General Anesthesia, also known as Narcosis

The general anesthesia, commonly known as sedation, is a medical procedure that allows for the controlled reduction of consciousness, thus eliminating the patient’s sensation of pain and relaxing the skeletal muscles. During this process, the patient enters a completely unconscious state, which is essential for many surgical interventions. Anesthesia serves not only to reduce pain but also to guarantee the immobility of the patient and the safety of the surgical environment.

The Principles and Effects of Anesthesia

The aim of general anesthesia is to achieve painlessness, reduce consciousness, and ensure immobility during surgery. During anesthesia, the patient becomes unconscious and does not remember the procedure, as they are under the influence of amnesia. It is particularly important to monitor the patient’s autonomic functions during the procedure, as the effects of anesthetics can weaken the reflexes of breathing and swallowing.

The drugs used in anesthesia can be classified into two main categories: inhalational and intravenous anesthetics. Inhalational agents are gases or aerosolized liquids administered to the patient’s body through a mask, while intravenous agents are delivered directly into the bloodstream. In practice, the use of intravenous agents is more common, as they act quickly and in a controlled manner. Monitoring the dosage of medications during anesthesia is essential to achieve the appropriate depth of anesthesia.

During anesthesia, the patient’s physiological responses are continuously monitored, including blood pressure, pulse, and respiration. To ensure adequate anesthesia, doctors also pay attention to heart rate, the degree of sweating, and the condition of the pupils. The depth of anesthesia is crucial for the success of the surgery, and specialists ensure that the patient remains at the appropriate level during the procedure.

The Anesthesia Evaluation

Before anesthesia, a detailed anesthesia evaluation is essential. During this process, the doctor assesses the patient’s health status, as well as any previous surgeries and their complications. The purpose of the anesthesia evaluation is to determine whether the patient can be safely anesthetized and which anesthetics and dosages are most suitable for the nature of the procedure.

According to the American Society of Anesthesiologists, patients are classified into six groups based on risks and overall health status. Doctors take into account the patient’s age, gender, weight, medication sensitivities, and lifestyle habits such as smoking and alcohol consumption. The evaluation also inquires about the patient’s lifestyle, exercise habits, diet, and any harmful addictions.

An important consideration is the presence of chronic diseases and their medications. If the current health status or diseases warrant it, the anesthesiologist may request further specialist examinations. Accurate diagnosis and proper preparations are essential for ensuring that the surgery proceeds smoothly and safely.

The Preparation and Stages of Anesthesia

During the preparation for anesthesia, the patient signs a consent form that includes possible complications of anesthesia. Typically, eating and drinking is prohibited on the day before the surgery to avoid aspiration into the lungs. Before the surgery, the patient must take medications recommended by the anesthesiologist, which may include sedatives, antihypertensives, and analgesics.

General anesthesia can be divided into four stages. The first stage is the induction of anesthesia, where consciousness decreases, but pain sensation is still retained. The second stage is the REM state, where the patient’s movements are uncontrolled, and nausea may occur. The third stage is the state of surgical anesthesia, which is the goal, as the patient’s muscles relax, and breathing becomes regular. The fourth stage, which can occur in cases of overdose, must be avoided as it can cause life-threatening conditions.

During the surgery, the patient’s condition is continuously monitored, keeping track of the ECG, blood pressure, and respiration. The depth of anesthesia is also indicated by clinical signs, but various monitors can assist in maintaining the appropriate level.

The Complications and Risks of Anesthesia

Although general anesthesia is a safe procedure today, complications can occur, which may manifest in various forms. One of the most frightening risks is waking up during surgery, when the patient is aware but cannot move. This can occur particularly with the use of fast-acting anesthetics.

After the surgery, the patient may experience nausea and vomiting, leading to discomfort similar to a hangover. Additionally, anesthetics can have toxic effects on the liver, kidneys, or red blood cells, which requires special attention during the procedure.

A rare but serious complication is malignant hyperthermia, which occurs as a result of hypersensitivity to certain anesthetics. Symptoms include rapid heart rate, high fever, muscle spasms, and breathing difficulties. Such cases require urgent medical intervention, as they can lead to life-threatening conditions.

During anesthetic procedures, specialists follow strict protocols to minimize complications and continuously monitor the patient’s condition to ensure the smoothness of the surgery and the safety of the patient.