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General anesthesia

Definition

General anesthesia is treatment with certain medicines that puts you into a deep sleep so you do not feel pain during surgery. After you receive these medicines, you will not be aware of what is happening around you.

Description

Most times, a doctor called an anesthesiologist will give you the anesthesia. Sometimes, a certified registered nurse anesthetist will give you the anesthesia.

Anesthesia often involves more than one medicine. Some medicines are given into your vein. You may be asked to breathe in (inhale) a special gas through a mask. Once you are asleep, the doctor may insert a tube into your windpipe (trachea) to help you breathe and protect your lungs.

You will be watched very closely while you are asleep. Your blood pressure, pulse, and breathing will be monitored. The health care provider taking care of you can change how deeply asleep you are during the surgery.

You will not move, feel any pain, or have any memory of the procedure because of this medicine.

Why the Procedure Is Performed

General anesthesia is a safe way to stay asleep and pain-free during procedures that would:

• Be too painful

• Take a long time

• Affect your ability to breathe

• Make you uncomfortable

• Cause too much anxiety

As an alternative to general anesthesia, you may also be able to have conscious sedation for your procedure. Sometimes, though, it is not enough to make you comfortable. Children may need general anesthesia for a medical or dental procedure to manage any pain or anxiety they may feel.

Risks

General anesthesia is usually safe for healthy people. You may have a higher risk of problems with general anesthesia if you:

• Take large amounts of alcohol or other medicines such as sedatives, opioids, or illicit drugs

• Have allergies or a family history of being allergic to medicines

• Have heart, lung, or kidney problems

• Smoke

Ask your doctor about these complications:

• Death (rare)

• Harm to your vocal cords

• Heart attack

• Lung infection

• Mental confusion (temporary)

• Stroke

• Trauma to the teeth or tongue

• Waking during anesthesia (rare)

• Allergy to the medicines

• Malignant hyperthermia (fast rise in body temperature and severe muscle contractions)

Before the Procedure

Tell your provider:

• If you could be pregnant

• What medicines you are taking, even drugs or herbs you bought without a prescription

During the days before the surgery:

• An anesthesia provider will take a complete medical history to determine the type and amount of the anesthesia you need. This includes asking you about any allergies, health conditions, medicines, and history of anesthesia.

• Several days to a week before surgery, you may be asked to stop taking blood thinning medicines, such as aspirin, ibuprofen (Advil, Motrin), and warfarin (Coumadin, Jantoven).

• Ask your provider which medicines you should still take on the day of your surgery.

• Stop smoking. Your provider can help.

On the day of your surgery:

• You will likely be asked not to drink or eat anything after midnight the night before the surgery. This is to prevent you from vomiting while you are under the effect of the anesthesia. Vomiting can cause food in the stomach to be inhaled into the lungs. This can lead to breathing problems.

• Take the medicines that your provider told you to take with a small sip of water.

• Arrive at the hospital on time.

After the Procedure

You will wake up tired and groggy in the recovery or operating room. You may also feel sick to your stomach, and have a dry mouth, sore throat, or feel cold or restless until the effect of the anesthesia wears off. Your nurse will monitor these side effects, which will wear off, but it may take a few hours. Sometimes, nausea and vomiting can be treated with other medicines.

Follow your surgeon's instructions while you recover and care for your surgical wound.

Outlook (Prognosis)

General anesthesia is generally safe because of modern equipment, medicines, and safety standards. Most people recover completely and do not have any complications.

References

Cohen NH, Gropper MA, Mahajan A. Perioperative medicine. In: Gropper MA, ed. Miller's Anesthesia. 9th ed. Philadelphia, PA: Elsevier; 2020:chap 3.

Hernandez A, Sherwood ER. Anesthesiology principles, pain management, and conscious sedation. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 21st ed. St Louis, MO: Elsevier; 2022:chap 14.

Review Date: 1/23/2023

Reviewed By: Mary C. Mancini, MD, PhD, Cardiothoracic Surgeon, Shreveport, LA. Review provided by VeriMed Healthcare Network. Also reviewed by David C. Dugdale, MD, Medical Director, Brenda Conaway, Editorial Director, and the A.D.A.M. Editorial team.