered through a mask, but endotracheal and endobronchial methods of administering anesthesia are also used. Inhalation anesthesia is attractive because it allows you to keep the patient unconscious for a long time. It is enough to supply the drug in the required concentration in a timely manner;
- intravenous - a common method of immersion in medicated sleep. Has the least impact on health, suitable for operations performed within 20-30 minutes. For longer treatment, the drug is re-administered;
- combined - a combination of inhalation and infusion methods is necessary in especially severe cases. Combined anesthesia prolongs the operation time, but the very mixing of medications and techniques is fraught with complications. Combined exposure produces a strong reaction and threatens the development of life-threatening conditions.
Course of anesthesia
Even before the start of the operation, the patient begins preparing to turn off consciousness. General anesthesia remains an extremely responsible undertaking, and therefore requires careful monitoring at all stages. It is important to correctly introduce the patient into the required state, avoiding overexcitation.
Stages
It takes time to relax the entire body and turn off pain receptors. Conventionally, there are 4 stages of anesthesia: from initial lethargy to awakening. Let's look at each in more detail:
- analgesia - at this stage the patient seems lost or stunned. The eyeballs move voluntarily, the activity of the cerebral cortex increases, which affects the general condition;
- arousal – characterized by muscle activity of various parts of the body. The pressure increases, the pupil dilates, the pulse is rapid and uneven;
- surgical anesthesia - during this period there is no consciousness, excitability is replaced by relaxation, while muscle tone is preserved. Surgical anesthesia has several levels: from superficial to ultra-deep. Superficial and light anesthesia are suitable for simple operations that do not require long-term procedures. Full and ultra-deep anesthesia are necessary for surgical treatment of internal organs located deep, as well as during combined operations;
- awakening is often accompanied by inappropriate behavior on the part of the patient, and therefore requires medical supervision. As you awaken, the functions of internal systems and organs are restored.
The effect of anesthesia on the body
It is known that drug-induced sleep affects health, but what exactly does forced blackout affect? General anesthesia is considered the most powerful anesthesia, which means it affects the body to one degree or another. It is believed that life expectancy is reduced after surgery, but this is more a myth than truth. Medication-induced sleep can be difficult for older people, but thanks to it, it is possible to save lives and not shorten their duration.
General anesthesia has a significant effect on the nervous system and brain. But this does not mean that problems will begin after waking up. If the loss of consciousness affects the brain, then there may be difficulties with analytical thinking and sleep. Does anesthesia affect mental clarity and memory? Problems are possible, but they are temporary. Spinal anesthesia has virtually no effect on mental detail, and light forms of anesthesia, which are used in dental treatment, are not capable of disrupting the functions of the brain and central nervous system.
It is difficult to say exactly how anesthesia affects the entire human body. Much depends on the skill of the anesthesiologist. The negative impact can be reduced with correctly calculated dosage and successful choice of drug.
Men are worried that the anesthetic may harm the quality of sperm, but modern drugs do not affect spermatogenesis. More often, anesthesia affects the heart, liver, and respiratory organs. How does anesthesia affect the cardiovascular system and the heart in particular? Drugs for medicinal sleep provoke hot flashes, decreased heart rate, and pressure in the chest. The blood vessels narrow, the pulse quickens, and tingling occurs in the heart.
Drug-induced sleep has the least effect on the immune system, the functioning of the stomach and other digestive organs. Sometimes, after deep anesthesia, hair begins to fall out, temporary visual impairment occurs, and intellectual capabilities deteriorate. Doctors continue to study how general anesthesia affects the human body, and immersion methods and groups of drugs are important.
On the child's body
The patient's age plays a role when prescribing medicated sleep. Children under the influence of anesthetics may experience developmental problems. For this reason, babies under one year of age are given anesthesia with the utmost caution. Moreover, you will have to refrain from turning off consciousness in the case of childhood viral diseases and fever for no apparent reason.
The whole truth about anesthesia: what myths about anesthesia do patients still believe?
How do anesthesia and anesthesia work in general? And aren't they the same thing?
No, these are different things. Anesthesia is a state into which doctors put a patient. Its goal is for the patient to lose consciousness, that is, to fall asleep, and therefore, his skeletal muscles relax and pain relief occurs.
Anesthesia is an element of anesthesia when the patient loses sensitivity to pain. Moreover, the process may differ depending on which components are used.
For example, opiate analgesics - the well-known morphine - interact with the corresponding receptors in the body and block the pain response.
And local anesthetics, for example, lidocaine, reversibly block the conduction of the nerve near which they are injected.
What types of anesthesia are there?
One of the most common is intravenous anesthesia. It is usually used for short-term operations (no more than half an hour).
The patient is injected intravenously with a number of substances, for example, hypnotics (made to fall asleep).
They can be combined with painkillers; narcotic analgesics are often used for this, which, on the one hand, anesthetize a person, and on the other, enhance the sedative effect.
For long-term operations, endotracheal anesthesia is usually performed. For this purpose, gaseous anesthetics are used, which are introduced into the human body through a special tube. The drug enters the blood through the lungs, and from it into the central nervous system, thereby inducing sleep.
One of the oldest and still widespread gas anesthetics is nitrous oxide (laughing gas). It is usually supplied to the apparatus from special cylinders.
The advantage of this type of anesthesia is its complete controllability and relative safety, the person is completely relaxed, so the surgeon can perform any manipulation of any complexity.
Modern gas anesthetics are volatile liquids. In the anesthesia machine, they are poured into an evaporator - a special device that dispenses the drug to the patient in doses. This process is managed by an anesthesiologist. Doctors may also use combinations of the two depending on the surgery.
During surgery, the patient does not always require anesthesia; for minor operations, local anesthesia can be used.
This usually depends on the person’s anatomy, whether they are intolerant to analgesics, the extent of the operation, the area of the body where it will be performed, and the wishes of the surgeon. But the patient’s wishes must also always be agreed with the specialist.
Before each operation, the anesthesiologist is obliged not only to ask consent for anesthesia, but also to talk about its features and potential complications.
That is, there are different standards for pain relief for different types of operations?
Yes. For example, for urological, proctological and gynecological surgical procedures, as well as for operations on the lower extremities, spinal anesthesia is used - when a local anesthetic is injected into the spinal canal.
An alternative to spinal anesthesia can be epidural, when a local anesthetic is injected into the epidural space located in the spine through a special catheter. Depending on the type of operation (chest, abdominal cavity), the anesthesiologist determines the place of its introduction.
In this case, the doctor can inject not only a local anesthetic into the epidural space, but also opioid painkillers that enhance the effect.
Sometimes the epidural catheter may be left in place temporarily to provide pain relief as required by the patient (called an extended epidural).
More complex and serious interventions are always associated with lengthy preparation on the part of the anesthesiologist - installation of a central venous catheter, administration of infusion therapy, correction of blood coagulation parameters and other important parameters. It is also important to consider whether the operation is an emergency or a planned one.
Can you tell me more about the difference between spinal and epidural pain relief?
During spinal anesthesia, the drug is injected at the lumbar level into the subarachnoid space (into the cavity between the pia mater and the arachnoid mater of the spinal cord, filled with cerebrospinal fluid).
Usually everything is limited to a couple of injections. In this way, the soft tissues above the injection site are anesthetized and the drug is directly administered under the dura mater.
This anesthesia lasts from two to six hours and is technically easier to administer.
During epidural anesthesia, the drug is injected into the space between the dura mater of the spinal cord and the periosteum of the vertebrae, which contains connective tissue and venous plexuses. It is located closer to the skin compared to the spinal one. Anesthesia is given at any level of the spinal column. It is considered a technically more complex manipulation.
I've read that epidurals can cause paralysis.
This is a common fear, but anesthesiologists say that today it is practically impossible.
Such a complication could arise after surgery due to improper care of the catheter, as a result of which the patient developed purulent epiduritis, which caused neurological symptoms with loss of function of the lower extremities.
Or due to incorrect actions of the anesthesiologist, when puncture of the epidural space occurs at high levels (there is a risk of unintentional damage to the spinal cord). But in most cases, epidural anesthesia does not threaten anything other than a headache for several days after surgery.
Can everyone have anesthesia?
In life-threatening situations when a person needs surgery, doctors almost always use anesthesia. For example, if there is a victim of an accident on the couch who urgently needs surgery, the risk of having it performed with anesthesia for any health condition will be less than the risk of refusing it.
If a patient comes for a planned operation, then the anesthesiologist is obliged, after collecting an anamnesis, to select the appropriate type of anesthesia taking into account the patient’s health.
Doctors are guided by the rule: the volume and risk of anesthesia should not exceed the risks on the part of the surgeon. The patient's age cannot be a contraindication.
Specialists take into account all severe chronic diseases that complicate the state of health, and allergic reactions to anesthesia components.
Is there a difference between old and new drugs?
Yes there is: in their consumption, efficiency and safety of use.
However, it is invisible to patients; To appreciate the difference, you have to be an anesthesiologist. How to prepare for anesthesia and how to survive recovery from it?
Preparation depends directly on the type of anesthesia and surgical intervention. The doctor will tell you what and how best to do before the operation. Just build a trusting relationship with your treating doctors, it will be much calmer.
Each patient experiences recovery from anesthesia individually; not everyone feels bad, but many feel nausea and drowsiness, and muscle tremors. It all depends on the characteristics of the body and the drugs that were administered during the operation. After waking up, it is important to listen to your body and report any deviations to your doctors.
Can there be long-term effects of anesthesia?
After an epidural, you may experience headaches, itching, nausea, and vomiting, which usually lasts no more than a week. After intravenous anesthesia, hallucinations may appear (briefly), but this goes away on its own without medical intervention. With inhalational anesthesia, the only complication that has been studied is a decrease in fertility and an increase in the frequency of miscarriages in women.
Does anesthesia affect memory and life expectancy?
After surgery, patients sometimes cannot remember how the preparation took place. But in the long term, anesthesia has no effect on memory. Although there have been scientific publications that have noted that in some people, anesthesia can have an adverse effect on the so-called instant memory.
They like to joke about anesthesia that it takes three years of life from the patient and gives them to the anesthesiologist. But this is nothing more than a horror story. The consequences of anesthesia cannot shorten life expectancy; only the consequences of surgery can affect it.
In medical practice, there is no anesthesia that the patient cannot tolerate. It is impossible not to recover from anesthesia and die; this is a myth, doctors assure, if everything was done correctly.
Is it possible to wake up during surgery?
Such a case happens one in a thousand. You can only wake up on a couch with a low-qualified anesthesiologist. Moreover, the risks are small: it will not cause any harm to health, except for nervous stress.
Many anesthesiologists prefer to wake the patient at the final stage of the operation, when the surgeons are placing the final stitches.
In this case, the patient does not feel pain (if painkillers were administered at the same time), but he comes to his senses faster.
The BBC tells the story of a woman who woke up while under anesthesia, but because her body was paralyzed, she was unable to tell doctors.
She was so frightened that for 10 years since the operation she has been having nightmares about it every night. The publication indicates that about 5% of people around the world can wake up on the operating table during anesthesia.
The Guardian, citing experts, also notes that awakening during surgery is extremely rare.
At the same time, The Guardian writes that one in a thousand people is in a state of awareness during anesthesia. In addition, the mortality rate from general anesthesia has decreased over the past 30 years: from one death per 20 thousand patients to one or two deaths per 200 thousand people.
How do you know if an anesthesiologist is a good one?
In Russia, there are just over 20 anesthesiologists for every hundred thousand people, according to a report by the World Federation of Societies of Anesthesiologists (WFSA). It is difficult to determine how many good specialists there are among them.
There is no universal question that can be asked of an anesthesiologist to understand how qualified he is. You can ask a few questions that concern you and see what your doctor answers.
Unfortunately, you will be able to understand whether you have found a good specialist only after the operation.
You should not trust reviews on the Internet; most patients do not remember the name of their anesthesiologist and see him only three times in their life.
Source: https://spid.center/ru/articles/2516/
Complications and consequences
Under the influence of anesthetics on the body, memory abilities deteriorate, hallucinations and interruptions in heart function occur. General anesthesia affects a particular person individually, so the symptoms after recovery from drug sleep may vary. Main effects on the body:
- persistent headaches;
- memory and sleep disturbances;
- obsessive states;
- panic attacks;
- hearing and speech disorders.
Such changes last from several hours to several days. Complications occur in the case of incorrectly selected anesthetics or errors in dosage. Intolerance to medications can cause coma and death.
An overdose of drugs used during operations is dangerous for humans. In this case, the effect of anesthesia on the functions of individual systems is difficult to predict. Various body systems are affected, but problems with the nervous system, brain, respiratory and cardiovascular systems are more common. Putting a person into medicated sleep can result in cerebral edema, renal failure, cerebrovascular accident, and suffocation.
Mechanism of action
How anesthesia works and whether it is harmful to humans has been studied for a long time. It is known that the introduction of anesthetic agents affects the subcortical formation of the brain, its main function is to provide the cortex with “energy”. Under the influence of anesthetics, this function fades, the brain slowly falls asleep, and the patient is immersed in anesthesia.
During anesthesia, the body’s reaction to injections and similar effects often remains. This is normal and is taken into account during surgery. During complex operations, the patient is immersed in deep anesthesia so that the muscles do not tense. The method of anesthesia and its dose are prescribed by the anesthesiologist in each specific case.
Absolute contraindications
There is no need to talk about the importance of anesthesia in medical practice. But there are such negative consequences of general anesthesia for the body that the risk of deadly conditions exceeds the expected benefit. The use of anesthetics is prohibited in the following cases:
- for heart diseases - unstable angina, heart failure, aortic and mitral valve defects, etc. The risk of heart failure during general anesthesia remains high;
- for diseases of the respiratory system - general anesthesia is harmful in the case of pneumonia, respiratory failure, obstructive bronchitis;
- for pathologies of the liver and kidneys - complications are guaranteed in case of renal and hepatic failure, acute glomerulo- and pyelonephritis, cirrhosis of the liver;
- in the presence of foci of infection , before surgical treatment, eliminate inflammatory processes and exclude terminal conditions.
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