GENERAL ANESTHESIA implies reversible loss of the sense of pain, consciousness, reflexes and the emergence of a different degree of muscle relaxation. General anesthesia consists of several stages:
PREOPERATIVE PREPARATION OF THE PATIENT, PREMEDICATION – the purpose of this stage is to prepare the patient for entry in the operating room, that is, to reduce the excitement (stabilization of blood pressure and pulse). Sedatives intended to calm the patient and to cause mild amnesia are used as premedication. Use of sedatives is recommended also during the night before the surgery.
Introduction to anesthesia
The patient is already on the operating table. For the last time, the functionality of the anesthesia device is checked, and the patient’s vital parameters are checked (blood pressure, pulse and oxygen saturation). The introduction begins with the application of hypnotics (medications that induce an artificial state of sleep) through a venous line or by inhalation of volatile anesthetics that rapidly induce a state of deep sleep. This is followed by administration of a relaxant that blocks the conduction of the impulse to the muscle fiber and causes total relaxation of muscles. Next step is the performance of endotracheal intubation and placement of a tube that corresponds to the width of the trachea of the patient, or setting a laryngeal mask. This ensures safe airway. The tube or the laryngeal mask is connected to the anesthesia device. This is followed by administration of pain relief medications (analgesics).
CONDUCTING ANESTHESIA – in this stage the patient is introduced to a so called surgical anesthesia, that is, the most appropriate muscle relaxant and analgesic is chosen. The analgesics are applied continuously during the surgical intervention. The vital parameters are carefully monitored during the entire intervention.
Waking up from anesthesia
WAKING UP FROM ANESTHESIA – by terminating the administration of anesthetics, they are metabolized and eliminated. The patient slowly wakes up, reflexes return and the muscle tone is manifested with the occurrence of spontaneous breathing. The patient performs the commands of the anesthesiologist, aspiration of saliva and secretions is performed, the functionality of the protective reflexes is examined, and at the moment when these are satisfied, extubation of the patient is performed.
POSTOPERATIVE CARE OF THE PATIENT – it is performed in a special space, a unit for post-anesthetic care, which is in the vicinity of the surgical block. It consists of continuous monitoring of the vital parameters of the patient, stabilization of the condition of consciousness, oxygen therapy, treatment of postoperative pain, and postanesthetic nausea and vomiting.