When someone faces surgery, they most likely have many concerns. Among them usually include going under anesthesia. They may worry about losing consciousness, how they may feel afterward, or if it is even safe. There are several types of anesthesia that can be used depending on the needs of the surgery, such as: general, local, regional, and conscious sedation. In this paper, I will focus on discussing general anesthesia’s history, purpose, effects, and safety. History of Anesthesia.
Nearly 60,000 people nationwide undergo surgery using general anesthesia every day (Wein, 2011). Anesthesia is described as using a “combination of drugs” that makes surgery more tolerable for both doctors and patients. This type of anesthesia is usually administered through intravenous injection and inhaled drugs, which cause a complete loss of consciousness in the patient (NSRL, n. d. ). It also blocks pain as well as keeps the patient immobile during the operation.
Uses of anesthesia have been recorded and were experimented with by the Ancient Greeks, Romans, and Egyptians, whom of which documented their research in medical texts; however, there is also evidence of anesthetic use that predates written text going back thousands of years (Grupo Biblio Medical, 2009). This history of anesthesia has a painful background. “The primary motive was to save countless lives that were being lost every year by diseases and conditions unknown to the physicians of the time” (Hani, para 1, 2010).
Throughout our history, surgeons have tried many means to relieve pain during surgery. The most common came from plants and herbs, alcohol, or even a physical blow to render an unconscious state of the patient. Obviously, these methods often rendered significant consequences (Hani, 2010). Early plant derivative anesthetics range from: mandrake, henbane, and Datura and were utilized to numb the area in which to be treated (Fischer, 2011). In the thirteenth century, these derivatives were combined with opiates to induce a continuous dose of anesthesia within a patient (which created an unconscious state).
This alkaloid combination was used until the nineteenth century, when another plant was discovered as being used to attain pain relief-coca. It has been known that the Incan shamans used to chew coca leaves before performing skull operations. They believed that by drilling holes in the heads of people it would release their demons and cleanse them. The shamans would then spit into the wounds they had inflicted which would anesthetize them (Grupo Biblio Medical, 2009), and until the discovery of morphine, derivatives of cocaine were actually used until the twentieth century.
Just as popular are the inhalation of anesthetic drugs which began near the twelfth century. This process involved wetting a sponge in a solution of an anesthetic such as opium and other substances, was then dried and stored, and brought out for the patient to inhale just before the surgery. If everything went as planned, the patient was rendered unconscious after breathing in the fumes. There were many dangers in experimenting with these chemicals however, and some became extremely flammable.
One such chemical is known as “sweet vitriol” (presently known as ether) and was used until the eighteenth century when the discovery of nitrous oxide, also known as laughing gas, came about and completely replaced it (Grupo Biblio Medical, 2009). Even though the use of anesthetics has been somehow recorded since the pre-recorded history era-the study and experimentation of them have had the most breakthroughs just within the last 150 years, and have been almost perfected in the medical field.
There are no longer “experimentations” regarding anesthetics because the results are known, and fortunately, patients have options when undergoing procedures requiring anesthesia. The safety and efficacy of general anesthesia have been improved via the uses of intubation (breathing tube inserted down the throat) which allows for airway and breathing management, the use of electronic monitoring of patient vitals, and finally of course the standardized training programs that anesthesiologists (and nurses permitted to induce) undergo. Purpose of Anesthesia.
We now understand the basis for anesthesia and a brief overview of its history, but truly understanding the purpose of anesthesia really allows one to appreciate it. General anesthesia has three stages: induction (being put under), maintenance (being kept under), and emergence (recovering from being under), and purposes of use that are beneficial for both surgeons and patients, which are: analgesia (loss of response to pain), amnesia (loss of memory), immobility (loss of consciousness), unconsciousness (loss of consciousness), and skeletal muscle relaxation.
Depending on the surgery, only one or all of these symptoms may be required before performing. There are several factors that allow us to understand the importance of each (and scientists are constantly striving to improve the safety and effectiveness of all). Without the loss of pain, almost all surgical procedures would be completely unbearable and avoided by patients and doctors alike. If a patient could ever recall anything from the surgery it would most likely lead to post traumatic stress disorder (Hani, 2010).
Imagining the kind of impulsive fears that would run through the mind of a person if memories were attained during surgery are hard to fully comprehend and the psychological effects devastating. “Life-saving procedures like open-heart surgery, brain surgery, or organ transplantation would be impossible without general anesthesia” (Wein, para 4, 2011). In order for general anesthesia to be effective, it must affect a patient’s entire body. Immobility is necessary to ensure that no movement occurs as the surgeon is performing the operation.
If the slightest movement were to happen it could have detrimental and devastating results for the patient, which may leave them worse off than when they started. Unconsciousness and muscle relaxation are extremely important so as to allow easy maneuvering within the patient’s body and contributes to the amnesia (Wein, 2011). Risks and Rewards When a patient is induced, a series of deficits is experienced, as noted above. These include not remembering things, or repeating words, but having no memory of them after waking up.
Patients will then lose the ability to respond completely, and then the final step of maintenance, drifting into “deep sedation” (Wein, 2011). Though being induced under general anesthesia is commonly referred to as “going to sleep,” there has been much research that shows the exact opposite of a sleep-like state in the body. For instance, when a person sleeps, the body has continual muscle spasms and flexes throughout the sleep cycle. Under general anesthesia no movement of the body occurs at all. In fact, being induced is more closely related to a coma (a reversible coma) than sleep.
The ability to form memories, move, and feel pain are completely lost. These characteristics of general anesthesia is what enable dozens of thousands of people to under live-saving and elective surgery daily with little risks to those of which are in “good health. ” Several factors are included in one of many assessments usually done by the doctor for the patient before surgery is performed. Good health generally means anyone fitting the criteria falling under a certain age bracket, proper height and weight standards, non-smokers or abusers of any substances, and maintains a healthy and active lifestyle.
The effects of anesthesia on the body elsewise can be varied and complex. During the surgery several functions of the body are put under stress such as breathing, decreased heart rate, and decreased blood pressure (Tahoedoc, 2013). This suggests that the likeliness of a problem occurring during or after a procedure will increase due to the current health status of the patient. Once unconscious, the anesthesiologist uses monitors and medications to keep it that way, but in rare cases, something can go wrong.
“About once in every 1,000 to 2,000 surgeries, patients may gain some awareness when they should be unconscious” (Wein, para 11, 2011). When this occurs, patients may hear their doctors actually talking and remember what they said afterwards, or even worse, they may feel pain but of course are unable to tell the doctors or even move. This incredibly terrifying event is known as “anesthesia awareness”, is what may trigger post-traumatic stress disorder as mentioned above as a possibility (Wein, 2011).
Unfortunately doctors cannot accurately assess exactly which patients are at risk for this type of awareness, so science is not only researching in the general health of patients, but also genetic variations that may allow memories to form under anesthesia, and the process in which anesthesia is metabolized within the body (Wein, 2011). Proper doses and selection of drugs vary from patient to patient and prove vital to the entire operation and performance. Patients also usually worry about a lengthy recovery time, if they will be in pain, and if so… how much pain?
After the anesthesia wears off, there may be some discomfort and pain, but how quickly they recover is said to really depend on the medications used during the procedure, and the health factors previously addressed above. Every patient is different and no one person will heal exactly like another. Conclusion In this paper, I have discussed the history of general anesthesia, purposes, risks factors, as well as the effects it has on the body. These days, anesthesia is generally considered safe for most patients and has proven to become much safer over the last hundred years, especially regarding the problems people generally worry about, such as: the patient’s blood pressure being too low, or even dying.
According to one of the most recent estimates, only about 1 in 250,000 patients died after undergoing general anesthesia (Wein, para 20, 2011). If a person should choose to undergo on elective surgery it is important for them to be candid with their physician about any factors that could inhibit the process from going as directed, and understand the facts, risks, and rewards of using general anesthesia. The patient should discuss any concerns or fears they have about being induced and heed any caution or provide.
I believe knowing more about it may help a person feel safer or less concerned about anesthesia if they are provided the proper information about what it entails. ? References Fischer, A. (2011, August 04). Under the knife: Study shows rising death rates from general anesthesia. Retrieved from http://healthland. time. com/2011/08/04/under-the-knife-study-shows-rising-death-rates-from-general-anesthesia/ Grupo Biblio Medical. (2009, May 04). A brief history of anesthetics. Retrieved from http://www. grupobibliomed. com/? p=3 Hani. (2010, February 24).
History of anesthesia. Retrieved from http://explorable. com/history-of-anesthesia NSRL. (n. d. ). Neural signal processing algorithms. Retrieved from http:// www. neurostat. mit. edu/ Tahoedoc. (2013, April 03). How does anesthesia affect the body?. Retrieved from http://tahoedoc. hubpages. com/hub/How-Does-Anesthesia-Affect-the-Body Wein, H. (2011, April). Waking up to anesthesia: Learn more before you go under. Retrieved from http://webcache. googleusercontent. com/search? q=cache:http://newsinhealth. nih. gov/issue/Apr2011/Feature1.