Written by Bahar Madani
Anesthesia is a medical treatment that prevents patients from feeling pain during surgery. To produce anesthesia, doctors use drugs called anesthetics. Scientists have developed a collection of anesthetic drugs with different effects. These drugs include general, regional, and local anesthetics. The task of general anesthetics is to put patients to sleep during the procedure. Local and regional anesthetics just numb part of the body and allow patients to remain awake during the procedure. Depending on the pain relief needed, doctors provide aesthetics by injection or inhalation. In some cases, doctors will use a lotion, spray, eye drops, or skin patch.
History of Anesthesia
William Thomas Green Morton (August 9, 1819 – July 15, 1868) was an American dentist who first publicly demonstrated the use of inhaled ether as a surgical anaesthetic in 1846. The promotion of his questionable claim to have been the discoverer of anaesthesia became an obsession for the rest of his life.
On 30 September 1846, Morton administered diethyl ether to Eben Frost, a music teacher from Boston, for a dental extraction. Two weeks later, Morton became the first to publicly demonstrate the use of diethyl ether as a general anesthetic at Massachusetts General Hospital, in what is known today as the Ether Dome.
General anesthesia
General anesthesia affects the whole body, making patients unconscious and able to move. Surgeons use it when they operate on internal organs and for other time consuming surgeries, such as back surgery. Without general anesthesia, many of the important procedures would not be possible, such as open-heart surgery, brain surgery, and organ transplants. Anesthesiologists provide general anesthetics either directly into the bloodstream (intravenously) or as an inhaled gas. General anesthesia delivered intravenously will act quickly and disappear rapidly from the body. This allows the patient to recover sooner. Inhaled anesthetics may take longer to wear off.
Effects of general anesthesia
General anesthetics typically are very safe, but they can have negative effects on some patients, such as the elderly or people with chronic diseases or diabetes. Serious side effects, such as dangerously low pressure, are much less less common than they once were. To minimize these risks, anesthesiologists carefully monitor the patients and can adjust the amount of anesthetic they receive.
How does anesthesia work?
The primary site of action is in the central nervous system .
The general anesthetics cause a reduction in nerve transmission at synapses, the sites at which neurotransmitters are released and exert their initial action in the body. General anesthetics induce a type of anesthetic state, one of general insensibility to pain patients loses awareness, yet his vital physiologic functions, such as breathing and maintenance of blood pressure, continue to function. The most commonly used general anesthetic agents are administered by breathing and are thus termed inhalation or volatile anesthetics.
Epidural Anesthesia
Epidural Anesthesia is the most popular method of pain relief during labor. More than 50% of women giving birth request Epidural . Epidural Anesthesia is “regional anesthesia” that blocks pain in a particular region of the body. The main goal of epidural is to provide pain relief, analgesia, rather than anesthesia, which leads to total lack of feeling. The main task of epidural id to block the nerve impulses from the lower spinal segments, which results in decreased sensation in the lower half of the body. Epidural medications fall into a class of drugs called local anesthetics. These include bupivacaine, chloroprocaine, or lidocaine. They are often given as a combination with opioids or narcotics, such as fentanyl and sufentanil in order to decrease the required dose of local anesthetic. This action produces pain relief with minimal effects. These medications may be used in combinations may be used in combination with epinephrine, fentanyl, morphine, or clonidine to prolong the epidural’s effect or to stabilize the mother’s blood pressure.
Procedure of Epidural Injections
The mother will be asked to arch their back to the left side or sitting up.
A small area on the back will be injected with an anesthetic to numb it.
A needle is then inserted into the numbed area surrounding the spinal cord in the lower back.
A small tube is threaded through the needle into the epidural space.
The needle is then removed, leaving the tube in place to provide medication either through periodic injections or by continuous infusion.
Benefits of epidural anesthesia
Epidural Anesthesia has many positive factors. For example, the mother is able to rest if the labor is prolonged. The mother is able to stay alert and active during labor. When other types of coping mechanisms are no longer helping the mother, an epidural can help deal with exhaustion, irritability, and fatigue. An epidural can allow the mother to rest, relax, and stay focused on the actions of labor.
Negative aspects of epidural
Epidural can cause the blood pressure of the mother to suddenly drop, but can be treated with IV fluids, medications, and oxygen. The mother needs to alternate sides while lying in bed, because lying in one position can sometimes cause labor to slow down or stop. In rare instances, permanent nerve damage may result in the area where the tube was inserted. Some studies suggest that some babies will have trouble “latching on” causing breastfeeding difficulties. Other studies suggest that a baby might experience respiratory depression, fatal malpositioning, and an increase in fetal heart rate variability, thus increasing the need for forceps, vacuum, cesarean deliveries and episiotomies.
Both epidural anesthesia and general anesthesia have made a beneficial impact in the medical field. Both anesthetics block pain from affecting our body, that is why doctors are able to perform surgeries that are complex. Without anesthesia, many complex medical procedures could not be performed, which can result in an increase in death rate. Because of the many beneficial factors of anesthesia, anesthesia is one of the crucial fields in medicine.
Sources
“Anesthesia.” National Institute of General Medical Sciences,
www.nigms.nih.gov/education/Pages/factsheet_Anesthesia.aspx.
“What Is an Epidural?” WebMD, www.webmd.com/back-pain/what-is-an-epidural#1.
“Epidural.” American Pregnancy Association, americanpregnancy.org/healthy-
pregnancy/labor-and-birth/epidural-782.
Sherer, David. “Alternatives to General Anesthesia.” BottomLineInc, 1 Sept. 2017,
bottomlineinc.com/health/surgery/alternatives-to-general-anesthesia.
“Spinal and Epidural Anesthesia.” MedlinePlus, medlineplus.gov/ency/article/007413.htm.
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