There are three broad categories of anesthesia: general, regional and local. The nature of the surgery will often dictate the type of anesthesia that is administered. In many situations, however, there are several options as to the type of anesthesia that can be used. Your anesthesiologist or nurse anesthetist will discuss with you the risks and benefits of the various anesthesia options.
Under general anesthesia, the patient is placed in a state of total unawareness of his or her surroundings. Most often, an induction drug such as propofol is given through the IV to put the patient asleep initially. After the patient is sleeping, a tube may be placed in the windpipe to allow for administration of oxygen as well as anesthetic gases that will keep the patient asleep. These gases are given for the duration of the surgical procedure and turned off to wake the patient up. Frequently for shorter procedures, the tube in the windpipe is not used, and the patient can simply breathe through a mask for the duration of the operation.
This can be chosen for a variety of surgical procedures. Spinal or epidural anesthesia can be used for major surgical procedures on the legs and lower abdomen. Spinal or epidural anesthesia is performed by placing local anesthetic in the area of the spinal cord to numb the nerves running to the lower body. Most commonly, this is accompanied by the administration of medications through the IV to make the patient relaxed and comfortable. These drugs are also often given while the spinal is actually being placed. One advantage of spinal or epidural anesthesia is that long-acting medications can be placed near the spinal cord to give pain relief for an extended period after the operation. Surgery on the upper extremity can be performed using nerve blocks on the arm.
Several types of surgery (for example: hernia, breast biopsy, or skin procedures) can be performed under local anesthesia. Commonly IV sedation medications are given as well to relieve anxiety and discomfort.
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