Anaesthesia


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Anaesthesia (Wikipedia)

Anesthesia
Pronunciation/ˌænɪsˈθziə, -siə, -ʒə/
MeSHE03.155
MedlinePlusanesthesia
eMedicine1271543

Anesthesia or anaesthesia (from Greek "without sensation") is a state of controlled, temporary loss of sensation or awareness that is induced for medical purposes. It may include some or all of analgesia (relief from or prevention of pain), paralysis (muscle relaxation), amnesia (loss of memory), and unconsciousness. A patient under the effects of anesthetic drugs is referred to as being anesthetized.

Anesthesia enables the painless performance of medical procedures that would otherwise cause severe or intolerable pain to an unanesthetized patient, or would otherwise be technically unfeasible. Three broad categories of anesthesia exist:

  • General anesthesia suppresses central nervous system activity and results in unconsciousness and total lack of sensation, using either injected or inhaled drugs.
  • Sedation suppresses the central nervous system to a lesser degree, inhibiting both anxiety and creation of long-term memories without resulting in unconsciousness.
  • Regional and local anesthesia, which blocks transmission of nerve impulses from a specific part of the body. Depending on the situation, this may be used either on its own (in which case the patient remains fully conscious), or in combination with general anesthesia or sedation. Drugs can be targeted at peripheral nerves to anesthetize an isolated part of the body only, such as numbing a tooth for dental work or using a nerve block to inhibit sensation in an entire limb. Alternatively, epidural and spinal anesthesia can be performed in the region of the central nervous system itself, suppressing all incoming sensation from nerves outside the area of the block.

In preparing for a medical procedure, the clinician chooses one or more drugs to achieve the types and degree of anesthesia characteristics appropriate for the type of procedure and the particular patient. The types of drugs used include general anesthetics, local anesthetics, hypnotics, sedatives, neuromuscular-blocking drugs, narcotics, and analgesics.

The risks of complications during or after anesthesia are often difficult to separate from those of the procedure for which anesthesia is being given, but in the main they are related to three factors: the health of the patient, the complexity (and stress) of the procedure itself, and the anaesthetic technique. Of these factors, the health of the patient has the greatest impact. Major perioperative risks can include death, heart attack, and pulmonary embolism whereas minor risks can include postoperative nausea and vomiting and hospital readmission. Some conditions, like local anesthetic toxicity, airway trauma or malignant hyperthermia, can be more directly attributed to specific anesthetic drugs and techniques.

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