Everything to Know About Anesthesia

Anesthesia is the use of medications and drugs (known as anesthetics) that cause a loss of feeling and awareness. These drugs are used for a variety of surgeries, childbirth, diagnostic tests, biopsies, and dental work to prevent you from feeling pain during these procedures. 

There are different types of anesthesia including general, regional, and local. The type your healthcare provider uses depends on the procedure you're undergoing and your overall health. Anesthetic medications can be given by injection (needle), inhalation (breathing mask or tube), or topically (directly on the skin). 

Knowing how anesthesia works before your procedure can keep you informed about the process and reduce any concerns you may have.

The Purpose of Anesthesia

Anesthesia keeps you from feeling pain during medical procedures. Because of anesthesia, healthcare providers can provide life-saving surgeries and diagnostic tests without causing you any pain. 

There are three different types of anesthesia: general, regional, and local. Most major surgeries use general anesthesia to put your whole body to sleep while a surgeon operates on you. However, providers can also use regional anesthesia (numbing a large area of the body such as an arm or leg) or local anesthesia (numbing a small area of the body like your teeth or gums) depending on the procedure you're getting.

General Anesthesia

General anesthesia is a type of anesthesia that takes away all feeling and awareness throughout your body—a type of anesthesia commonly used for major surgeries that require you to be asleep so you don't notice or feel pain. 

Once you receive general anesthesia, you are unable to move. Receiving general anesthesia feels like a deep sleep. Surgeries that may require this type of anesthesia include heart surgery, back surgery, or brain surgery, among others. During general anesthesia, you are unable to breathe on your own, so your surgical team will place a breathing tube down your throat that breathes for you. 

General anesthesia is administered directly into your bloodstream intravenously (meaning, through an IV). However, you can also inhale general anesthesia as a gas. Anesthesia from an IV acts quickly and usually wears off quickly after the surgery is complete. However, inhaled anesthesia can take longer to wear off. 

Regional Anesthesia

Regional anesthesia is a type of anesthesia that affects one area (or region) of the body. It blocks pain in one part of the body (such as your arm or leg) while keeping you awake and comfortable during the procedure. This type of anesthesia is typically used for hand or joint surgeries, but providers can also administer regional anesthesia during childbirth.

Your provider can give you regional anesthesia with an injection. This process involves injecting the medication with a needle near a bundle of nerves in the spine. This blocks the nerves from sending pain signals to the brain. An epidural that reduces the pain of childbirth is a common example of regional anesthesia. 

Local Anesthesia

Local anesthesia is a type of anesthesia that numbs a small area of your body. You are not sedated with local anesthesia and you will feel awake and alert during the procedure. 

Healthcare providers use local anesthesia for minor procedures that involve one area of the body. Some examples include dental work, eye surgery, skin biopsies, and mole or wart removals. Your provider can give you local anesthesia topically as a spray or ointment or via needle injection. However, for eye procedures, you will receive eye drops. 

How Does It Work?

Anesthesia works by preventing pain signals from reaching the nervous system. Your nervous system is made up of the brain, spinal cord, and nerves. The nerves are responsible for sending messages to the spinal cord and brain. These messages include sensory experiences like pain, itching, pressure, or temperature. 

Anesthesia blocks these signals by temporarily preventing your nerve cells from being able to function normally. Anesthesia medications do this by targeting certain proteins in the membranes around your nerve cells. When this happens, pain signals cannot reach the brain, which prevents you from feeling any discomfort and pain during your surgical procedure. 

Who Performs Anesthesia?

Anesthesiologists are medical doctors who specialize in anesthesia and pain management. Before most surgeries or procedures (especially those that require general or regional anesthesia), an anesthesiologist will be present to administer the anesthesia to you. They will also carefully monitor your health and vital signs (e.g., blood pressure, heart rate, and blood oxygen levels) while a surgeon is performing the procedure.

While anesthesiologists play an important role in surgery, you may also have one present during diagnostic tests like an endoscopy or colonoscopy—both of which are examples of procedures that allow a healthcare provider to see the inside of your body and organs. Anesthesiologists are typically a part of your labor and delivery team during childbirth. 

Anesthesiologists have extensive training, including a college degree, a medical degree (M.D. or D.O.), a four-year residency program, and a one-year fellowship program. This amount of training allows them to thoroughly understand how to properly administer the right amount of anesthesia for each person. 

What To Expect

Your anesthesia experience will depend on several factors including the type you receive, the surgery or procedure you’re undergoing, and your overall health. 

As you wait for your procedure to begin, your anesthesiologist will come to talk with you about what to expect and perform a quick exam. They may also administer a relaxing medication to sedate you and help you feel sleepy before receiving a full dose of the anesthesia.

Once they administer the anesthesia, you will be in a deep sleep. During surgery, your anesthesiologist will closely monitor your breathing, heart rate, blood pressure, temperature, and blood oxygen levels to ensure that the anesthesia is working properly and keep your body stable during the surgery.

After your surgery is complete, someone from your care team will take you to an area of the hospital known as the post-anesthesia care unit (PACU). When you wake up from general anesthesia, you likely won’t have any memory of the procedure. You may feel groggy and a little confused as you wake up. It’s also common to feel nauseous or cold. If you had a breathing tube placed, your throat may feel sore or dry. Keep in mind: the effects of anesthesia can last for about 24 hours.

Every surgical procedure is different. If you have specific concerns about your surgery, your healthcare provider is best suited to answer those questions and calm any worries you may have. It's also important to note that if you feel sick in the days leading up to your procedure, you should let your healthcare provider know.

Risks and Precautions

Anesthesia is safe for most people but there is a rare chance of experiencing some risks or complications, including:

• Heart rhythm changes
• Breathing problems
• Low blood pressure 
• Allergic reaction
• Confusion (delirium) after general anesthesia 
• Waking up or becoming aware during your procedure

There is also a different set of risks of anesthesia for pregnant people. In the US, it's common for the birthing person to receive regional anesthesia (e.g., an epidural) during childbirth or C-section. Pregnant people who receive anesthesia may experience the following risks:

• Post-dural puncture headache: Headaches affect up to 40% of people after childbirth. This could be caused by a variety of factors including the use of an epidural. When you receive an epidural, it could cause a loss of cerebrospinal fluid (a clear fluid that cushions and flows through your spinal cord and brain) and lead to a severe headache.
• Nerve injury: A nerve injury can occur when there is trauma to the nerves where the epidural was placed. 
• Inadequate block: An inadequate block means that you still feel some pain during a C-section, despite receiving an epidural. 
  

When To Contact a Healthcare Provider

Most people tolerate anesthesia well and recover normally. However, there are specific signs to look for after having anesthesia. These symptoms could indicate a serious problem and need to be examined right away. 

Keep in mind: anesthesia lasts in the body for about 24 hours, so it's normal to feel some effects immediately after your procedure. However, you should contact a healthcare provider if you or a loved one experience any of the following symptoms after having anesthesia:

• Severe headache
• Dizziness or lightheadedness 
• Uncontrolled vomiting 
• Trouble breathing 
• Drowsiness that does not improve within 24 hours 
• Confusion 
  

A Quick Review

Anesthesia uses medications known as anesthetics to cause a loss of feeling and awareness in your body when you're undergoing medical procedures such as surgeries, diagnostic tests, and childbirth. Without anesthesia, major surgery would not be possible. 

The different types of anesthesia include general, regional, and local—and the type of anesthesia you receive will depend on the exact surgery you're getting. Your healthcare provider and anesthesiologist can determine the right amount of anesthesia that you need based on your procedure and overall health.

Keep in mind: anesthesia is safe for most people. But, like any other medical process, anesthesia does come with its risks, especially for those who may be pregnant or giving birth. Each surgery is different, so it's best to consult with your healthcare provider about your individual risk and how to prepare for your procedure.