What is anaesthesia?
The word “anaesthesia" is of Greek origin, meaning “the lack of sensation". This indicates that interest in a pain-free state had occupied science even thousands of years ago.
Anaesthesiology is that arm of medicine that deals with anaesthesia, the loss of sensation produced by the administration of one or more agents that block the passage of pain impulses to the brain. The anaesthesiologist is the physician specializing in anaesthesiology whose job it is to stop pain during and after a treatment as well as monitor and control the patient's vital signs. The anaesthesiologist specializes in intensive therapy as well and, as such, also takes care of critically ill patients in the Intensive Care Unit.
What are the most prevalent anaesthesia methods?
The anaesthetic chosen by the anaesthesiologist depends on whether the anaesthesia should be general, affecting the entire body, or local, affecting only a particular area of the body, and whether the patient should remain conscious or unconscious during the course of the intervention.
General anaesthesia (unconsciousness)
The general anaesthesia is administered either intravenously or through a face mask causing the patient to lose consciousness and the sensation of pain. Muscle relaxants, required at times to loosen the patient's muscles, stop lung muscle function necessitating the use of artificial respiration during surgery. At the end of surgery, the effect of the administered medications will decrease, the anaesthesiologist stops the anaesthesia causing the Patient to return to consciousness and breathe on his own. This method is usually used in abdominal and chest surgery.
Spinal and epidural anaesthesia (EDA)
The spinal anaesthesia is a form of regional anaesthesia involving the injection of a local anaesthetic through a fine needle into the proper section of the spinal canal blocking the nerves in the myelon and the sensation of pain. The epidural anaesthesia is a technique whereby the local anaesthetic is injected through a catheter placed into the epidural space of the spinal canal. The patient remains conscious under both methods. These are the most prevalent methods used in caesarean sections.
Peripheral nerve blocks
The peripheral nerve blocks are generally performed in surgeries of the upper and lower extremities, by injecting a local anaesthetic near the nerve that control sensation and movement to a specific part of the body, temporarily numbing the area in question.
In infiltration anaesthesia, the anaesthetic (i.e., lidocain) is injected into the skin surrounding the area to be treated causing only that area to be free of sensation. This method is usually used in dermatological surgeries and generally administered by the surgeon.
What determines the method to be used?
Examination by an anaesthesiologist precedes all surgeries and includes laboratory tests, blood pressure, ECG and, if necessary, other examinations such as cardiac ultrasound, pulmonary function test, etc. The anaesthesiologist will be informed regarding the type of surgery to be performed, will check all previous illnesses, surgeries, current medications taken and allergies to medications. Following this, the anesthesiologist will discuss with the patient and the surgeon the best anaesthesia method to be used. In some cases, the patient may decide, but the protocol set for each surgery usually determines the method to be used.
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