Remain anesthetists during the operation

General anesthesia


Important NOTE:
The description of the interventions was compiled with the greatest care. However, it can only be an overview and does not claim to be complete. The websites of the service providers and the personal consultation with the doctor or the surgical explanation in the respective operating facility provide further information.
The persons responsible for the content of this website do not guarantee the completeness and correctness of the information, as constant changes, further developments and concretizations are made as a result of scientific research or adaptation of the guidelines by the medical societies.

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The possibility of general anesthesia - i.e. the temporary complete deactivation of consciousness in the absence of pain sensation - made many surgical interventions possible in the first place. The dentist W.T.G. Morton from Boston was the first to put his patient into an artificial deep sleep before the procedure - since then, anesthetic drugs and technology have been refined and improved more and more. The fear of not waking up from anesthesia is no longer justified today, as, thanks to modern technology, all vital functions of the body and the correct composition of the anesthetic gas are monitored during the entire operation time.

What happens in this process?

Before the general anesthesia, the anesthetist will talk to you in detail about your medical history and ask about medication to be taken regularly. Some additional tests, such as an electrocardiogram (EKG), pulmonary function test, and laboratory tests, may also be done to ensure that general anesthesia is not putting too much strain on your body and that there are no drug-drug interactions to worry about.

On the day of the procedure, you should not eat anything or drink any more cloudy liquids 6 hours before the anesthesia! Clear liquids should also not be drunk 2 hours before anesthesia. (Exception: preparation tablet (s) with a little water) Do not smoke on the day of anesthesia. If you take medication in the morning, please discuss with your anesthetist which medication you can still take before the anesthesia.

General anesthesia itself is started with a strong sleeping pill that is injected into the vein of the arm. For you, the matter is done within a few moments, i.e. you will not notice more of the anesthesia and the procedure. You won't wake up until it's all over.

The sleeping pill used is so strong that it not only puts you in a deep sleep, but also paralyzes your muscles and loses your breath drive. Therefore, every patient must be artificially ventilated during general anesthesia.

For short interventions, ventilation can be provided through a ventilation mask that is placed tightly over the mouth and nose. For longer or larger interventions, a ventilation tube is inserted into the windpipe. Since the muscles have to be completely relaxed for this, the patients also receive a muscle-relaxing drug.
The anesthesia is maintained by the continuous supply of a gas mixture into the lungs, which consists of oxygen (for breathing), nitrous oxide (to switch off pain) and a gas similar to ether (sleep-inducing). By supplying this gas mixture in its various proportions, the anesthetist can now control the anesthesia very well, i.e. he can deepen the anesthesia if necessary and terminate it at any time at the end of the procedure.

Your safety is very well taken care of during the anesthesia: the heart rhythm, blood pressure and oxygen saturation of the blood are continuously monitored during the entire procedure, so that the anesthetist can take corrective action at any time. A sensor in the outside breathing air also monitors whether the gas mixture administered has the right composition.

As soon as the operation is finished, the anesthetist stops the supply of breathing gases and pulls the ventilation tube while you are asleep. You will slowly wake up, usually through the voice of the anesthetist, who will check whether you can be spoken to again. The memory gap is very typical after general anesthesia, i.e. unlike normal sleep, you have the feeling that no time has passed.

In which situations is this procedure recommended?
General anesthesia is recommended for most procedures in the abdominal cavity, as it is not just a single nerve or a network of nerves that is responsible here that can be specifically switched off as part of a conduction anesthesia. In addition, there are a number of procedures in which the anesthesia is not deep enough using the local anesthetic procedure.
Even if you, the patient, find the procedure too stressful and do not want to experience it consciously, this can be a reason for general anesthesia.

Who is not suitable for this procedure?

In principle, with appropriate monitoring, almost every patient can be given general anesthesia today. Of course, you will always weigh the risks and benefits against each other. For example, you would not perform cosmetic surgery under general anesthesia on a high-risk patient who has certain underlying diseases (e.g. the lungs). The situation is completely different if the intervention is urgently necessary for health. The anesthetist will determine your personal anesthetic risk in advance through appropriate examinations.

As an alternative, many interventions can now also be carried out under regional anesthesia.

How is the risk to be assessed?

Many patients are disturbed by the idea of ‚Äč‚Äčlosing control of their bodies during general anesthesia. The fear of never waking up from anesthesia is as old as the anesthesia itself. However, thanks to modern monitoring technology, such anesthetic incidents rarely occur today. The risk of dying from anesthesia is now 0.008 to 0.009% and is therefore hardly greater than when awake.
Very old, sick patients and very young children have a somewhat higher risk of anesthesia.

The most common unpleasant after-effects of general anesthesia are transient nausea and vomiting, which occur in about 10% of patients. Due to the ventilation tube, around 10% of patients complain of slight hoarseness. In very rare cases, blood pressure and cardiac arrhythmias as well as temporary states of confusion can occur after general anesthesia.

What happens afterwards and what do you have to consider?

Even with outpatient general anesthesia, you will remain under observation for some time after the procedure - until you feel fit for the way home. The anesthesia will subside relatively quickly, so that you will soon be responsive again. However, it may take a little longer before you are completely clear in your head again. You are therefore not allowed to drive your own car on the day of the operation and you should also not use public transport on your own. Let family or friends pick you up or take a taxi home. You may be exhausted and sleepy for several hours after the procedure. So lie down in bed and rest. However, you should take a few steps on the day of the operation to get your circulation going again.

The basic rule is: You are not allowed to be at home alone for the next 24 hours.