4 Main Types of Anesthesia and How They’re Used

The goal of anesthesia is to keep you pain-free during surgery or other procedures, such as dental work or sutures. This is achieved by the use of medications called anesthetics. Anesthesia prevents the feeling of pain by stopping nerves from passing signals to the brain.

Anesthesia is commonly characterized into four main types:

• General
• Regional
• Local
• Sedation (monitored anesthesia care, or MAC)

The choice of anesthesia depends on factors such as the procedure, the individual’s health, and preferences.

General Anesthesia

General anesthesia is used for major operations, including (but not limited to):

• Brain and heart surgeries
• Organ transplants
• Knee and hip replacements
• Certain types of surgical procedures to treat cancer

It is the strongest and the most frequently used type of anesthesia.

An anesthesiologist administers the anesthesia through a mask or an intravenous line (IV) placed in the vein.

During general anesthesia, you will be unconscious, and many of the body’s functions will slow down and need support to work effectively. A tube may be placed in the throat to help you breathe. During surgery, the anesthesiologist will monitor the your heart rate, blood pressure, breathing, and other vital signs.

When the surgery is complete, the anesthesiologist will reverse the medication and continually monitor your breathing, circulation, and oxygen levels.

Some people may feel side effects from the medication. The anesthesiologist will help you manage these symptoms.

Side Effects

Side effects of general anesthesia include:

• Nausea and vomiting
• Sore throat
• Postoperative delirium (confusion when regaining consciousness)
• Muscle aches
• Itching
• Chills and shivering (hypothermia)

These side effects may go away after some time.

Risks

Rarely, general anesthesia can cause more severe complications. Some risks are present and include:

• Postoperative delirium (sudden mental disturbance after surgery) or cognitive dysfunction can cause confusion and memory loss, lasting longer than a few hours or days. This can result in long-term memory and learning problems in certain people. Delirium is more common in older people, and those who have conditions such as heart disease, Parkinson’s disease, Alzheimer’s disease, or stroke are more at risk.
• Malignant hyperthermia (severe reaction to anesthesia) can occur during surgery, causing a fever and muscle contractions. Tell your anesthesiologist if you have a family history of heatstroke or suffered from malignant hyperthermia during a previous surgery.
• Aspirationwhich occurs when food or fluids are vomited up and into the airway during surgery. This is why it is advisable not to eat in the hours before receiving general anesthesia.
• Death (rare) is a risk of general anesthesia due to overdose. The risk increases with age.

Local Anesthesia

Local anesthesia numbs a small part of the body. It might be used for procedures such as pulling a tooth, performing a skin biopsy, repairing a broken bone, or stitching a deep wound.

In local anesthesia, you are awake and alert and may feel some pressure, but you won’t feel pain.

Side Effects

Local anesthesia is the least likely to cause side effects. However, you may feel sore or experience itching at the injection site.

Regional Anesthesia

Regional anesthesia numbs a large part of the body, such as an arm, a leg, or from the waist down. The anesthetic is delivered through an injection or small tube called a catheter. You may be awake or given sedation during the surgical procedure.

Regional anesthesia includes spinal blocks and epidurals and is often used for childbirth and minor surgeries:

• Epidural: Commonly used to reduce pain during labor and delivery. It allows the individual to be awake and able to push to deliver the baby.
• Spinal block: Is stronger and is used for cesarean deliveries, also known as C-sections.

Spinal blocks and epidurals allow the healthcare professional to surgically deliver the baby without causing pain to the person giving birth. It also protects the baby from the harmful effects of sedating drugs.

Side Effects

Regional anesthesia is safe and doesn’t involve potential complications or side effects. However, it carries some risks and must be provided and monitored by an anesthesiologist.

Risks

The risks and benefits of regional anesthesia should be assessed individually.

Fortunately, severe complications, including spinal cord damage, vertebral cord hematoma, and epidural abscess (infection between the bones of the spine and the membrane of the spinal cord), are quite rare.

Sedation

Sedation makes you sleepy and keeps you from feeling pain. It is also known as monitored anesthesia. There are different levels of sedation. Some people are drowsy but awake and can talk. However, others fall asleep and don’t remember the procedure.

Side Effects

Sedation has fewer side effects than general anesthesia and generally goes away quickly. Some common side effects include:

• Headache
• Nausea
• Drowsiness
• Difficulty urinating (if numbed from the waist down)
• Hematoma (bleeding beneath the skin)

Risks

Severe complications are rare, but they can be a risk factor and include:

• Pneumothorax: When anesthesia is injected near the lungs, the needle may accidentally enter the lung. It can cause a lung collapse, filling trapped air between a lung and the chest wall.
• Nerve damage can occur, causing temporary or permanent pain.

How to Prepare For Anesthesia

Your anesthesiologist will meet you a day before the procedure to discuss all pertinent medical information, such as:

• Allergies
• Chronic health conditions, including high blood pressure, heart problems, diabetes, liver or kidney disease, sleep apnea, thyroid disease, asthma, chronic obstructive pulmonary disease (COPD), or other breathing problems
• Smoking history
• Alcohol intake
• Prescription or over-the-counter drug use, including nonsteroidal anti-inflammatory drugs (NSAIDs), steroids, insulin, or oral hypoglycemics
• Pregnancy

If you’re getting general anesthesia, your healthcare provider will ask you to stop eating and drinking six to eight hours before the procedure.

Anesthesia relaxes the muscles of the stomach and throat, which can cause food to back up and get into the lungs. An empty stomach helps prevent this.

The American Association of Anesthesiologists’ guidance suggests that you can drink sugar-free, clear liquids, like water, for up to two hours before the surgery.

Your healthcare provider may tell you not to use certain medications a few days or more before your surgery due to potential interactions with the drugs used for anesthesia. These include blood thinners such as Plavix (clopidogrel) and Jantoven (warfarin) and NSAIDs like aspirin and Advil (ibuprofen).

Tips For Recovery

Recovery from anesthesia varies depending on the type of surgery and the type of anesthesia given. The following are the different stages of recovery from anesthesia.

General anesthesia typically requires a longer recovery time than other types of anesthesia.

After the surgery, an anesthesiologist reverses the medication. The person will be shifted to a recovery room. A healthcare professional will continue to monitor breathing, heart function, and vital signs in the recovery room.

Some people feel sleepy as the anesthesia wears off. Others may have side effects such as nausea, vomiting, chills, or a sore throat from a tube that helped breathing during surgery.

A discharge from the hospital will depend on the type of surgery you had and the time to recover. You may continue to be sleepy, and your judgment and reflexes may take time to return to normal.

For other anesthetics, the recovery process is as follows:

• Sedation: Recovery is similar to general anesthesia, but you will usually wake up quicker and recover faster.
• Regional anesthesia: Recovery from regional anesthesia is quicker. However, people may sometimes experience headaches.
• Local anesthesia: Local anesthesia does not require recovery time and has no side effects.

Summary

Different types of anesthesia are used to remove pain and sensation during surgery or other medical procedures. They work on brain and spinal cord nerves to achieve a loss of sensation.

Anesthetics are medications used to achieve anesthesia, and the specialist administering them is called the anesthesiologist. Anesthesia is classified into four main types: general, local, regional, and sedation.

The selection of anesthesia type and its mode of administration can depend on several factors, such as the procedure, individual factors (like certain health conditions), and preferences.