What is anesthesia?

Anesthesia is the prevention of pain with the help of various drugs for a painless and safe surgery. Anesthesia not only prevents the person from feeling pain during the operation, but also creates an environment in which the surgeon can work. Today, with modern anesthesia techniques, patients can be operated comfortably with very little risk. Anesthesia is given by the anesthesiologist doctor.

What is pre-anesthesia evaluation?

Before the application of anesthesia, the anesthesiologist doctor meets with the patient and makes evaluations about the patient's health status. This assessment covers the following topics:

1. General health status of the patient, information about the diseases, if any.
2. Allergy status, drug allergies.
3. Medication use.
4. Information about previous surgeries, the surgical method and anesthesia techniques are used during these surgeries.

The current state of health is very important for the safety of the surgery and the patient. If necessary, pre-operative diseases are reviewed, whether they cause an obstacle to the operation is discussed, and treatments are rearranged. If the person has a known allergy, this should be stated to the anesthesiologist. Knowing drug allergies in particular prevents the use of these drugs during surgery and the problems that may develop due to a possible allergy. Some drugs that are used may cause undesirable conditions by making them prone to bleeding or interacting with drugs used in anesthesia. For this reason, it is important to know such drugs being used and, if necessary, to discontinue them under the control of an anesthesiologist before the operation. Previous surgery and anesthesia experience should also be known and one should be prepared for the risk that the difficulties encountered before may recur.

What tests are done in the pre-anesthesia evaluation?

Diagnostic tests that are primarily requested in the evaluation of anesthesia are as follows:

Lung film
Electrocardiography (usually requested in patients older than 30 years)
Blood count, liver and kidney function tests

If the anesthesiologist wishes, he or she may request other tests. A rough idea of ​​the lungs and heart is obtained with the preoperative chest X-ray and electrocardiogram. However, if the patient has a lung disease such as chronic bronchitis or asthma, an additional test such as a pulmonary function test or, if there is a heart-related disorder, additional tests such as echocardiography may be required. If the patient is found to have anemia in the blood count, it is corrected before the operation, and if there is a possible bleeding during the operation, a bag of blood is prepared for the patient. The patient's blood group should also be known before the operation. Some of the anesthetic drugs may have side effects on the liver and kidney. For this reason, these organs should be evaluated with liver and kidney function tests before anesthesia, and precautions should be taken in case of any disorder. Surgery risk is determined for each patient with the pre-anesthesia interview, physical examination and tests. The factors that increase the risk for the surgery and the patient's safety are corrected.

What is in the anesthesia room?

In the section reserved for anesthesia in the operating room, there are the following tools and equipments related to anesthesia;

Anesthesia machine: Drugs that stop the patient's consciousness and breathing are used to give anesthesia. After the patient's consciousness and respiration are lost, the patient is artificially ventilated with an anesthesia machine to maintain vital functions. With the help of this machine, the patient is given oxygen and sedative gases that provide the continuation of the anesthesia. A tube is placed from the patient's mouth to the trachea to ensure breathing. This event is called intubation.
Medications: Various medications are given to the patient to provide anesthesia. These drugs enter the circulation through a needle with a tap placed in one of the patient's veins. With these drugs, the patient loses consciousness, the sense of pain is eliminated, and the abdominal muscles are relaxed so that the surgery can be performed comfortably.

What kind of follow-up is done during anesthesia?

When the patient is taken to the operating room, electrodes are placed on the chest skin. Thus, heartbeats and rhythm are checked on the screen. Blood pressure is monitored by a cuff placed on the arm. Thanks to a precision instrument placed on the nail bed, the amount of oxygen in the blood can be monitored. Thanks to some advanced instruments, the amount of carbon dioxide in the blood can also be measured. During the surgery, heart rate, rhythm, blood pressure, oxygen in the blood
The amount of the drug can be closely monitored by the anesthesiologist, and any changes that may occur in these parameters can be intervened immediately with drugs. Thus, a safe anesthesia is provided.

What are the anesthesia methods?

Anesthesia methods; It consists of general anesthesia, Regional anesthesia: spinal anesthesia, epidural anesthesia, nerve block anesthesia and local anesthesia. The anesthesia method to be chosen is determined by the general health condition of the patient, the presence of concomitant diseases, and the surgical site. For example, if a knee surgery is to be performed in a patient with lung disease and inconvenient to receive general anesthesia, this can be done with spinal anesthesia provided by numbing the lower part of the waist.

What is general anesthesia?

General anesthesia is a method of anesthesia in which the consciousness is removed with the help of drugs and the whole body is under the effect of anesthesia. In general anesthesia, consciousness is lost with the help of a drug given intravenously. A tube is then inserted through the patient's mouth into the trachea. this tube
Thanks to this, oxygen and other anesthetic gases from the anesthesia machine pass from the lungs to the blood circulation, ensuring the continuation of the anesthesia situation. In addition, the patient is prevented from feeling pain by administering pain relievers intravenously.
At the end of the operation, the administration of anesthetic gases from the machine is terminated, and the tube in the trachea is removed when the patient's consciousness and breathing returns. This type of anesthesia method is applied in operations that cover large areas, such as brain surgeries, abdominal surgeries, heart surgeries.

Ways to make general anesthesia more reliable

Preoperative examination: The patient must be examined and questioned by the anesthesiologist before the operation. During the examination, concomitant heart, lung and systemic diseases should be investigated. The history of the patient should be carefully questioned whether he/she has a drug that he/she takes every day, whether he/she has drug allergy, whether he/she has received general anesthesia before, and if he/she has received general anesthesia before.
Quitting smoking: Smoking is shown as the cause of respiratory problems after surgery. When the patient quits smoking, it takes time between 1 week and 6 months for the improvement in the lungs to be fully seen.
Obesity: Postoperative problems are more common in obese people.
Empty Stomach: Although it varies according to age, a fasting period of at least 6 hours is required for adult patients before general anesthesia. Because problems such as vomiting due to satiety and leakage of stomach contents to the lungs can cause very important problems during and after anesthesia. Therefore, the patient should carefully follow what the anesthesiologist says about fasting for non-urgent surgeries.

What is spinal and epidural anesthesia?

Important points:

Anesthesia is the prevention of pain with the help of various drugs for a painless and safe surgery.
Anesthesia is given by the anesthesiologist doctor.
Surgery risk is determined for each patient with the pre-anesthesia interview, physical examination and tests. The factors that increase the risk for the surgery and the patient's safety are corrected.
Anesthesia methods; It consists of general anesthesia, spinal anesthesia, epidural anesthesia, nerve block anesthesia and local anesthesia.
During the surgery, the heart rate, rhythm, blood pressure, and the amount of oxygen in the blood are closely monitored by the anesthesiologist, and any changes in these parameters can be intervened immediately with drugs.
The anesthesia method is determined by the anesthesiologist, taking into account the general condition of the patient, diseases, surgery site and the patient's preference.

Spinal and epidural anesthesia are two anesthesia methods that have gained popularity in recent years. Among these methods, some operations of general surgery, gynecology and orthopedic surgery are frequently used. In addition, thanks to epidural anesthesia, postoperative pain control is provided. Spinal anesthesia is performed by administering anesthetic agents to the spinal space where the spinal nerves pass in the lumbar region. Anesthesia starts from two or three vertebrae above the injection level and spreads to the toes. This type of anesthesia is preferred in painless birth, gynecology operations such as cesarean section, general surgery operations such as hernia, appendicitis, orthopedic operations in the legs, and in relieving cancer pain. There is no loss of consciousness in this type of anesthesia method. The patient is conscious, but there is no pain in the anesthetized area. In epidural anesthesia, a small catheter is placed through the epidural space and left in this area. Postoperative pain can be prevented by administering pain relievers with this catheter for a day or two after the surgery. In addition, this method can be preferred in patients with heart disease where the drugs used in general anesthesia pose a risk, if the area to be operated is suitable.