Temporary loss of consciousness and decrease in reflex activity by administering various drugs to the patient by respiratory and intravenous means without any change in vital functions are called general anesthesia.
General anesthesia application prevents the patient's awareness during surgery by causing temporary loss of consciousness, eliminates pain and provides comfort to the patient during surgery, and facilitates surgical intervention by providing reflex activity reduction and muscle relaxation.
During general anesthesia, all muscles, including the muscles that allow the patient to breathe, are paralyzed. During the procedure, the patient inhales and exhales with a respirator.
The anesthesiologist regularly monitors the patient's vital signs during the procedure. Examination of parameters such as blood pressure, heart rate, oxygenation rate has an important value in terms of ensuring a safe surgical procedure. The purpose of general anesthesia, which provides a reversible loss of consciousness and desensitization to pain, is to ensure that the patient loses consciousness and does not feel any pain during the surgery by providing appropriate surgical conditions.
Before anesthesia is applied, the person is monitored and controlled. In addition, it is the duty of the anesthesiologist to maintain the patient's health and safety. In general anesthesia, various drugs are administered alone or in combination.
There is a preparation phase before anesthesia. The preparation phase for anesthesia is called preanesthetic medication or premedication.
Premedication Application Objectives
Calming the patient, relieving his/her concerns and fears about the surgery
Facilitate and accelerate induction
Eliminating the effects of anesthetics to be given (nausea, pain, allergies, etc.)
It is used to reduce the dose of surgical anesthetics to be given.
General anesthesia is administered by intravenous (intravenous injection, TIVA), inhalation (respiration, VIMA).
Intravenous anesthetics are anesthetic drugs that are applied into the veins (veins) to create anesthesia.
Inhalation anesthetics are given to the patient by airway. The anesthetic gas taken from the lungs primarily comes to the alveoli where gas exchange is provided in the lungs. It passes from the alveoli to the blood and is distributed through the blood to the brain and other tissues. When it reaches a certain concentration in the brain, then the anesthetic effect occurs.
The anesthesiologist monitors the health of the person throughout the surgery and reduces or increases the amount of medication depending on the situation. After general anesthesia, the patient is in a deep sleep and does not feel what is happening. The anesthesiologist then intubates the patient by giving muscle relaxants.
Thanks to intubation, artificial respiration begins by connecting to the anesthesia device, and thanks to this method, the pressure in the airway and the amount of anesthetic drugs in the body of the person is constantly monitored.
The effect of an ideal anesthetic substance should start quickly and end quickly. The longer the effect of the anesthetic substance lasts, the more its effects on the systems will continue.
There are 3 basic periods of general anesthesia.
1. Induction Stage: It is the stage where anesthesia begins. In fact, this phase is the only period that the patient can remember. The induction phase is the phase in which all systems begin to be affected. The most serious effect will undoubtedly occur in the respiratory system and circulatory system. It is a phase in which the patient cannot breathe on his/her own following the administration of the drugs, needs artificial support in this regard, and due to the suppression of protective mechanisms, dramatic changes occur in the vital signs of the patient. In order to keep these dramatic changes under control; the effects of the drugs that cause these changes, the mechanisms that cause these effects and the measures to be taken to prevent these results should be known.
2. Maintenance Phase: Following the initiation phase of anesthesia, it is the stage where the patient is now delivered to the surgical team with unconsciousness and airway patency. The stage where anesthesia continues is the maintenance stage.
The maintenance phase is a phase in which follow-up and measures are intense. The patient is connected to the anesthesia machine, respiratory functions are artificially provided by the machine, there is an ongoing surgical procedure.
3. Sobriety Stage: It is the stage where anesthesia is terminated and the administration of anesthetic drugs is completed. The most important issue that should be especially sensitive during the sobering phase is complications to the respiratory system. This stage should be considered especially important in terms of the types and approaches of complications that will prevent the patient from performing his/her respiratory functions for different reasons.
The anesthesia drugs used at the end of the surgery are terminated and the patient's breathing and reflexes are restored under the supervision of an anesthesiologist.
At the appropriate time, the patient leaves the respirator.
When her/his breathing is completely normal and she regains consciousness, she is taken from the operating table and taken to the recovery room under the observation of the anesthesiologist. The patient is relieved in the recovery room, heated, and sent to his room comfortably by taking some precautions against nausea and vomiting.