Anesthesia; Faced with the prospect of being subjected to surgery, human beings respond in many ways, and at that moment there are multiple questions that arise.
This page will try to help answer some of those doubts.
What is anesthesiology?
It is defined as the practice of Medicine dedicated to the relief of pain and the complete and comprehensive care of the surgical patient, before, during and after surgery.
Any surgical intervention or exploration and diagnostic tests that are performed in hospitals, clinics or medical offices are often painful and produce neuro-endocrine alterations in the person that manifest as anxiety and changes in the normal parameters of the body’s functioning.
The Anesthesiologist is a specialized doctor who is responsible for the patient’s well-being before, during and after surgery and maintains the closest contact with him so that the surgical or diagnostic procedure is carried out without compromising his life, that is , the Anesthesiologist is in charge of ensuring the safety and comfort of the patient during the anesthetic-surgical act, always seeking to minimize the complications that may arise during it.
How do I get in touch with the anesthesiologist?
Ideally, every Hospital or Clinic should have an Anesthesia Consultation -ascribed to the Anesthesia Service- so that the doctor in charge of taking the Anesthesiological History to the patient is an Anesthesiology Specialist, and thus establish the first contact in order to Gather the pertinent information from the clinical point of view, make the individual assessment of the case, request the necessary laboratory and office tests and enter to answer the questions that the patient has.
If your Hospital does not have this service, ask the surgeon in charge of your case to put you in contact with the anesthesiologist who will administer the anesthesia. This first contact is extremely important since, in addition to solving doubts, giving information about anesthesia and surgery, it is considered to be extremely calming to the point that it is calculated to have the same effect as the administration of a sedative.
When do they hospitalize me?
There are several ways to enter a hospital for surgery. If your case is an Emergency, you will enter through the emergency service where you will be given a Clinical History, they will request the minimum laboratory and cabinet tests necessary to be taken to the Operating Room as soon as possible.
If your case is Urgent, that is, you can wait a little more than 24 hours, you will be given the Clinical History and the necessary laboratory and office tests, as well as the pertinent consultations if you suffer from chronic diseases and the request for the Assessment by the Anesthesiologist, from the Emergency Service or in the Hospitalization Rooms, in order to be taken to the Operating Room in better conditions.
If your condition is not emergency or urgent, it is classified as Elective, which means that the Clinical History and pertinent examinations can be carried out with much longer time through the Outpatient Service and your hospitalization will be scheduled once all are complete. tests and consultations and there is field availability in the hospital or clinic.
How do I enter the operating room?
You will be taken to the Operating Room (SOP) from the site where you are hospitalized. If your condition is emergency or urgent, you will be taken on a stretcher by the nursing staff and the orderly to the SOP, there you are received by the ward staff, who will verify your name and other personal information, your condition and the surgery that will be performed. .
The anesthesiologist in charge of your case will also verify all this information, in addition to verifying your physical-athletic condition, concomitant diseases, fasting time and if everything is in order to enter you into the PCOS.
It is noteworthy that an Emergency anesthetic-surgical procedure implies not being able to comply with all the requirements that are observed in emergency or elective cases that mean greater safety for the patient, for example, fasting and better preparation to face successfully Surgery.
If your surgery is elective, you will be taken from the hospitalization room and received by the anesthesiologist and the nursing staff assigned to the Pre-anesthesia room. There, in addition to performing all the procedure described for emergency patients, they will take a venous access route, if you do not have one, and it will be verified that everything is in order to perform your surgery. Almost always the transfer is carried out on a stretcher or wheelchair, but it may be perfectly valid for the patient to enter by their own means.
What type of anesthesia will I receive?
The type of anesthesia that will be administered during the anesthetic-surgical act will depend on many factors. Among them we can mention the type of surgical procedure, the area to be operated on, your current and previous health status and, perhaps one of the most important, your preference or choice.
There are several types of anesthesia, namely: General, regional, local, mixed. The anesthesiologist will decide according to your preference which is the most convenient according to your case and your clinical condition.
What is general, regional or local anesthesia?
General anesthesia is one in which the anesthesiologist induces a dream similar, but not the same, as physiological sleep, with drugs injected through the vein that channel it, in adults and young people, or by inhaling gases in children . Once the “induction” is performed and the person is relaxed, an orotracheal tube is placed and connected to the anesthesia machine for the “maintenance” of anesthesia using inhaled gases or intravenously administered drugs. During this time, the person remains relaxed so that the surgeon can work more comfortably.
In regional anesthesia only one part of the body is anesthetized, eg from the waist down. For this, local anesthetics are used (among the best known are Lidocaine, Bupivacaine) injected into a site that allows to block the nerve roots in that area.
For example, epidural block for an inguinal hernia, or subarachnoid block for a Transurethral Resection of the Prostate. Local anesthetics prevent the nerves from carrying the information that an injurious action is being carried out on the body (a cut by a scalpel, for example) and therefore prevent the brain from developing responses to this stimulus.
Local anesthesia is when local anesthetics are applied to a small part of the body, eg, a hand, a finger.
What are the risks during anesthesia?
Anesthesia is a procedure with risks, which must be thoroughly explained by your anesthesiologist. No one but him is trained to give you the most accurate and concise information. Medical, scientific and technological advances have produced that anesthesia is administered today with greater safety than 20 or 30 years ago, this logically does not imply that it is free of complications.
These complications depend on many factors. Your fasting status is very important, your physical status classification according to the American Association of Anesthesiologists (ASA), whether your surgery is emergency, urgent or elective, the area to be operated on, the risk inherent in the surgery that will be performed, etc.
What are the fasting guidelines?
Fasting is important since the gastric content could regurgitate into the larynx and from there pass to the lungs, which could produce a catastrophic event known as Gastric Content Aspiration, which is characterized by pneumonitis (inflammation of the lungs), probable development of infection, with the consequent alteration of gas exchange (entry of Oxygen, elimination of Carbonic Gas) that can lead to death.
Today’s recommended guidelines are detailed in the following table:
1. Children under 0-6 months: milk / solids 4 hours; clear liquids 2 hours
2. Children from 6 to 36 months: milk / solids 6 hours; clear liquids 2 hours.
3. Children over 36 months: milk / solids 8 hours; clear liquids 2 hours.
Could you die during the operation?
Yes. An anesthetic-surgical act carries risks from both the anesthetic and surgical point of view. No surgery is harmless. All, absolutely all, carry risks that can lead to death. Remember that there is a maxim in anesthesia: “There may be minor surgeries, but there are NEVER minor anesthesia.” That is why the person who is going to undergo surgery should talk to their anesthesiologist and surgeon about this and other risks.
Make sure that the doctors you are going to allow to perform the anesthetic-surgical act are competent, up-to-date and ethical. Don’t put yourself in the hands of merchants who minimize all risks and pretend to be God.
For your information, we add data with anesthetic mortality according to ASA:
ASA I: MORTALITY 1: 10,000
ASA II: MORTALITY 1: 10,000
ASA III: MORTALITY 1: 347
ASA IV: MORTALITY 1: 134
ASA V: MORTALITY 1: 64
(E ) EMERGENCY DOUBLES THE RISK
Can I wake up?
No. Currently available monitoring allows the person to be taken to a suitable deep plane of anesthesia that facilitates the successful performance of surgery. Anesthesia etymologically means “without sensations”, that is, the objectives of anesthesia are unconsciousness, amnesia, absence of pain, muscle relaxation and adequate homeostasis.
This implies that you should not wake up in the middle of the surgery and tell the surgeon: That is wrong! However, there are people who can listen throughout the surgery. Fortunately, these cases are exceptional and the anesthesiologist has medications that easily allow such a situation to be avoided.
What do they do to me when I get to the operating room?
Upon arrival at the Operating Room (SOP) they verify your identification, what type of procedure they are going to perform, then they transfer you to the operating table. Your anesthesiologist inserts a catheter into a suitable peripheral vein (if it was not brought from the Salon) to apply the necessary medications and infuse fluids as required and transfuse blood if warranted. It monitors her with the devices to monitor her vital signs, the minimums are: Electrocardiogram, Non-invasive Blood Pressure, Pulse Oximetry.
The process of induction of anesthesia and Orotracheal Intubation begins, and later the connection to the anesthesia machine, if General Anesthesia is applied. If you are given Regional or Local Anesthesia, the anesthesiologist performs the procedure and waits for the local anesthetic to take effect.
In the meantime, the Surgeons wash, put on the sterile clothing, proceed to wash the area and place the necessary sterile lingerie, exposing the area to be operated on. During all this time and the duration of the surgery, the anesthesiologist is the one who remains in close contact with you, making sure that you “are alive”, monitoring your vital signs, controlling the monitors, feeling your pulse, listening to your heart
After surgery, where do I go?
After the surgery has been successfully performed, the process is reversed, the person is led to the gradual recovery of their consciousness, this is what is called “awakening”. Once you recover your reflexes and can breathe on your own, you are transferred to the Recovery Room.
There are qualified personnel there to ensure that your return to consciousness is fully satisfactory, commanded by an anesthesiologist responsible for that section.
Sometimes, given the severity of the surgery performed and the person’s clinical situation, it may be necessary for their recovery to take place in an Intensive Care Unit (ICU), where surveillance is extremely tight 24 hours a day.
If your surgery is outpatient, you will spend two or three hours in the Recovery Room and will be discharged (sent home) if you do not present any complications, accompanied by a responsible person. If your surgery warrants hospitalization, you will be sent to your Salon once the Recovery Room requirements for it have been met.
Will I feel a lot of pain?
Medicine must be your raison d’être for the existence of pain. This is particularly true for anesthesiology. Hippocrates stated that relieving pain is the art of the gods: “Anaesthesia Deorum Ars”. It is the primary responsibility of the anesthesiologist that you recover from pain free anesthesia.
Many doctors and surgeons argue that surgery must hurt. The anesthesiologist is responsible for ensuring that you are free of pain during the convalescence of your surgery and from before starting the surgery you must begin to manage the pain that it produces. There are several schemes for this and your Anesthesiologist will decide together with you which is the best according to your clinical case.
The information that you will find in these articles is not intended to replace the necessary medical advice or the need for professional medical treatment for a medical condition or disorder.
You should always consult a doctor if you have any questions about your health and before starting a new treatment with drugs, diet or physical exercise program