What Is General Anesthesia?

General anesthesia is the type of anesthesia best known to the public.

But describing it only as "being put to sleep" is incomplete.

During general anesthesia it is not only consciousness that is switched off. Pain is controlled, the muscle relaxation required for surgery is provided, and the patient's vital functions are monitored and managed throughout the operation.

In short, general anesthesia produces a controlled and reversible loss of consciousness while the body's responses to surgery are also managed.

What happens during general anesthesia?

When general anesthesia is given, the patient enters a state resembling sleep. But it is not natural sleep.

In normal sleep a person still responds to some extent to stimuli around them. Under general anesthesia consciousness is switched off in a controlled way and the patient is not aware of what is happening.

At the same time:

• The sensation of pain is blocked
• Responses to surgical stimuli are reduced
• Muscle relaxation is provided where needed
• Breathing and circulation are kept under control

General anesthesia is therefore not simply the administration of a drug. It is a management process that continues throughout the operation.

How does it begin?

General anesthesia usually begins in the operating room.

Once basic parameters such as heart rhythm, blood pressure and oxygen level are being monitored, the anesthetic drugs are given. These are most often delivered intravenously.

In some cases, particularly in small children, induction with anesthetic gases through a mask may be preferred.

Once the drugs take effect the patient loses consciousness within a short time. From that point the anesthesia team monitors all vital functions continuously.

Does the patient breathe during general anesthesia?

The answer depends on the operation and the drugs used.

In some operations the patient continues to breathe independently. In others the drugs mean that breathing is temporarily supported, or taken over entirely, by the anesthesia team.

During surgery the following are therefore followed closely:

• Breathing
• Oxygen level
• Carbon dioxide level

One of the most important tasks of the anesthesiologist is to make sure breathing is maintained safely.

The four components of general anesthesia

Modern general anesthesia consists of four basic components.

Switching off consciousness

The patient is not aware of what happens during surgery and does not remember it.

Pain control

The pain signals generated during surgery are blocked.

Muscle relaxation

Some operations require muscles to be relaxed in order to be performed safely. This matters particularly in abdominal, thoracic and certain orthopedic operations.

Maintaining physiological balance

Heart rhythm, blood pressure, breathing and other vital functions are monitored throughout the operation, and treated when necessary.

Is general anesthesia safe?

This is one of the questions anesthesiologists are asked most often.

Modern anesthesia is in one of the safest periods in its history. Thanks to better drugs, advances in monitoring technology and higher patient safety standards, serious complications are far rarer than in the past.

No medical procedure is entirely without risk, however. Every patient is therefore assessed in detail before surgery. The aim is to reduce risk as far as possible and to build an anesthesia plan around the individual.

Is it possible not to wake up?

This is one of the fears patients express most often.

Most of the anesthetic drugs used today are short-acting. Once the operation is complete their effect wears off and the patient is woken in a controlled way.

The reason this fear persists is usually films, urban legends and experiences from earlier decades. Today the patient's condition is monitored continuously during anesthesia and drug administration is adjusted accordingly.

What is felt afterwards?

Every patient is different. Some things that may be seen after surgery are:

• Drowsiness
• Sore throat
• Feeling cold and shivering
• Nausea
• Dry mouth
• Fatigue

Most of these are temporary and resolve within a short time. Depending on the operation, additional methods of pain control may be used.

Who can have general anesthesia?

General anesthesia can be given across a very wide age range, from newborn babies to elderly patients.

What matters is that the preoperative assessment is done properly and that a suitable plan is made. That assessment reviews in detail:

• Heart conditions
• Lung conditions
• Diabetes
• Current medication
• Previous anesthesia experiences

What to pay attention to beforehand

There are some basic rules patients should follow before surgery. The first is the fasting period: a set time without food or drink is needed to prevent stomach contents from passing into the lungs during anesthesia.

It is also important for the anesthesia plan to report:

• Any medication being taken
• Any herbal products
• Smoking and alcohol use
• Any weight-loss injections used recently

General anesthesia and pain control

The aim of modern anesthesia is not only to remove pain during surgery. Reducing pain afterwards is an important part of the plan as well.

The following are therefore used frequently today:

• Nerve blocks
• Epidural catheters
• Regional anesthesia techniques
• Multi-drug combinations

The purpose is to improve the patient's comfort after surgery and to make recovery easier.