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My surgical patients undergoing General Anesthesia relate an experience of deep sleep and complete absence of memory of time spent in surgery. It sounds almost miraculous. The patient cannot hear, move, see, or feel anything during that time span. The heart continues to beat. Lungs continue to be filled with oxygen and other bodily functions continue. Albeit, the time freezes for the duration of anesthetic being in the system.
General Anesthesia is completely unlike MAC, Conscious Sedation, Regional Anesthesia, or Local Anesthesia.
As a patient, one must have complete trust in the Anesthesia provider when going under general anesthesia. Once under anesthesia, patients loose autonomy and can no longer express their wishes.
This is why it is so important to be ready to ask all the questions before the start of surgical procedure. It is essential to be as clear as possible about your wishes and requests, as they relate to surgery and anesthesia.
General Anesthesia from Patient’s Perspective
Below is an experience related by one of my patients.
“As an avid hiker and lover of outdoor adventures, my active lifestyle came to a halt when I started experiencing excruciating pain in my feet. After thorough exam and x rays, I was diagnosed with severe plantar fasciitis or heel pain syndrome.
At first, my podiatrist tried all the conservative treatments including physical therapy, pain and inflammation reducing medications, orthotics, and activity modification. Even though these modalities improved the pain, the did not provide complete healing and I continued to limp and be limited.
After months of conservative treatments. my foot surgeon recommended surgery as the best solution to alleviate my discomfort and restore my mobility. Little did I know that this transformative journey would involve the marvels of general anesthesia.
The day of the surgery arrived, and I felt a mixture of nervousness and anticipation. Upon arriving at the hospital, the anesthesiologist greeted me with a warm smile, instantly putting me at ease. Anesthesia doctor and nurses patiently explained the entire process of general anesthesia, emphasizing its purpose of ensuring a pain-free and comfortable surgical experience.
They explained that other anesthesia modalities were available. However, I decided to proceed with general anesthesia as did not want to be aware of the surgical procedure at all. This was the only way for me to have no anxiety during my heel surgery.
As I was wheeled into the operating room, the team prepared the anesthesia equipment and carefully inserted the IV line. The anesthesiologist assured me that they would closely monitor my vital signs throughout the procedure. Anesthesia doctor put an oxygen mask over my face and asked me to take deep breaths.
She asked me to imagine a happy vacation destination and to start counting back from 10. A sense of calm washed over me as the anesthesia gradually took effect.
The next thing I remember is waking up in the recovery area, surrounded by compassionate nurses who ensured my comfort. Although groggy, I felt a profound relief knowing that the foot surgery was successfully completed.
The pain that had plagued me for months was now replaced by a sense of hope for a future filled with pain-free steps.
The days following the surgery were a blend of rest, recovery, and diligent follow-up appointments. The anesthesia team’s expertise in managing pain ensured that my discomfort was effectively controlled, allowing me to focus on my healing.
Today, as I take my first steps post-surgery, I am grateful for the remarkable impact of general anesthesia. It enabled me to undergo foot surgery with minimal pain, ensuring a smoother and more comfortable recovery. Thanks to the collective efforts of my surgeon and the anesthesia team, I am now ready to embark on new adventures, one pain-free step at a time.
My experience with general anesthesia for foot surgery was nothing short of transformative. The expertise and care provided by the anesthesia team allowed me to face the surgery with confidence and emerge on the other side with renewed hope for a pain-free future.”
The experience relayed by this patient is not unusual!
What to Expect?
a. Preoperative Assessment: Before undergoing general anesthesia, a thorough preoperative assessment is conducted to evaluate the patient’s medical history, allergies, current medications, and overall health condition. This helps the anesthesiologist tailor the anesthesia plan to ensure optimal outcomes.
b. Induction Phase: Once in the operating room, the anesthesiologist will administer the anesthesia through an intravenous line or inhalation mask. The patient will gradually fall asleep, and vital signs will be closely monitored.
c. Maintenance Phase: During the maintenance phase, the anesthesiologist carefully monitors the patient’s breathing, heart rate, blood pressure, and oxygen levels. Adjustments to the anesthesia levels are made as necessary to ensure a stable and pain-free surgical environment.
d. Emergence and Recovery: At the end of the surgery, the anesthesiologist will gradually reduce the anesthesia drugs to allow the patient to wake up naturally. The patient will then be transferred to a recovery area where vital signs are closely monitored until they are fully alert and ready to be discharged.
The Role of the Anesthesiologist
The anesthesiologist is a crucial member of the surgical team, responsible for administering and managing the general anesthesia. They have extensive training in pharmacology, physiology, and patient monitoring to ensure a safe and comfortable experience for the patient. Their role extends beyond the operating room, as they also provide pain management and post-operative care. Anesthesiologist is like the pilot of the plane. They are responsible for safe take off and landing; patient falling asleep and leaving the operating suite fully awake and alert.
What are the Risks and Side Effects of General Anesthesia?
While general anesthesia is generally safe, it is important to acknowledge potential risks and side effects. These may include nausea and vomiting, sore throat, confusion, allergic reactions, and rare complications such as pneumonia or nerve damage. If these become severe, you may have to be admitted to a hospital for recovery. However, it’s important to note that advances in anesthesia techniques and monitoring have significantly reduced these risks over the years.
Preparing for General Anesthesia
a. Fasting:
It is important to follow the preoperative fasting guidelines provided by the medical team. This usually involves refraining from food and drink for a specified period before the procedure.
But why fast?
Prevent Aspiration: Fasting helps prevent the aspiration of stomach contents into the lungs. When under general anesthesia, the body’s protective reflexes that prevent swallowing or inhaling substances are temporarily suppressed. If there is food or liquid in the stomach, it can be regurgitated and enter the airways, leading to aspiration pneumonia or other respiratory issues.
Minimize Nausea and Vomiting: An empty stomach reduces the likelihood of experiencing postoperative nausea and vomiting (PONV). Surgery, anesthesia, and pain medications can sometimes cause gastrointestinal disturbances. Fasting helps mitigate these symptoms and provides a more comfortable recovery.
Ensure Optimal Conditions: A clear stomach allows the anesthesiologist to accurately assess the patient’s vital signs, administer medications, and maintain airway control during surgery. It also creates a safer environment for the surgical team to operate without interference.
The duration of fasting before surgery depends on the type of food or drink consumed. Typically, patients are instructed to refrain from eating solid food for 6-8 hours and clear liquids (such as water, black coffee, or clear juice) for 2 hours prior to the scheduled surgery time. However, it’s important to follow the specific fasting instructions provided by the healthcare team, as individual requirements may vary based on factors like age, medical condition, and the type of surgery being performed!
In general, it is better to have absolutely no food or liquids at least 8 hours prior to surgery. Unless, your surgeon or anesthesia doctor instructs you otherwise based on your underlying medical condition or type of surgery.
Medication Review:
Inform your healthcare team about any medications you are currently taking, including over-the-counter drugs and supplements. They will advise you on whether to continue or temporarily discontinue certain medications before the procedure. For foot surgery, it is regularly recommended to stop medications that can cause excessive bleeding and may slow healing. However, there are certain health conditions that may prevent you from stopping these medications. Speak with your surgeon to clarify! Remember that some certain supplements such as Vitamin E and Garlic may have a blood thinning effect.
Openly discuss any concerns or questions you may have about the anesthesia procedure with your healthcare provider. They are there to address your doubts and provide reassurance.
General anesthesia is an incredible medical advancement that allows patients to undergo complex surgical procedures with minimal discomfort and risk. The careful administration and monitoring provided by anesthesiologists ensure a safe and controlled environment throughout the surgery. By understanding the process, potential risks, and taking necessary preparations, patients can approach their anesthesia experience with confidence and peace of mind.
Remember, every medical procedure is unique, so consult with your healthcare provider to receive personalized information and guidance regarding.
Author bio:
My name is Dr. Marat Kazak. I have been working as a professional Podiatrist serving Northern California community since 2014. My extensive medical and surgical knowledge combined with an ongoing curiosity to learn about the latest trends define my success in the field of foot, ankle and leg medical and surgical care.
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