What is Anesthesiology?

Anesthesiology is a branch of medicine that aims to provide pain relief and management of the surgical patient before, during and after the surgery. This is one of the most vital branches of medicine as pain management is one of the biggest challenges for a surgical patient.

What are the different methods used in Anesthesiology?

There are a number of methods that are used for an anesthetic procedure. Mostly, the choice for the particular method of anesthetic depends on the anesthesiologists’ discretion as well as the patient’s overall health status and the kind of surgery that is being performed.

These are the various methods of anesthetics that are used in anesthesiology:

General Anesthesia:

General anesthesia involves inducing complete unconsciousness in the patient which prevents the patient to use any of the senses (such as touch, hear, see, etc) during the surgical procedure. The anesthesiologist administers the anesthetic using an intravenous (IV) drip or use a gas mask. The patient is constantly monitored by an Anesthesiologist and a certified nurse anesthetist (or anesthesia assistant).

General anesthesia is more advantageous in most cases as it not only completely block the pain stimulus responding ability of the body (to a surgical incision) it also blocks the muscle movements and the automatic nervous response (increased heart rate, heightened blood pressure, etc).

General anesthesia is required for the complete duration of the surgical procedure. As soon as the surgery is over the anesthesiologist will remove the anesthetic IV or gas mask to allow the brain to return to consciousness once the effects the anesthetic wears off from the brain.

The anesthetic breathing gas is passed out from the body through breathing them out while the IV anesthetic is passed out from the body by the liver and kidneys.

Side-effects of general anesthesia include vomiting or nausea later on. The patient may rarely experience other side-effects such as tooth damage, headache, sore throat, dizziness or drowsiness.

The time for recovery from general anesthesia and the hospital stay required after it depends mainly on the type of surgery and the anesthetic used. Some patients are discharged the same day after spending a few hours under observation.

Sedation Techniques:

Sedation techniques are performed as mild, moderate or deep sedation. This condition differs from the general anesthesia condition in the sense that the patient under sedation is comparatively more responsive to pain stimuli and is able to breathe more easily and does not require the assistance of a ventilator or breathing tube, which shows less adverse affect to on the blood pressure and heart rate.

Sedation techniques are required to:

  • Administer IV anesthetic
  • Provide oxygen (through breathing tube or face mask)
  • Constantly monitor the vital signs of the patient during the surgery

As the anesthetic level in sedation is lower than that used in general anesthesia the recovery period after sedation is significantly shorter.

Local Anesthesia:

Also known as Regional anesthesia, this anesthetic technique requires injecting the surgical area with anesthetic medications that are useful in numbing the nerves that supply pain response to the body. This technique ‘blocks’ the nerves and they are not able to transmit the pain signals to the brain.

It is important to administer local anesthetic close to a nerve, or a bundle of nerves or the spinal cord, in order for it to be successful in numbing the region sufficiently. For this, usually two techniques are used to locate the nerves around the surgical site:

  • Ultrasound – This technique requires using ultrasound imaging techniques to view the superficial nerves better and guide the anesthesiologist towards them.
  • Nerve Stimulation – This technique involves passing small amounts of low-intensity electric current through a needle which causes the nerves present in the region to contract, thus showing the proximity of the nearest nerves for injecting the local anesthetic.

Epidural Anesthesia:

An epidural anesthesia is a form of local anesthesia that requires injecting the anesthetic in the epidural space in the spinal canal closest to the spinal cord nerve roots. This technique requires using a special needle attached with a catheter to be inserted in the lower back and precisely inside the epidural space. The catheter is then guided by the needle inside to the epidural space and administers the anesthetic and the needle can be removed. 

Spinal Anesthesia:

This technique is an alternate to the epidural anesthesia method. This is a comparatively simple procedure in which the surgeon inserts a long and thin needle in the lower back till it reaches the spinal nerves and this needle is used to administer the anesthetic solution directly into the spinal nerves. This anesthetic technique does not require a catheter to be used. The spinal nerves are the main nerves that transmit the various stimuli between the nerves and the brain, this technique blocks the ability of the main spinal nerves to send and receive signals temporarily.

Local Anesthesia:

This is a fairly simple anesthetic technique. It involves applying the anesthetic solution directly on the surgical site or injecting in the skin using an injection.

This technique may also involve the administration of adrenaline (epinephrine drug) to reduce the blood flow to the surgical site and make it numb.

Local anesthesia is suitable for minor and superficial surgeries in which the patient does not mind being conscious.

Anesthesiology is the most commonly required medical specialty around the world today as it is required for almost all surgical procedures. A practiced and  experienced anesthesiologist can ensure that the surgical experience for the patient is painless and as comfortable as possible.

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