All About General Anesthetics And How They Are Used

By Lila Barry


General anesthetics are medications given to patients to prepare them for surgery which cause a total loss of consciousness and sensation. It is not known exactly how these drugs actually work, but there are several theories. Although these theories differ, they all indicate a disruption in the receptor cells of the central nervous system which prevent pain from being experienced.

There are two possible ways to administer a general anesthetic, intravenously or though inhalation. In most cases a combination of the two methods is used. A doctor called an anesthetist will administer the anesthetic and monitor it closely during the surgery, afterwards it will be reversed and the patient will become conscious.

Inhaled anesthetics are delivered using an anesthesia machine, which mixes gases or vaporized liquids with oxygen, air, and in some cases nitrous oxide and releases these through a breathing mask which goes over the patient's nose and mouth. This apparatus monitors the patient's response and also manages the levels being administered. The compounds most often used are Isoflurane, Desflurane, and Sevoflurane.

Injectable anesthetics are typically fast-working and work to both induce unconsciousness and maintain it during the procedure by means of an intravenous drip. In some cases benzodiazepines are given simultaneously as a sedative. The drugs most used for surgical IV's include Etomidate and Propofol.

Surgeries which are more complex procedures that typically take a longer time to complete are usually best suited to using a general anesthetic as opposed to a local. This will be decided by the patient and his or her anesthetist. Some operations which normally always use a general include gallbladder removal, hysterectomy, hernia repair, and appendectomy.

As there are some rare but possible risks associated with anesthesia, the anesthetist will first ask the patient some questions about his or her health history. Most complications are seen in obese patients, heavy drinkers or smokers, or those with unusual allergic reactions. It is also important to always follow the instructions given by the doctor too, such as not eating for several hours before surgery as to avoid the possibility of vomiting and aspirating.

Anesthesia has four stages. The first involves the induction of unconsciousness. The second stage is known as the REM stage. The third stage is termed "surgical anesthesia" and is characterized by constriction of the pupils, relaxation of the muscles, and regular breathing, this is the most stable stage during which the surgery will be performed. Stage four is to be avoided, as it is classified as overdose of the compounds administered and may be fatal if not reversed.

During the procedure the patient's vital signs will be closely watched to ensure they are not in jeopardy. There are also some side effects which may be experienced after the use of general anesthetics. The patient may feel nauseous, have chills, be dizzy, or have a sore throat due to the insertion of a breathing tube. These feelings typically abate in a few hours and a full recovery will take place. The benefits of this type of anesthesia normally outweigh the minor discomforts which can accompany it.




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