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Out cold: an overview of anesthesia

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While in the past people may have bitten down on something hard or imbibed prior to and during invasive medical procedures, today we are fortunate to have the advanced medical field of anesthesiology to make operations as pleasant as possible.

This week on “Take Care,” Dr. Jane Fitch discusses the types of anesthesia and their various applications.  Fitch is president of the American Society of Anesthesiologists and professor and chair of the department of anesthesiology at the University of Oklahoma Health Sciences Center.

The word “anesthesia” may be difficult to pronounce and spell, but it has a simple definition.

“Anesthesia actually means rendering a patient free of pain,” Fitch says.

Anesthesia comes in three forms: general, regional, and sedative.  General anesthesiainvolves a loss of consciousness in the patient and affects the entire body.  Regional anesthesia numbs a specific area of the body, and sedative anesthesia puts the patient in a “twilight” state where they are conscious and able to follow instructions but are more relaxed than usual.

While regional and sedative anesthesias are typically used for minimally invasive procedures, general anesthesia is required for surgeries that are more involved. 

People often refer to the loss of consciousness during general anesthesia as “sleep,” but Fitch says such an association is not entirely accurate.

“It’s really not at all like the normal physiologic sleep that you go through.”

Patients rarely dream as they do in normal sleep, and if they do, they are unlikely to remember the dream. During general anesthesia, only the patient’s vital functions are maintained.   

“We take patients closer to dying than they are ever going to be and bring them back again,” Fitch says.

Due to the delicate and highly involved nature of anesthesia procedures, a team of specialists is usually required.  Fitch says that anesthesia care teams are responsible for administering the anesthesia properly and include a physician anesthesiologist, a nurse anesthetist, and/or an anesthesiologist assistant.

The American Society of Anesthesiologists has standards for monitoring patients during anesthesia that include heart rate, oxygen saturation, blood pressure, breathing, and body temperature. 

Thanks to improved medications and procedures, Fitch says that anesthesia mortality has gone from approximately one in 10,000 to one in every 300,000 to 400,000.

In order to havethe best possible experience with anesthesia, Fitch says it is critical that you have good communication with the anesthesiologist.  Underlying medical conditions can cause complications if they are not properly addressed before administration.

After any procedure, resting for a few hours while the drugs wear off is important. 

“It does take several hours for all of these medications to clear out of your system,” Fitch says.