Anesthesia is the (mysterious) branch of medicine that keeps you safe and comfortable during surgery. Even though anesthesia is safe, nearly 90% of patients are afraid of anesthesia, and 25% of patients will postpone surgery because they're afraid. Learning about your anesthesia helps you prepare safely for surgery. Here's what you need to know about general anesthesia before your surgery.
What is anesthesia, Dr. Kaveh?
Anesthesia is a combination of medications and life support that keeps you safe and comfortable during surgery. Anesthesia ranges from light anesthesia (twilight anesthesia) to general anesthesia. On top of that, a nerve block can be added to any type of anesthesia for additional comfort.
Anesthesia keeps you safe and comfortable during surgery.
What is GENERAL anesthesia?
General anesthesia is the "deepest" type of anesthesia. You are fully unconscious during the surgery. This is different from local anesthesia or sedation because you're fully asleep. You don't respond to people saying your name. You also don't respond to people touching (or cutting you).
So is general anesthesia like being in a coma?
Yes and no. General anesthesia is like a reversible coma. You go into a deep sleep, but you can predictably wake up from it. Unlike a typical coma, like from head trauma. this is a medically supervised, unconscious state. Importantly, you wake up at the end!
General anesthesia is an unconscious state. You don't feel, remember, or respond to things around you.
General anesthesia is reversible!
"Reversible" means that you go unconscious, and then come back to consciousness. You can "reverse" the state of consciousness. In other words, it's not a one-way ticket. It's quite incredible, actually!
What does your anesthesiologist do while you are under general anesthesia?
To keep you safe while unconscious, your anesthesiologist uses medications and life support techniques.
- Medications: these drugs help keep you unconscious and comfortable.
- Life support techniques: your organs don't function normally when you are in this "medical coma." Your heart, lungs, and kidneys need to be supported when you are under general anesthesia.
Together, this keeps you safe, and comfortable, during your surgery. Imagine surgery without anesthesia. That's why elective surgery barely existed before anesthesia!
What drugs do you give for general anesthesia?
Your specific anesthesia medications will depend on many safety factors. To learn about your specific anesthesia, you should speak with your anesthesiologist before surgery. Some of the common medications to keep you asleep under general anesthesia include:
- Gas, including "laughing gas."
- IV medications.
- Combination of gas and IV medications.
You may also have a nerve block, spinal, or epidural in addition to your general anesthesia. See my articles on those other types of anesthesia.
What life support do you need under general anesthesia?
Your organs need support when you are under general anesthesia. Why? Because anesthesia "turns off" nerves throughout your body. These nerves include:
- Nerves in your brain, this keeps you asleep!
- Nerves that ordinarily support your other vital organs, like your heart, liver, and kidneys.
The level of life support you need is specific to you and your surgery. Meeting with your anesthesiologist before surgery is the best way to learn about your specific anesthesia. Typically, life support includes:
- Oxygen masks to give your body extra oxygen while you're asleep.
- Breathing tubes to support your breathing if your body can't do so on its own.
- A ventilator to help deliver oxygen and anesthesia gas through your breathing tube.
- IVs to deliver critical medications.
- Some of these medications are needed to raise or lower your blood pressure.
- Warming and cooling devices to maintain your core body temperature.
- Monitors to measure your vital signs, like blood pressure and oxygen levels.
General anesthesia includes both medications and life support techniques to keep you safe while you're unconscious.
Is general anesthesia safe?
General anesthesia is typically very safe. However, the safety depends on many factors, including:
- Is your surgery an emergency? Like emergency caesarian section or a car accident?
- Emergency surgery has more risks than elective surgery.
- There are many reasons why. One reason is because emergency surgery is unpredictable. It is harder to prepare for unpredictable surgery. The less you can prepare, the riskier the surgery is.
- How healthy are you at baseline?
- Conditions like heart disease, lung disease, diabetes, strokes, and kidney disease increase your risk of complications.
- What kind of surgery are you having?
- Smaller surgeries are typically safer than larger surgeries.
- For example, foot surgery is typically safer than open heart surgery.
General anesthesia is very safe, but it depends on your type of surgery and how healthy you are before surgery.
Overall, the risk of major complications from general anesthesia (for non-emergency surgeries) is less than 1%. Once again, this number depends on many factors!
Always discuss your medical history with your anesthesiologist before your surgery. This is important for your anesthesiologist to safely give you general anesthesia and keep you comfortable.
Duceppe et al. Canadian Cardiovascular Society Guidelines on Perioperative Cardiac Risk Assessment and Management for Patients Who Undergo Noncardiac Surgery. Can J Cardiol. 2017 Jan;33(1):17-32. doi: 10.1016/j.cjca.2016.09.008. Epub 2016 Oct 4. Erratum in: Can J Cardiol. 2017 Dec;33(12 ):1735.
Matthey P, Finucane BT, Finegan BA. The attitude of the general public towards preoperative assessment and risks associated with general anesthesia. Can J Anaesth. 2001 Apr;48(4):333-9. doi: 10.1007/BF03014959. PMID: 11339773.
American Society of Anesthesiologists. Vital Health Report 2. Park Ridge, IL: ASA;; 2010.
Ruhaiyem ME, Alshehri AA, Saade M, Shoabi TA, Zahoor H, Tawfeeq NA. Fear of going under general anesthesia: A cross-sectional study. Saudi J Anaesth. 2016;10(3):317-321. doi:10.4103/1658-354X.179094
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