Important questions about anesthesia
General anesthesia
With the anesthetist and your surgeon, you have another experienced specialist at your side.In the run-up to the operation, he will explain the anesthetic procedure to you, evaluate your findings and, together with you and your surgeon, select the most suitable anesthetic procedure for you. Approval for anesthesia and assessment of your anesthetic risk is the sole responsibility of your anesthetist.The anesthetist initiates the anesthesia for you, maintains it and guides you safely and painlessly through the operation. You wake up protected in his hands. Together with the surgical team, he will accompany you to the recovery room, where he will ensure your well-being and postoperative monitoring. The anesthetist is not just a "stunner". Years of experience in dealing with the physiological reactions of the body and their therapy during surgical interventions determine his actions.Anesthetist works with heart and mind for your heart and mind. Both you and your surgeon can rely on this at all times.
3 forms of anesthesia
There are different types of anesthesia:
General anesthesia
With this form of anesthesia, you will sleep deeply, soundly and safely. Your pain response is suppressed as is your consciousness. The anesthetics are supplied continuously via the blood or the breath. This anesthesia is therefore easy to control. It can be used in any operation. (Mask anesthesia, laryngeal mask anesthesia and intubation anesthesia)
Regional anesthesia
It extends to a certain part of the body, depending on the system. You remain conscious during the procedure or you can also choose to sleep in twilight. These procedures include anesthesia close to the spinal cord (spinal anesthesia) and nerve blocks of the upper and lower extremities. (Plexus anesthesia, knee blockage, etc.)
Local anesthesia
Only a small area of your body is made insensitive to pain. This anesthetic procedure is carried out by your surgeon himself.
What should I do before anesthesia?
Please inform your anesthetist about all medications you are taking, including those you bought yourself from the pharmacy! It is particularly important to be sober, i.e. no solid food or cloudy liquids at least 6 hours before the operation and no clear liquids 2 hours before the operation! (Exception: some sips of water to take important medication - but you should also clarify this with your anesthetist beforehand!).
Refrain from smoking on the day of anesthesia! Please remove make-up and nail polish!
Jewelery - including piercings - must be removed! In principle, glasses, contact lenses and hearing aids as well as removable tooth parts and other prostheses do not belong in the operating theater. Exceptions are only possible after consulting the anesthetist.
Why am I not allowed to eat or drink anything before the operation?
The anesthesia switches off the protective reflexes (such as automatic swallowing). As a result, there is a risk that stomach contents will get into the throat and subsequently into the airways. This can lead to severe pneumonia. The shorter the last meal, the greater the risk of swallowing (aspiration). It is therefore in the interests of your own safety to tell the anesthetist exactly when you last ate and drank.
Why am I not allowed to smoke on the day of the operation?
Smoking can increase gastric acid secretion and is therefore the same risk as eating before an operation. Gastric juice can run back up the esophagus and enter the lungs (aspiration), causing pneumonia.
What are the risks and complications of general anesthesia?
The most common complications are:
- Nausea after surgery (mostly caused by narcotics). It only occurs in patients with a certain predisposition and can be treated very well with medication as a preventive measure.
- Hoarseness (after intubation), usually disappears within 24 hours.
- Aspiration (this is understood as the penetration of foreign bodies into the windpipe or into the lungs by swallowing). If the patient adheres to the prescribed pre-operative rules of conduct ("sober"!), Aspiration can almost be ruled out. This risk is most common in acute interventions (unplanned operations).
- Cardiovascular disorders (dangerous if you have pre-existing diseases of the cardiovascular system) can be triggered by the stress of the operation.
- Cooling down (very rare today: the patient is warmed up accordingly during the operation), manifests itself as postoperative tremors.
- Tooth damage can occur during intubation - but it is very rare.
Malignant hyperthermia (extremely rare, 1: 250,000, but life-threatening), the cause is a hereditary disposition of the patient. This complication begins with a greatly increased body temperature and can lead to kidney failure. If there is a family history of malignant hyperthermia, it is imperative that you inform your anesthetist!
How quickly does the anesthetic work?
Regardless of whether the anesthesia is initiated through the bloodstream or through the air you breathe, you will fall asleep within a few seconds.
Could I wake up or overhear something during the operation?
After you have fallen asleep, your anesthetist will not only check the vital organ functions, but also the depth of anesthesia. With the drugs available today, especially the gaseous anesthetics that are administered through the breath, you can almost completely rule out the possibility of waking up or overhearing during the operation. Furthermore, modern devices offer the possibility of measuring the depth of anesthesia.
Will I feel sick after the operation?
About 25% of patients complain of nausea after surgery. The causes are a personal disposition (e.g. tendency to travel sickness), the type of operation and, ultimately, the selected anesthetic method. You can counteract nausea with preventive medication. Even if the nausea cannot be completely avoided, it is less common and weaker.
When can I eat and drink again?
Depending on the type of operation, this time interval can be very different. You should wait at least 3 hours before drinking, and at least 6 hours before consuming solid food.
Do I have to be afraid of pain when I wake up?
No. Pain cannot be completely avoided after surgery, but of course you will receive the appropriate pain therapy in the wake-up phase, as well as afterwards. The need for pain relievers depends primarily on the operations performed.
When can I go home for an outpatient procedure after a general anesthetic?
The surgeon and the anesthetist must discharge the patient two hours after the operation at the earliest. The patient is once again warned against driving a vehicle, entering into contracts of any kind, or taking alcohol or sedatives (except for the medication recommended) within the first 24 postoperative hours.
What is regional anesthesia?
Regional anesthesia is the temporary loss of pain sensation within a certain area of the body due to an interruption in the transmission of pain to the brain. Usually the patient remains conscious during this form of anesthesia.
The interruption of the pain conduction is possible in several places:
- In the area of the spinal cord ("cross stitch")
- In the area of the nerve plexus, i.e. where the nerve fibers unite to form nerves after exiting the spinal cord (plexus anesthesia)
- In the area of individual nerves (so-called peripheral regional anesthesia or peripheral nerve blocks)
What is a cross stitch?
The term "cross stitch" means spinal and epidural anesthesia. Both belong to the regional anesthesia procedures close to the spinal cord. The difference between the two procedures lies in the depth of the puncture.
In contrast to spinal anesthesia, in epidural anesthesia the level of the puncture site and the amount of local anesthetic determine the location and size of the anesthetized area.
"Regional anesthesia" because only a certain part of the body is anesthetized, "close to the spinal cord" because the nerves emerging from the spinal cord are anesthetized. In contrast to general anesthesia, the patient is conscious during the operation.
When a cross stitch is the best option?
Spinal anesthesia can be used for all operations below the navel, i.e. for operations on the legs, in the pelvis, in the perineal area and in the lower abdomen. Operations on the upper abdomen, pelvic and genital areas and on the legs can be performed under epidural anesthesia.
Is the cross stitch dangerous?
With today's modern equipment, anesthesia near the spinal cord is a safe procedure. As with any method, complications are occasionally possible, but these are mostly temporary. Permanent damage is extremely rare.
Are you awake during an operation under regional anesthesia?
Depending on the patient's wishes, he or she can stay awake. But if he prefers to sleep, he can be given a light sedative.
Do I have to be sober before regional anesthesia?
As with general anesthesia, the same rules of conduct apply to regional anesthesia.
What is plexus anesthesia?
With plexus anesthesia, certain nerve bundles are specifically anesthetized, which, for example, supply the arm, buttocks or the leg. The same drugs (local anesthetics) are used here as for local or spinal anesthesia.
For which surgical areas is plexus anesthesia suitable?
Plexus anesthesia is very well suited for interventions in the shoulder, forearm, wrist and finger areas (e.g. in the case of carpal tunnel syndrome, the quick finger or to treat fractures). Plexus anesthesia in the leg area is also possible, but is done less often.
Are there any other forms of regional anesthesia?
A special form of regional anesthesia is intravenous regional anesthesia, in which the local anesthetic is injected into the vein of an extremity that has previously been blood-drained and tied with a cuff. Today this procedure is used almost exclusively in hand surgery.
