When it comes to anesthesia, many individuals who’ve experienced it might describe the process as “taking a nap and waking up after the surgery.” This aspect of surgery, often considered relatively “invisible,” has kept anesthesiologists shrouded in a veil of mystery.
October 16 marks World Anesthesia Day, and we had the opportunity to interview Dr. Sun Yang, an anesthesiologist at Peking Union Medical College Hospital and a member of the Democratic National Construction Association of China. He shared some insights into the intricate stories behind the “sleep” experienced during surgery.
**A Customized “Painless” Approach**
In modern surgery, anesthesia is not merely about putting patients to sleep; it is a complex and critical process that creates optimal conditions for surgeons.
Dr. Sun explained that anesthesia methods are generally divided into general and local anesthesia. Local anesthesia includes techniques like epidural anesthesia and regional blocks. The selection of each type is tailored by anesthesiologists to meet the specific circumstances of each patient and the requirements of their procedure.
General anesthesia, as most people understand it, equates to “being asleep,” or in medical terms, “loss of consciousness.” Local anesthesia, on the other hand, involves injecting anesthetics in specific areas—such as administering an epidural block during labor to effectively ease pain without affecting labor progression. Regional anesthesia utilizes ultrasound guidance to precisely inject anesthetics around nerves, achieving the desired localized numbness.
However, determining the best method of anesthesia is not a one-size-fits-all answer. “We need to consider the patient’s health status, the type of surgery, and the potential risks and benefits to determine the most suitable anesthetic plan,” Dr. Sun stated. For patients with severe cardiovascular or pulmonary conditions, anesthesiologists often prioritize methods that have the least physiological impact to ensure quicker recovery and minimize surgical risks.
Importantly, anesthesiologists also assume the role of “safety guardians” during the procedure. “The surgeons address the medical issues, while anesthesiologists are responsible for maintaining the patient’s vital signs,” Dr. Sun explained. Parameters like breathing, blood pressure, heart rate, and even body temperature are monitored and adjusted continuously by anesthesiologists.
**Distinguishing Between “Intraoperative Awareness” and “Necessary Consciousness”**
As the role of anesthesiologists gains visibility, numerous misconceptions about anesthesia have surfaced.
“Some patients worry that they might suddenly wake up during the surgery and feel pain or see the surgical environment,” Dr. Sun clarified. In reality, the likelihood of intraoperative awareness is extremely low, particularly with current monitoring technologies that enable anesthesiologists to continuously assess a patient’s consciousness level, ensuring they remain unconscious during general anesthesia.
That said, certain specialized surgeries do necessitate patient alertness. For instance, during specific brain surgeries, doctors may require patients to perform certain actions or respond verbally to ensure critical nerve structures aren’t inadvertently harmed. In these cases, the ability to awaken the patient is not an issue but rather a pivotal component of surgical success.
To alleviate fear and anxiety in patients who remain conscious due to local anesthesia, anesthesiologists typically administer appropriate sedatives to keep patients calm and comfortable. “This is a reflection of compassionate anesthesia,” Dr. Sun noted.
**Preoperative Preparation and Postoperative Recovery**
Preoperative preparations are crucial for safe anesthesia. Patients are usually required to fast prior to surgery, not only to avoid vomiting during the procedure but also to prevent the aspiration of gastric contents into the trachea, which can be dangerous. Dr. Sun emphasized, “Aspiration of stomach contents into the lungs can lead to aspiration pneumonia, with potentially severe consequences.”
In addition, “removing makeup” before surgery is equally important. Products like nail polish and lipstick can interfere with the medical team’s assessment of the patient’s physical condition, as changes in nail color can affect the monitoring of blood oxygen saturation.
After anesthesia, patients may experience symptoms like nausea and pain. Dr. Sun explained that nausea is not solely a direct result of anesthetic drugs; it is also related to the nature of the surgery, other medications used, and the patient’s individual constitution. “For instance, patients may experience temporary gastrointestinal dysregulation and nausea after gastrointestinal surgery.”
To manage postoperative pain, modern medicine offers various pain relief methods, from traditional oral medications to nerve blocks and postoperative pain pumps. Doctors can select the most appropriate pain management plan based on each patient’s specific situation to alleviate discomfort.
“Some patients worry about the effects of anesthetic drugs on the brain and memory,” Dr. Sun reassured. “Current anesthetic techniques and medications have a temporary and reversible impact on the body; the metabolic rate of anesthetic drugs within the body is rapid, so there’s no need for such concerns.”
In recent years, the field of anesthesiology has made significant advances. Dr. Sun noted that with the development of anesthetic drugs, techniques, and the efforts of specialized professionals, the safety and comfort of surgical procedures have greatly improved.
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