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It is important to take an active role in your own medical decisions. When faced with surgery, whether minor or major, Anesthesia is a large part of that surgery. Anesthesia controls pain levels so that there is not unbearable pain. Don’t leave these important decisions to your doctor or the anesthesiologist. Become informed as to the choices you have and understand there are advantages and disadvantages to choosing General Anesthesia. What is General Anesthesia - it is a state produced when a patient receives medications that create a controlled, reversible state of unconsciousness. When a person is under General Anesthesia they cannot be awakened even to secondary pain stimulus. They do not have the ability to remember what happened during the operation and are also unable to maintain adequate airway protection during the surgery so a ventilator is needed. Some drugs that are often used as General Anesthesia include barbiturates or other hypnotic agents to induce sleep. Inhalation agents, opioids, and muscle relaxants as opposed to high concentrations of potent inhalation agents alone, is preferred for obstetrical applications. One of the advantages to General Anesthesia is that it reduces intraoperative patient awareness and recall. You don’t want to have the patient remembering what happened during the surgery. It also allows for muscle relaxation for an extended period of time allowing for the doctors to do what they need to do. The use of General Anesthesia forces the need for a ventilator which may be a good thing in that it facilitates complete control of the airway, breathing and circulation. It also can be adapted to all procedures – especially if the extent or duration of the operation is unknown. Last but not least of the advantages of General Anesthesia is that it can be administered rapidly as in the case of an emergency and it is reversible. Some of the Disadvantages to General Anesthesia are that it requires an increased complexity of care and associated costs. It also needs to have some degree of preoperative patient preparation. General Anesthesia can also induce physiologic fluctuations that require active intervention. Physiologic fluctuations are changes in oxygen, body temperature and cardiac arrhythmia just to name a few. Some lesser disadvantages to general anesthesia is nausea, vomiting, sore throat, headache, shivering and a delayed return to normal mental function. It is essential that a patient communicates about their previous medical history such as kidney, heart or lung problems, alcohol status, diabetes, high blood pressure, smoking, stroke, jaundice and other psychiatric problems if any, to the doctor as such can have a direct affect on the anesthesia administered. The level of blood loss during a surgery can be greatly affected by the current medications taken by the patient. For example, aspirin can increase blood loss, so if the person is taking aspirin then he has to stop taking it a few days before the surgery. If these points are kept in mind, then risks can be minimized. Allergic reaction to the administered drug may occur in rare cases. With all the advances in medications, monitoring technology and safety systems as well as highly educated anesthesiologists the risk associated by general anesthesia to a patient is very small. The mortality rate attributed to general anesthesia is said to occur at rates of less than 1: 100,000. So talk to your doctor and your anesthesiologist about the procedure and make an informed and wise choice as to what is best for you. About the Author:
Dr. Andrew Snell is an anesthesia specialist in New Zealand. He MB ChB, FANZCA, was a fellow in Cardiothoracic Anaesthesia at Papworth Hospital, Cambridge (UK).
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