Dorothy FarrarLocal anesthesia
Local anesthesia switches off the sensation of pain locally. The anesthesia form is associated with much lower risks than general anesthesia. Local anesthetics are used both for minor operations and in pain therapy.
What is local anesthesia?
With any anesthesia, the nervous system is dampened. In this context, local anesthesia is a reversible and controlled functional impairment of the nerve tracts, which numbs the sensation of pain in a locally limited area of the body. The procedure is also known as local anesthesia and is performed using local anesthetics. Local anesthesia has many advantages compared to general anesthesia. All bodily functions are only slightly impaired by local anesthetics. In comparison, general anesthesia is much more strenuous for the organism and therefore carries higher risks.
Applications
Typical areas of application of local anesthesia:
- Operations
- Surgical pain
Local anesthesia may be indicated in various contexts. As a rule, local anesthetics are used for operations so that the patient cannot feel the pain of the operation. Especially patients with lung impairments, allergies to general anesthesia, overweight patients, patients with cardiovascular diseases or constitutionally otherwise impaired persons prefer local anesthesia to general anesthesia.
For patients with chronic lung diseases, mechanical ventilation of general anesthesia is always accompanied by a decrease in functional lung residual capacity and compliance. In chronic lung patients, respiratory complications often occur under general anesthesia. The drugs of general anesthesia also initiate a histamine release, which can be dangerous for a diseased bronchial system.
Patients with acid-base balance disorders or metabolism are also preferred to be operated on with local anesthesia, as general anesthesia has more significant effects on these systems. In addition, for various operations, it is necessary that the patient remains conscious. This can apply, for example, to operations on the eye, in which the patient must regularly change the direction of view. In some cases, local anesthetics are also used in pain therapy or are combined with general anesthesia.
What methods and procedures are there?
Depending on the type of application, different forms of local anesthesia are distinguished. The size of the anesthetized body area also plays a role in this distinction. Both surface anesthetics and infiltration anesthetics exclusively switch off local pain receptors or smaller skin nerves. Line anesthesia numbs entire regions of the body by completely switching off the supplying nerves.
In intravenous regional anesthesia, the blood is accumulated on one limb by means of a cuff so that the local anesthetic can be given directly into a vein.
In central conduction anesthesia such as spinal anesthesia or peridural anesthesia, spinal nerves are switched off near the spinal cord to numb individual body segments.
What does the patient have to consider?
A patient may have different contraindications to local anesthesia. If, for example, inflammation is present in the planned area of infection, local anesthesia must be postponed until the inflammation has healed. Inflammatory processes are associated with a high risk of infection. In addition, the patient must inform the anesthesiologist of any allergies to local anesthetics that he knows about.
In addition, anticoagulant treatment may be a contraindication to local anesthesia and should therefore be discussed with the doctor. In particular, conduction anesthesia close to the spinal cord should not take place in patients with anticoagulant treatment. In the run-up to local anesthesia, the patient is informed by the doctor about all risks and carefully assessed for contraindications. Important in this preliminary discussion is the openness of the patient. Untruths are absolutely counterproductive in the preliminary discussion, as they can lead to complications during anesthesia.
In some cases, pain occurs with local anesthesia, which should be reported immediately to the doctor. So he can switch to a different way of pain relief. A metallic taste or dizziness during anesthesia must also be reported, as these may be signs of poisoning from local anesthetics. In the aftercare of local anesthesia, it is particularly relevant that the patient immediately contacts the attending physician in case of persistent pain symptoms or other after-effects in order to rule out complications such as infections.
Implementation – How does the investigation work?
With local anesthesia, the doctor uses medication to switch off the signaling of nerves so that pain is no longer consciously perceived. The drugs do not reach the bloodstream, but act locally. In the case of topical anesthesia, the numbing drug is applied to the Skin or mucous membrane in the form of a spray, ointment and solution. With infiltration anesthesia, the local anesthetic is injected into the tissue and distributed around the nerves.
With regional anesthesia, the doctor injects the anesthetic in the area of the spinal cord or groin. Most local anesthetics work within a very short period of time. Once the effect has set in, a planned surgical intervention can be carried out. In some cases, such as complications, it may be necessary for the anesthetist to regularly adjust the medication dosage. In the context of an operation-related local anesthetic, the patient is usually also given a sedative before the operation so that he or she can experience the operation in a relatively relaxed manner.
The administration of sedatives is standard, especially for anxious patients , children and patients undergoing major operations. The more upset the patient is, the more likely it is that unforeseen movements will occur during the operation, which can eventually lead to complications. When dosing the individual anesthetics, anesthesiologists use the Richmond Agitation Sedation Scale. This allows you to plan the duration of the anesthetic relatively precisely.
Who bears the costs?
Local anesthesia is a health insurance benefit that is covered in full by both statutory and private health insurance companies if there is a corresponding indication. Local anesthesia is even cheaper than general anesthesia. The prerequisite for this is the assessment of the attending physician. If the doctor sees no indication, the costs will not be covered. The health insurance companies do not cover any costs for treatments that are not medically necessary. For this reason, local anesthesia is just as little accepted as part of purely cosmetic operations as is the cosmetic operation itself.
Risks, complications and side effects
If large amounts of a local anesthetic enter the bloodstream, this process can trigger a systemic effect. In this case, complications such as seizures or cardiac arrhythmias can occur. This scenario is relatively rare and is almost impossible with expertly performed local anesthesia. Infections are also rare. However, allergic reactions to local anesthetics can occur, which are associated with itching , reddening of the skin , shortness of breath OR, in extreme cases, circulatory failure.
Hello and welcome to my Health Guide & Encyclopedia! My name is Dorothy Farrar, and I'm the founder and main author of this platform.
My passion for health and wellness started at a young age when I became interested in the connection between the food we eat and the way we feel. This fascination led me to study nutrition and dietetics in college, where I learned about the importance of a balanced diet and the impact of various nutrients on the body.