General Anesthesia - Advantages and Disadvantages

It is important to take an active role in your own medical decisions. When faced with surgery, whether minor or major, Anesthesia is a large part of that surgery. Anesthesia controls pain levels so that there is not unbearable pain. Don't leave these important decisions to your doctor or the anesthesiologist (Dr. Andrew Snell). Become informed as to the choices you have and understand there are advantages and disadvantages to choosing General Anesthesia.

What is General Anesthesia - it is a state produced when a patient receives medications that create a controlled, reversible state of unconsciousness. When a person is under General Anesthesia they cannot be awakened even to secondary pain stimulus. They do not have the ability to remember what happened during the operation and are also unable to maintain adequate airway protection during the surgery so a ventilator is needed.

Some drugs that are often used as General Anesthesia include barbiturates or other hypnotic agents to induce sleep. Inhalation agents, opioids, and muscle relaxants as opposed to high concentrations of potent inhalation agents alone, is preferred for obstetrical applications.

One of the advantages to General Anesthesia is that it reduces intraoperative patient awareness and recall. You don’t want to have the patient remembering what happened during the surgery. It also allows for muscle relaxation for an extended period of time allowing for the doctors to do what they need to do. The use of General Anesthesia forces the need for a ventilator which may be a good thing in that it facilitates complete control of the airway, breathing and circulation. It also can be adapted to all procedures – especially if the extent or duration of the operation is unknown. Last but not least of the advantages of General Anesthesia is that it can be administered rapidly as in the case of an emergency and it is reversible.

Some of the Disadvantages to General Anesthesia are that it requires an increased complexity of care and associated costs. It also needs to have some degree of preoperative patient preparation. General Anesthesia can also induce physiologic fluctuations that require active intervention. Physiologic fluctuations are changes in oxygen, body temperature and cardiac arrhythmia just to name a few. Some lesser disadvantages to general anesthesia is nausea, vomiting, sore throat, headache, shivering and a delayed return to normal mental function.

It is essential that a patient communicates about their previous medical history such as kidney, heart or lung problems, alcohol status, diabetes, high blood pressure, smoking, stroke, jaundice and other psychiatric problems if any, to the doctor as such can have a direct affect on the anesthesia administered. The level of blood loss during a surgery can be greatly affected by the current medications taken by the patient. For example, aspirin can increase blood loss, so if the person is taking aspirin then he has to stop taking it a few days before the surgery. If these points are kept in mind, then risks can be minimized. Allergic reaction to the administered drug may occur in rare cases.

With all the advances in medications, monitoring technology and safety systems as well as highly educated anesthesiologists the risk associated by general anesthesia to a patient is very small. The mortality rate attributed to general anesthesia is said to occur at rates of less than 1: 100,000. So talk to your doctor and your anesthesiologist about the procedure and make an informed and wise choice as to what is best for you.

Symptoms & Preventive Measures of Over Dose of Local Anesthesia

In the field of medical history, there have been many such inventions that have changed the way we view medicine and medical procedures. From a key-hole surgery to an open heart surgery, every medical procedure has evolved over time to cater to thousands of patients around the globe. One of the things that haven’t really changed for decades is the use of anesthesia in medical procedures. We are not new to this concept. Remember your dentist who pricked you with a needle before extracting that tooth. Yes, that is one of the many types of anesthesia available and in use in the medical industry. The main purpose of using anesthesia is to numb the portion that needs to be operated on. This helps in reducing pain considerably, which makes even the most painful of medical procedures a bit more bearable. Basically, there are three main types of anesthesia: General, Regional and Local. The type of anesthesia to be used depends on the medical procedure to be performed. However, it is always good to remember that like any other medical procedure, there is a need for caution while handling any of the three types of anesthetics. This is more important in regards to the administration of Local Anesthesia. The reason being, that Local Anesthesia is mostly administered by a doctor or a nurse whereas the other two types require specialized experts who are also called anesthetists. In this article, we are going to discuss one of the complications that could arise due to improper administration of Local Anesthesia and what can be done to prevent it.

Anesthetic Toxicity due to Over Dose:

This is one of the most common errors that can occur while administering Local anesthesia and may lead to Anesthetic Toxicity. This occurs when the level of anesthetic in the blood is very high. This may occur as a result of an intravascular injection or repeated injections. An overdose of Local Anesthesia may cause the following symptoms:

1.    Depression of the Central Nervous System
2.    Dizziness
3.    Anxiety
4.    Drowsiness
5.    Circumoral Numbness or Tingling
6.    Increased Heart Rate and Blood Pressure
7.    Unconsciousness and Respiratory Arrest
8.    Cardiac Arrest

Preventive Measures:
1.    Follow proper technique while administering Anesthetic.
2.    Doctors or Clinicians should be aware of the maximum dosage to be given based on the weight of the patient.
3.    After administration, the patient’s condition needs to be monitored in order to detect early symptoms of possible toxicity.

Other complications related with Local Anesthesia include allergic reactions, infections, paresthesia, and complications due to temporary nerve block like facial paralysis. Most complications will disappear as the affect of the anesthetic agent is neutralized.

Local Anesthesia has been used in medical procedures for quite some time now. As we discussed, there are a few things that demands caution. However, with proper technique, knowledge and a skilled pair of hands, anesthesia is truly one of the marvelous inventions of medical science.

Benefits and Complications of General Anaesthesia

General anaesthesia is a method of treatment where in certain medications or anaesthetics are used to put a patient into a deep sleep or get him into a state of unconsciousness to ensure that the he does not feel pain during surgery. During this process, a close monitoring of the functions of the heart, kidney and lungs is crucial. A number of medications will be administered in order to ensure sleep, relaxation of skeletal muscles, amnesia and loss of control of reflexes of the nervous system. Once surgery is complete, the effects of these medications will be reversed and the patient will slowly regain consciousness.

General anaesthesia is used for five main reasons that are imperative for surgery, mainly to cause:
1)    Loss of response to pain
2)    Loss of memory
3)    Loss of motor reflexes
4)    Loss of consciousness
5)    Skeletal muscle relaxation.

General anaesthesia has its risks as well as benefits. Complications related to general anaesthesia include an allergic reaction to the anaesthetic used, temporary mental confusion, vomiting and nausea, nerve damage, lung infection, sore throat, skin ulcers, damage to teeth, lips, throat, tongue or vocal cords, heart attack or stroke, premature consciousness and sometimes even death.

Now let us consider the Benefits. The patient retains no memory of the surgery; it allows for multiple surgeries on different parts of the body simultaneously which is generally not possible with local anaesthesia, enables total control of the functions of the body by the surgeon.

It is best that the patient is well aware of both the risks and benefits of general anaesthesia. It is also imperative that the surgeon assigns a well seasoned anaesthetist to determine whether the procedure is appropriate for the patient and discuss this with the patient prior to the surgery.

Once the procedure is done and the patient has been sent home, the doctor must be contacted immediately if the person experiences any of the following symptoms: fever or chills, worsening mouth or throat pain and difficulty in breathing. These are all signs of post operative complications that could directly be attributed to an allergic reaction to the anaesthesia used.

General anaesthesia is generally safe for people with a healthy constitution but caution is required when administering it to people with the following conditions, as they have a higher risk of problems associated with general anaesthesia:
1.    people who abuse medications or alcohol
2.    people with allergies as well as a family history of being allergic to medicine
3.    people with lung, heart or kidney problems
4.     smokers

Though the risks are apparent, recent advancements in the field of General anaesthesia show that the benefits far outweigh them. Hi-tech electronic devices have enabled anaesthesiologists to carefully monitor the patient throughout the surgery. The device continually displays vital signs and monitors blood pressure, heart function, blood oxygen levels and respiratory patterns. Due to advancements such as these, the use of general anaesthesia has seen a dramatic surge and has made it possible to operate on patients who were here to fore consider too sick or old to undergo surgery.

For more information visit website: http://drandrewsnell.com/.

Local Anaesthesia - What You Need to Know

If you ever needed to have a surgery, you surely know what anaesthesia is. The most commonly used drug in hospitals around the globe. The word anaesthesia is derived from a Greek word meaning “loss of sensation”. The term “anaesthesia” was first coined by Oliver W Holmes in the year 1846 to explain insensibility to sensation by means of induced drugs. In a medical procedure, apart from numbing your sensation, anaesthesia is also used to induce other reversible effects on your body like relieving pain, reducing anxiety, causing amnesia to blank out your memory of the procedure or how it felt and paralyzing your muscles. Today anaesthesia can be broadly classified into three categories Local, Regional and General Anaesthesia. In this article, we will briefly discuss the first category Local Anaesthesia and the advantages and disadvantages involved in its use.

Local Anaesthesia

Local Anaesthesia is administered to affect just a small patch of the body. It obstructs the movement of nerve impulses and thus prevents the nerves from carrying pain signals to your brain without affecting the consciousness and sensitivity of other areas of the body. One very common use of Local Anaesthesia can be seen in dental procedures, where Novocaine shots are used to numb the nerves in the mouth. It does not leave the person unconscious. It rather helps in reducing pain and distress. Local Anaesthesia is readily available and can be easily administered.

The many advantages of Local Anaesthesia include;

1.    The patient does not lose consciousness.

2.    The patient is sustained by his own breathing.

3.    The risk of being choked by gastric content is improbable.

4.    Patient recovery is fast and smooth and does not need much skilled attention.

5.    Surgical stress is reduced considerably.

6.    Hospitalization may not be necessary for outpatients.

7.    The anaesthetic action stays for a longer time and provides pain relief even several hours after surgery.

8.    Patient can almost immediately resume normal activity like eating, walking and so on.

The disadvantages of local Anaesthesia include;

1.    Causing lethargy in Patients.

2.    Administration requires practice and skilled person for better results.

3.    In some instances, it may take up to 30 minutes or more for the effect to be seen on patients.

4.    In some cases, it may not even be effective and may require a combination of both General and Local Anaesthesia.

5.    In some cases, if Local Anaesthesia is administered intravenously or an overdose is given there are chances of toxicity.

Cocaine was the first anaesthetic to be discovered and still remains the only naturally produced local anaesthetic. Though used commonly in the 1800’s, the toxic effects of Cocaine were soon identified and this led to the need of developing a much safer means of local anaesthetic. The development of modern organic chemistry resulted in the development of synthetically derived Local Anaesthetics. The decades of growth in the field of science and medicine has seen the evolution of Local Anaesthesia as a more preferred and safer anaesthetic option. The future of Local Anaesthesia is bright with many more efforts and clinical trials being undertaken to make it more effective in various medical procedures.

For more information visit website: http://drandrewsnell.com/.

The Impact of Intra-Operative Transoesophageal Echocardiography on Cardiac Surgical Practice

The use of transoesophageal echocardiography during cardiac surgery has increased dramatically and it is now widely accepted as a routine monitoring and diagnostic tool. A prospective study was carried out between September 2004 and September 2007, and included all patients in whom intra-operative echocardiography was performed, 2 473 (44%) out of a total of 5 591 cases. Changes to surgery were subdivided into predictable (where echocardiographic examination was planned specifically to guide surgery) and unpredictable (new pathology not diagnosed pre-operatively). A change in the planned surgical procedure was documented in 312 (15%) cases. In 216 (69%) patients the changes were predictable and in 96 (31%) they were unpredictable. The number of predictable changes increased between 2004-5 and 2006-7 (8% vs 13%, p = 0.025). In these cases, intra-operative echocardiography was specifically requested by the surgeon to help determine the operative intervention. This has implications for consent and operative risk, which have yet to be fully determined.

For more information please visit website: http://drandrewsnell.com/.