General anesthesia – treatment, effect and risks

General anesthesia, also known as anesthesia or general anesthesia, forms a sub-area of ​​anesthesia. In this procedure, both the pain perception and the patient’s consciousness are switched off. In this way, certain diagnostic or therapeutic interventions, such as an operation, can be carried out optimally.

The patient receives special general anesthetics. These anesthetics exert their effect in the central nervous system. Furthermore, a relaxation of the skeletal muscles is also possible. In contrast to local or regional anesthesia, the patient is not responsive with this procedure.

General anesthetic procedures were already being used in the mid-19th century. Ether anesthesia was used, but it was difficult to control. With the introduction of modern anesthetic machines and intubation methods, anesthesiology was able to establish itself as an independent medical department. Eventually, anesthesia rose to become part of everyday medical procedures.

application and function

Surgical interventions are among the classic areas of application for general anesthesia. This can be for therapeutic purposes on the one hand and for diagnostic purposes on the other. Operations such as those in the abdomen can often only be carried out by administering a general anaesthetic. Thus, by switching off consciousness, the patient’s stress is reduced.

Furthermore, his recovery is going better. The surgeon can also perform the operation more easily with general anesthesia because the patient does not move during the operation. This circumstance is of particular importance in operations on the blood vessels or on the brain .

General anesthesia can also be used as part of a medical examination. For example, the pain during certain procedures such as a bronchoscopy (mirroring of the bronchi ) would be too intense. General anesthesia can also be useful for babies who are undergoing magnetic resonance imaging (MRI) . Since the baby would otherwise move too much, no usable recordings could be made without anesthesia.

General anesthesia is also used in emergency medicine. This is especially true in the case of obstructed breathing due to a serious accident, allergic reaction or cardiac arrest, in which case artificial respiration is necessary. In addition, the patient’s pain is effectively relieved.

methods and procedures

Different types of anesthesia are used in general anesthesia. Anesthesia can be achieved with drugs that can be administered through a vein . This form is also known as TIVA (total intravenous anesthesia).

Another type of anesthesia is pure inhalation anesthesia, in which only anesthetic gases are used. A combination of both anesthetic procedures is also possible. Doctors then speak of balanced anesthesia.

The drugs that are given during anesthesia are sleeping pills (hypnotics), painkillers (analgesics) and muscle relaxants. While the patient’s consciousness is switched off with sleeping pills such as propofol, the pain can be suppressed with strong painkillers such as opioids.

The muscle relaxants in turn relax the patient’s muscles, after which the patient is no longer able to move. However, the use of muscle relaxants is not necessary for every anesthetic.

What does the patient have to consider?

In the run-up to general anesthesia, the patient receives detailed information from the responsible anesthetist on how to carry out the general anesthesia. Any previous illnesses and medications that are taken regularly are also important for the doctor. In this way, the anesthetist can better assess the risks of anesthesia and have the right medication ready.

It is also important that the patient does not eat or smoke before the general anesthetic in order to prevent complications.

process and implementation

The implementation of a general anesthetic can be divided into three phases. These are the introduction, the entertainment and the conclusion. When inducing anesthesia, the patient must breathe pure oxygen for a few minutes. This creates an oxygen reserve in the blood if it is necessary to insert a ventilation tube later. A needle is also placed in a vein through which the medication can be injected.

After the painkiller, the patient receives the high-dose sleeping pill. After only a few seconds, the patient is unconscious and can no longer breathe independently. The breathing process is now carried out by the anesthetist through a tight-fitting face mask and a resuscitation bag.

If there are no problems, a muscle-relaxing drug is injected. If this develops its effect, a so-called tube (breathing tube) is inserted into the trachea . This tube ensures that the patient is ventilated via a machine.

Once the anesthetic drugs have reached their full potential, the surgeon can begin the operation. This stage is called entertainment or continuation. During this phase, the anesthetist adjusts the form and amount of medication to the patient’s needs.

If the procedure is longer, the patient is warmed up with a fan heater. This prevents the body from cooling down. The vital functions of the patient, which include pulse , blood pressure and respiratory rate, can also be viewed using a monitoring monitor .

After the end of the surgical procedure, the anesthetics must be drained from the body again. As part of the discharge, the concentration of anesthetics in the lungs and blood decreases, so that their effect becomes weaker. Finally, the patient gradually wakes up again.

It is important that the initiation and discharge take place as quickly as possible so that the body is not subjected to any unnecessary stress. In addition, the risk of side effects can be reduced by taking action quickly.

Self-service or health insurance – who bears the costs?

In the case of medically necessary operations or diagnoses, the costs for a general anesthetic are covered by the statutory health insurance companies. In the case of general anesthesia for dental treatments, however, this only happens under certain conditions such as allergies or organic diseases that do not allow local anesthesia.

Risks, dangers and complications

The most common side effects of general anesthesia include nausea and vomiting . About every fourth patient suffers from these symptoms after general anesthesia. An intense cold sensation and strong muscle tremors can be considered as further undesirable side effects.