Anaesthesia

Anaesthesia

The anaesthesia or also general anaesthesia is a through medication caused, controlled state of the unconsciousness to which according to demand pain elimination and muscle relaxation are added. The anaesthesia allows the realisation of especially painful or otherwise not from the patient to tolerated procedures in the human medicine and veterinary medicine. A scientific description of the anaesthesia is " pharmacological induced, reversible coma " - a description rather disturbing for laymen. The narkosis apprenticeship is a branch of the Anesthesiology.

1. anesthesias allow only certain medical interventions. Thus middle interventions in the belly cave hardly practicable without complete muscle relaxation - are already a state which can be realised only under anaesthetic or regional anaesthesia near to spinal cord.
2. anesthesias reduce the risk of surgical interventions. The knowledge belongs to the question after the anaesthesia risk as the anaesthesia decreases for their part the risk of a measure of treatment. After each surgical intervention, the results of the operationstrauma most be treated from the anesthetist doctor. But also already by stress avoidance the anaesthesia can prevent long-term dangers of the patient. Thus, for example, stress-conditioned damages atherosclerotic plaques lead by blood pressure increases also months till years later to infarcts, embolisms and strokes. Such disastrous successions of an OP can be avoided by anaesthesia.

The duties of the patient

Like all medical processes the anaesthesia not only from the doctor, but also from the patient requires active proceeding. The approach must be arranged, in any case, with the anaesthetist. The premedication conversation serves for it in practice of the lowered anaesthetist or in hospitals in a special "premedication outpatient clinic". The patient finds out here from the anaesthetist all important to the forthcoming anaesthesia and receives answers to all his questions.

The doctor judges the anaesthesia ability and the anaesthesia risk. Together with the patient the suitable anaesthesia kind is chosen. The patient is cleared up in detail about the risks of the anaesthesia and signs a consent explanation. To guarantee the safe course of anesthesias by level-cash operations, is to be respected to an empty stomach to avoid the penetration of stomach contents in the respiratory tract (see below{at the bottom} in the segment Complications). Should the stomach emptying not be disturbed by special illnesses {diseases} or other grounds do not speak against it, the following action can be recommended accordingly of actual guidelines:

It is allowed to eat a little thing to 6 hours before the operations (e.g., a slice of white bread). After this term one can assume from the fact that the food has left the stomach and the upper alimentary tract.

Up to 2 hours before the anaesthesia small quantities (150-200 ml) of a clear liquid  can be drunk. E.g., clear apple juice or fruit tea which can be sugared something belong to it. There are also suitable industrially precast products. By no means murky liquids or even milk may be taken in this period. These drinks with which it concerns emulsions are defeated by the rules for steady food (6-hour rule see above).

6 hours before the operation the smoking must be also omitted, because thereby in special measure the gastric acid production is stimulated. This signifies: after a cigarette the stomach does not count more than blank, he is filled with very sour gastric juice. Nevertheless, the role of the smoking is judged controversially.  The 6-hours rule likewise counts to the chewing gum masticating.

The work of the anaesthetist

The anaesthetist moves the patient by damping or suppression of consciousness and pain sensation into a state in which extremely traumatic procedures can be tolerated without damage. The natural respiration is present by the intervention, however, often also by the anaesthesia impaired. The anaesthetist has to provide therefore for a sufficient respiration (i.e. oxygen care) of the patient.

For the realisation of the anaesthesia the anaesthetist needs technical aids. With an anaesthesia device (fig.) he can give artificial respiration the patient and supply gaseous and evaporateable anaesthetics (see segment Narcotics) beside oxygen also. Injectable anaesthetics are often given with special programmable sputter pumps.

The purposes of the anaesthesia are marked by three properties: consciousness loss (hypnosis), herewith psychic stress is avoided during an operation pain elimination (analgesy) . muscle relaxation (relaxation) makes different operations technically only possible. Thus big belly operations have become possible (for example, in intestine and stomach) only under the muscle relaxation which is not necessary, however, with all interventions.

Anaesthesia stadia

• Introduction
  The phase in which the drugs used to the anaesthesia only must reach a concentration managing to her effect in the organism. It comes in the introduction phase to extensive rearrangement processes between compartiments of the organism. The concentration at the active place (here brain) is vital. In this period another medical intervention (for example, OP) is not possible.
• Entertainment
  The drugs have reached a sufficient concentration in the brain. Concentration and with it effect allow the medical intervention (for example, the OP). In this phase the drug supply to the varying need is adapte. The necessity in addition can arise with the progress of the operation, because the regions of the intervention are differently sensitive to pain.
• Lead out
  After ending of the intervention the anaesthetics from the organism are eliminated.

The methods of the anaesthesia

General anaesthesia leads to hypnosis (sleep), analgesy (pain freedom) and muscle relaxation. The most important property of the anaesthesia is the lead in of an artificial "sleep" (academically seen it concerns, actually, a coma state). The muscle relaxation it is often renounced. Even the pain elimination is not necessary as a function of intervention now and then. Nevertheless, the procedure carries, even if only "sleep" should be caused, the name anaesthesia because with the sleep reflexes are limited. The anaesthesia leads to a desired reflex damping.

Local anaesthesia is a form of the anaesthesia. It causes by targeted application of anaesthetics the temporary, reversible functional inhibition of well-chosen nerves and, besides, leads to insensivity, pain freedom and inhibition of the active mobility in parts{sections} of the body. The local anaesthesia allows, as an alternative to the anaesthesia, disagreeable (for example, painful) medical procedures, how operations and different investigations.