Anesthesia is a medical treatment that prevents patients from feeling pain during surgery and other procedures, such as screening or diagnostic tests like endoscopy.
Anesthesiologists and certified registered nurse anesthetists (CRNAs) deliver anesthesia with a combination of different anesthetic drugs to produce specific effects. Anesthesia increases patient comfort, which can in turn reduce recovery times. It also allows medical professionals to perform procedures safely and with knowing the patient does not feel distress.
General anesthesia affects the patient’s entire body. The patient experiences muscle relaxation and a complete loss of consciousness. After the patient is unconscious or “asleep,” an airway device (either a mask or breathing tube that delivers oxygen directly into the lungs) is placed to assist the patient’s breathing during surgery. The effects of general anesthesia can be delivered directly into the patient’s bloodstream (intravenously) or as an inhaled gas through the airway device.
General anesthesia is typically very safe. Patients are monitored the entire time that they receive anesthetic drugs and during their recovery.
Although some effects of anesthetic drugs wear off very quickly, other side effects like nausea and drowsiness can last longer. Any side effects depend upon patient sensitivity to the drug, dose, and length of time under general anesthesia.
Deep intravenous (IV) sedation results in the complete loss of consciousness but occurs without muscle relaxation. Patients can breathe without assistance (unlike general anesthesia); however, patients often breathe most comfortably with a nasal cannula (a small oxygen-delivering tube that sits directly under the nose).
Deep IV sedation is a type of anesthesia that is used with minimally stimulating procedures (for example, most colonoscopies are performed under deep IV sedation) or along with local or regional anesthesia methods.
Local anesthesia specifically affects the part of the body where a procedure takes place. Most of the time, local anesthesia involves the superficial (or shallow) injection of one drug (a local anesthetic) to cause numbness in the same area. This treatment helps to keep the patient comfortable without requiring a state of unconsciousness.
Local anesthesia is appropriate for short procedures in a small area suchas setting stiches or removing a tooth. Local anesthesia may be injected by the anesthesiologist or by the surgeon immediately before the procedure.
Regional anesthesia allows the patient to remain conscious or “awake” as well as comfortable. Regional anesthesia is appropriate when the procedure or surgery involves a wider—or deeper to reach—area of the body. Regional anesthesia is delivered as an injection of a local anesthetic drug, but the injection to block nerve impulses often is delivered to an area outside of where the procedure or surgery will happen. This type of anesthesia is frequently called a peripheral “nerve block” because the injection of local anesthetic will cause a temporary block of sensation in the affected nerve fibers.
Compared to local anesthesia, regional anesthesia affects larger areas to provide adequate pain control since it blocks any feeling to limbs or a section of the body. Neuraxial anesthesia, including epidural anesthesia to manage labor pain. Spinal anesthesia allows patients to tolerate orthopedic surgery or cesarean delivery and is a popular type of regional anesthesia. Regional anesthesia can be used for long-term pain management.
Monitored anesthesia care (MAC) delivers anesthetic drugs to produce a sense of relaxation and to control pain. Patients remain aware of their surroundings (like the sound of the surgeon’s voice). This level of anesthesia is ideal in situations when cooperation is needed in situations such as implanting a device comfortably and correctly in a patient.
The procedure is easily tolerated without large doses of anesthetic drugs for pain. MAC also requires that the patient is alert enough to breathe easily and naturally. This state is sometimes described by patients as “twilight” anesthesia.
Delivering a baby is the first time many patients experience hospital care or receives anesthesia. Pain control is an important part of a patient’s labor and delivery.
During labor, the most common option for contraction pain control is an epidural. This type of anesthesia requires the placement of a small, flexible tube (known as the epidural catheter) into the “epidural space” of a patient’s lower back. Medication is delivered by this catheter throughout labor to relieve contraction pain.
The epidural procedure is performed by the anesthesiologist, or by an anesthesia resident and supervising anesthesiologist team, upon patient request. If the epidural procedure is not appropriate for the patient (for example, a patient who has undergone major spine surgery or a patient who is diagnosed with a bleeding disorder), intravenous (into the blood vessel) or inhaled (nitrous gas delivered through a mask) pain medication may be offered.
During a cesarean delivery, the most common option for pain control is a spinal. This type of anesthesia involves an injection of pain medication and local anesthetic (numbing medication) in the patient’s lower back. The spinal procedure is performed by a member of the anesthesia team and allows a patient to tolerate the cesarean delivery while remaining conscious.
If the spinal procedure is not appropriate for the patient (for example, because of a bleeding disorder) or an emergency delivery does not allow time to perform the spinal, general anesthesia may be provided to keep the patient safe and comfortable through her surgery. A regional nerve block (called a Trans-Abdominal Plane (TAP) block), which includes the injection of local anesthetic to numb the area of the surgical incision, may be offered to improve pain control in the recovery period after general anesthesia.
If you still have questions about anesthesia, your obstetric care team is available 24 hours per day, seven days per week to discuss options for pain control during your labor and delivery. We appreciate your trust in providing you or a loved one exceptional care.
When it comes to health care for you and your family, UPMC is here. It's easy to find the right doctor, health screenings, programs, classes, and more.Contact UPMC in central Pa.