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The Role of Anesthesia in Pain Management

The Role of Anesthesia in Pain Management



The Role of Anesthesia in Pain Management

Anesthesia means the use of medications to prevent the patient from feeling pain during invasive treatments. Anesthesia is administered to patients undergoing surgery to numb specific parts of the body. It works by inducing a local or general loss of sensation, which means that the patient will not feel pain during procedures or surgery. Before every surgical procedure, an anesthesiologist will review the patient's medical history to plan the appropriate anesthetics for use during the surgery. Anesthesia helps facilitate surgical accuracy, ensure patient comfort and reduce trauma.

Understanding Anesthesia

Anesthesia refers to the use of medicines (anesthetics) to prevent pain during surgery and other procedures. It is administered to ensure the comfort and safety of the patient during a surgical procedure. Anesthetics may be given in the form of injections, inhalation, or topical lotion. They are administered during surgical operations to numb sensation in certain areas of the body, relieving the patient from pain and discomfort. The use of anesthetics makes it possible to carry out several medical procedures.

Types of Anesthesia

These are the common types of anesthesia:

  1. Local anesthesia: Only a certain area of the body is numbed, and the patient remains fully conscious during the procedure. Local anesthesia is given for minor procedures like stitching up a wound, pulling out a tooth, or performing biopsy. It can be administered via injection or applied to the skin to be absorbed.
  1. Regional anesthesia: This type is used to numb larger areas of the body, such as an arm, leg, or areas below the waist. Anesthetic is injected into a specific region of the body, and the patient will be awake during the procedure. Different forms of regional anesthesia include:
  1. Spinal anesthesia: Used for surgeries in the lower extremities, it involves injecting anesthetic medicine into the area around the spinal cord. When injected below the end of the spinal cord, it causes numbness in the lower body. This method is commonly used for orthopedic procedures in the lower extremities such as hip replacement. 
  1. Epidural anesthesia: Commonly used in childbirth, this procedure involves placing a catheter into the space in the lower back of the spinal cord and administering anesthetic medicine through the catheter. It is also used for chest or abdominal surgery and can be administered at a higher location in the back to desensitize the chest and abdominal areas.
  1. General Anesthesia: The patient will be unconscious during the procedure. It is used in major surgeries, such as heart surgery, brain surgery, and organ transplants. The patient either inhales the medicine through a breathing mask or tube or receives it via an intravenous (IV) line.

Why Anesthesia Matters

Anyone undergoing surgery will receive some form of anesthesia to prevent them from feeling pain during the procedure. General anesthesia involves a combination of intravenous medicines and inhaled gasses. The patient will fall asleep as soon as the anesthesia is administered. However, more than just putting the patient to sleep, anesthesia ensures that they do not feel pain during the procedure. The type of anesthesia administered depends on the type of surgery. 

General anesthesia is usually given for procedures that are time-consuming because it's safer and more comfortable for the patient to be unconscious. It is also used for very painful procedures and those that may involve significant bleeding or affect the patient's breathing, blood pressure, or heart rate. When the patient is under anesthesia, either during surgery or a procedure, the anesthesiologist will continuously monitor the vitals such as heart rate, blood pressure, breathing, to ensure they remain stable while the patient remains unconscious and pain-free.

The Anesthesia Process

Before a patient receives the scheduled operation, a consultation with the anesthesiologist and the patient is arranged to understand what type of anesthesia should be given. In this preoperative assessment, the anesthesiologist will ask about the patient's medical history, pre-existing medical conditions and also inquire about general lifestyle factors such as drinking or smoking habits, allergies to food, medicines, etc. 

Based on the assessment, the anesthesiologist will discuss the types of anesthesia suitable for the patient and explain the potential risks of it. The anesthesiologist will also discuss a plan with the patient regarding the anesthetic and pain control post-surgery. 

The preoperative assessment is an opportunity for the patient to ask the anesthesiologist any questions or express concerns they have about administering anesthesia. The patient will also be given instructions, such as how long they should fast before the surgery, and other necessary preparations for the surgery.

How Anesthesia Is Administered

Before the surgery takes place, the anesthesiologist will administer anesthetics to the patient, either in the form of a liquid injected into the veins or through gas, which the patient inhales via a mask covering the mouth and nose. The effects of anesthesia will take hold as soon as it is given. The patient may initially feel lightheaded before they become completely unconscious. The anesthesiologist will stay in the operating room throughout the procedure, monitoring the patient's vitals such as heart rate, oxygen concentration in the blood, and breaths per minute through an electronic monitoring device. They ensure that the patient continuously receives the anesthetic to stay unconscious. Painkillers will also be given through an IV to make the patient feel comfortable when they wake up.

Potential side effects of anesthesia:

There are temporary side effects associated with anesthesia, and they typically resolve within 24 hours. Patients who have received anesthesia may experience side effects such as:

  • Back pain or muscle pain.
  • Nausea or vomiting.
  • Difficulty urinating.
  • Fatigue.
  • Dizziness and feeling faint.
  • Headache.
  • Feeling cold or shivering.
  • Sore throat or hoarseness.
  • Itching.
  • Pain, tenderness, redness, or bruising at the injection site.

In some cases, anesthesia may carry a greater degree of risk. Potential risks or complications of anesthesia include:

Anesthetic awareness: In rare instances, about 1 out of every 1,000 individuals who undergo general anesthesia may regain consciousness during a procedure while being unable to move or communicate.

Collapsed lung: The use of a breathing tube in general anesthesia can lead to a collapsed lung, where air sacs in the lung fill with fluid, making it difficult for the patient to breathe.

Malignant hyperthermia: Malignant hyperthermia (MH) is a severe reaction to certain medications used in general anesthesia, resulting in fever and muscle contractions during surgery. MH is a rare inherited syndrome, so patients should discuss any personal or family history of MH with the anesthesiologist during the pre-operative assessment.

Nerve damage: Although rare, nerve damage can be a complication of anesthesia, leading to neuropathic pain that may be temporary or permanent, as well as numbness or weakness.

Postoperative delirium: After surgery, some individuals, particularly older patients, may experience confusion, disorientation, or memory difficulties. While this disorientation may come and go for about a week, some individuals may experience long-term memory issues.

Recovery After Anesthesia

When the anesthesia wears off, the patient will gradually wake up. Post-surgery, the patient will be moved to a recovery room and then later to their rooms. Some patients can leave the hospital a few hours after the surgery, and some need a few days, depending on the surgery received and the patient's condition. 

Once the effects of anesthesia subside, the patient may start feeling pain and discomfort. The anesthesiologist will advise the patient on pain management during recovery, both while in the hospital and after returning home. If the patient is discharged on the day of surgery, a family member or a friend should take them home, as they will not be able to drive after undergoing general anesthesia. 

The effects of anesthesia medication may remain in the system for a day or two, which can cause drowsiness. The patient's reflexes and judgment may also be affected.Once the patient is fully awake after the surgery, they will be given a sip of water. If the patient does not vomit and everything is well, they can drink water and then have a normal diet.

Aftercare

Patients are expected to be cautious during the recovery period at home after receiving general anesthesia. The patient may feel sleepy, drowsy, and nauseated, as anesthesia takes a day or longer to completely wear off. Here are a few things to keep in mind:

  • Spend most of the time resting or engaging in relaxing activities to facilitate faster recovery.
  • Consider taking leave from work.
  • Avoid engaging in challenging activities.
  • Do not drive.
  • Refrain from consuming alcohol.

Anesthesia Myths vs. Facts

There are plenty of misconceptions about anesthesia that can make the person undergoing surgery anxious. Asking the anesthesiologist about any concerns will help alleviate worries. Here are some of the common misconceptions about anesthesia:

Myth: The Anesthesiologist Doesn’t Stay in the Room.

Fact: It is a common misconception that the anesthesiologist will leave the room as soon as the patient is put under. This is not true, as the anesthesiologist will be there, constantly monitoring the patient throughout the entire procedure.

Myth: Anesthesia will wear off too soon.

Fact: Many people fear that anesthesia will wear off during the surgery, and they will feel the pain. During surgery, anesthesia is administered continuously. The patient will only wake up when the anesthesiologist stops giving the anesthetics at the end of the surgery.

Myth: Local Anesthesia Isn’t as Risky.

Fact: Whether the surgery is major or minor, or the anesthesia is local or general, they all pose the same level of risks. There are several risk factors associated with anesthesia, and it is advised to talk to the anesthesiologist to gain a better understanding of the procedure.

Myth: Tolerating pain will help in the healing process.

Fact: Tolerating pain and faster recovery have no connection whatsoever. In fact, higher levels of pain can increase stress hormone levels, which is not good for recovery. Patients get better faster and feel comfortable when there's less pain.

Anesthesia is an important part of surgery, whether it is minor or major. The administration of anesthetics keeps the patient from feeling pain and ensures comfort. Feeling anxious before receiving anesthesia is quite common. However, discussing your concerns or questions with your healthcare provider or anesthesiologist will help relieve your anxiety. The anesthesiologists will monitor and oversee your care before, during, and after surgery to ensure your utmost safety.