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Anesthesia at WNH

What is Anesthesia? 

Anesthesia is defined as the loss of feeling or sensation with or without a loss of consciousness. Actually, anesthesia does much more. In addition to keeping the patient pain -free during surgery, anesthesia controls the body’s reaction to stress and reduces the negative effects of fear and anxiety that frequently precede. 

Anesthesia Selection 

Anesthesia may begin with an injection or by inhaling gases mixed with air. Sometimes these methods are used in combination. Anesthesia is also classified by how much of the body is made to lose sensation and whether the patient is to remain conscious. (See specific types of anesthesia below.) Factors which will determine the type of anesthesia to be used include the patient’s overall health and medical history, the type of surgery, results of laboratory tests and patient preference. The patient’s safety and comfort will ultimately be the deciding factors. 

Regional Anesthesia 

When the loss of pain sensation in a limited area of a person’s body during a surgical procedure is desired, regional anesthesia techniques are used. This anesthesia is produced by drugs that temporarily interrupt the action of pain -carrying fibers. Unlike general anesthesia, regional anesthesia does not act on the brain to produce a loss of consciousness or awareness. In conjunction with a regional anesthetic, the anesthetist may administer a sedative or tranquilizer intravenously to help with anxiety and apprehension. The patient may have little or no memory of the surgical procedure.

Types of regional anesthesia:

  • Local - Reducing or eliminating the sensation of pain in a small area is frequently accomplished by directly injecting the area to be treated. This technique is utilized primarily for minor surgery and stitches. 
  • Spinal and Epidural - These two techniques are quite similar in the effect they produce. Both involve the injection of a local anesthetic drug into the lower part of the back between the bony vertebrae. Spinal anesthesia involves placement of the anesthetic into the fluid surrounding the spinal cord. Epidural anesthesia involves injection of the anesthetic into the epidural space just outside the spinal canal where the nerves leave the spinal cord. These techniques are most commonly used in obstetrics and surgical procedures of the lower abdomen, pelvis and lower extremities. 
  • Nerve Blocks - The administration of anesthetic agents in the area of single nerves or groups of nerves to numb the extremities or other parts of the body is called a “nerve block.” To make the administration of the block more comfortable, the anesthetist desensitizes the overlying skin with a local anesthetic. A sedative or analgesic (pain killer) may also be given intravenously. Because regional anesthesia involves only a part of the body and does not induce unconsciousness, it is often used for patients with diseases or physical conditions that may be undesirably affected by general anesthesia.

General Anesthesia 

General anesthesia is administered through the patient’s circulatory system by injection or inhalation. It acts primarily on the brain and nervous system rendering the person insensitive to pain and surgical stimulation. Combinations of inhaled gases and injected drugs are usually given for best results. Oxygen and inhaled gas anesthetics are dispensed from an anesthesia machine through a face mask or breathing tube temporarily inserted into the airway through the mouth or nose. Except in unusual circumstances, the breathing tube (endotracheal tube) is positioned after the patient is already asleep and removed prior to full recovery of consciousness. Modern gas anesthetics act rapidly and their effects are immediately reversible after surgery has been completed. General anesthesia is more commonly used when extensive and long surgical procedures are necessary, but is also appropriate for other surgeries, especially in emergencies.

Unwanted Consequences

In regional anesthesia one can experience undesirable reactions to the anesthetic if it is absorbed into the bloodstream too rapidly. Such systemic reactions can cause dizziness, ringing in the ears, a funny felling, loss of consciousness, seizures, and cardiac arrest. During spinal and epidural anesthesia, the blood vessels may relax and cause hypotension (low blood pressure). This may diminish the blood flow to the heart or brain. Infections at the site of injection are rare but can range from inconsequential to lifethreatening (meningitis). Permanent nerve damage is an extremely rare consequence of these techniques. In general anesthesia the likelihood of any consequences occurring depends on your preoperative medical condition, the nature of your operation, and the anesthetic technique used. Consequences can occur in the operating room, the recovery room, while recuperating in the hospital, or at home. Minor consequences such as sore throat, headache, hoarseness, drowsiness, muscle aches, and fatigue are common for the first several days. Other potential consequences are nausea and vomiting. Aspiration pneumonia (pulmonary infection caused by inhaling gastric contents into the lungs) is a rare but serious consequence of anesthesia. Other uncommon consequences could include low blood pressure, high blood pressure, irregular heart beat, heart attack, allergic reactions, airway blockage, lack of oxygen, physical injury, and muscle cramps. Please feel free to ask your doctor or anesthetist any questions about anesthesia including the risks and benefits.  

Anesthesia Providers

 At WNH anesthesia services are provided by Certified Registered Nurse Anesthetists (CRNA’s). Each CRNA obtains a Bachelor of Science in nursing before going on to a nurse anesthesia program. After completing 2-3 years of in-depth study and clinical work in anesthesia, candidates are eligible to take the national certification exam. All nurse anesthetists are required to pass this exam to practice as a CRNA and must also complete continuing education and recertification requirements every 2 years. CRNA’s practice in a wide variety of settings in which anesthesia services are necessary, ranging from large city medical centers to small rural hospitals. In rural areas, they provide 85% of the anesthesia delivered. Nurse anesthetists provide high quality anesthesia services combined with genuine concern for their patients. 

Patient Safety 

WNH is committed to minimizing the risks associated with anesthesia and surgical procedures. We do this by setting high expectations for our medical and hospital professionals, providing the best in medical technology and continuously monitoring and improving performance. Your safety is our number one priority.