Anesthesia is an important medicine which is applied during the surgical procedures to make the respective patient unconscious so that he or she may not feel the pain and cause disturbances during the process. So it is very obvious that the anesthesia role in the surgical process is a very integral and important one.
The history of anesthesia is very old and wide. The necessity of inception of anesthesia medicine arises with the requirement of big surgical procedures felt in order to treat major diseases and health conditions which cause to increase in the mortality rate rapidly around the world.
The increased number of death rate caused by cancer, pregnancy and childbirth and other chronic medical concerns needed immediate surgical treatment in order to relieve such life-threatening health concerns. But it would not be possible if there will be no technique to make a patient sleep or unconscious during the surgical process.
So in the 1950s at the very first time in history, the necessity and importance of a professional anesthesia provider or physician anesthesiologist for the safe anesthesia service arise so that it won’t cause any risk during surgery and recovery could be made in a fully safe mode.
Though the first anesthesia was already used in the year 1846 in an operating room however in those days the safety risk of the concerned patient remains too high. This is because at that point of time ether fumes are needed to be inhaled by the patient which make them fall asleep instantly until the completion of the procedure.
However, the risk with this ether inhaling technique was too high as there was no preapproved or standard quantity established by the medical practitioners which could be considered as a safe quantity and would not involve any risk thereafter.
In the lack of proper knowledge and scarcity of a professional anesthesia provider, either the health practitioners give too much ether causing the patient fall asleep for a very long time where chances of recovery were less and some patient could not be able to wake up again causing death.
Again if less amount of ether were inhaled by the patient then they used to wake up during the processing time which was a big risk as any patient cannot tolerate the pain of seizer and stitches in their conscious mode and risk of death involved in these cases too.
However, with the improvement of medical science, these old practices are now better guided by the physician anesthesiologist who get well-trained support of nurse anesthetist and anesthesiologist assistant who have to undergo through a well-recognized medical training and study. Only certified anesthetics practitioner can only now conduct these practices.
This necessity of safe anesthesia arrives with the increased rate of major surgery cases where it is vital to make the concerned patient fall asleep or numbing of the affected area where the surgical process is going to be applied.
This includes a thorough evaluation of the concerned patient’s medical history. So as per the current condition and previous medical history of a patient it is decided before the surgery whether anesthesia is safe for them or not.
Anyone who is under special medication or has a past medical history which doesn’t support the anesthesia used for processing a surgery should not be given anesthesia otherwise chances of death and major side effects lie to a great extent.
Physical Checkups and Lab Tests for Anesthesia Application
Table of Contents
Before applying anesthesia on a patient it is very crucial that the concerned physician goes through the thorough medical history and current complete health details of the patient so that there will be no risk of any side effect or mortality due to anesthesia usage, before the surgery.
This pre-checking process includes both physical examination and laboratory test of the patient to make respective doctor understand whether it is safe to apply anesthesia on them or not. Also which type of anesthesia will be used even that will also be decided on the basis of complete medical detailing of the patient.
This medical verification includes diagnosis of current illnesses and the reasons behind its growth, past medical history of any major kind of illnesses such as the previous history of stroke, pulmonary infections, coronary artery disease, heart disease, diabetes, kidney, lungs, liver, hypertension, and reactive airway disease, etc.
Whether the patient has any past surgical history or not that is also very important to evaluate the condition of the patient whether he or she can tolerate anesthesia without developing any side effects.
This involves the type of previous surgical procedure, types of anesthesia provided during that surgery process and any complications developed or not with that particular anesthesia are some important points a surgeon needs to know before the surgery process and anesthesia application.
Apart from these details, a doctor will evaluate whether there is any family history of side effects developed due to the use of a certain type of anesthesia during the surgical procedure. Also, patient’s current habits of drug addiction such as tobacco, alcohol, illicit drugs, etc. also matter a lot for the use of anesthetic and preventing the risk caused by unsafe use of anesthesia without evaluating this important medical detailing of the concerned patient.
Physical Checkups
Important physical examine and check-ups which are vitals before the application of anesthesia to any patient includes the following:
Pulmonary System
- Oxygen saturation in the room air.
- Thoracic shape and size expansion of the patient.
- Auscultation.
Airways
- Teeth verification to evaluate a disease, artificial or loose tooth etc.
- Mobility level of the cervical spine.
- The mobility of the temporomandibular joint.
- Thyromental distance evaluation.
- Mallampati score or mouth opening.
Hematologic
- Clinical evidence for anemia.
- Bruising.
- Petechiae.
CV System
- BP evaluation including heart rate and rhythm.
- Pulse rate.
- Venous pressure.
- Edema.
- Auscultation for murmurs.
CNS Test
- Cognitive function evaluation.
- Sensory and motor function evaluation.
General
- Jaundice’s physical verification.
- BMI checkup.
Lab Tests
In the cases of invasive surgery, it is very important that some important lab test of important organs of the body such as heart etc. are done in order to prevent the risk factors during the surgery processing time.
In order to check the periodic abnormalities of the patient, ECG or Electrocardiograms diagnostic test is required in order to understand the current status of the patient. This will clarify whether it is safe to conduct surgery or not at that particular time.
ECG and some other important tests are needed as per the type of surgery, operating time and the expected amount of blood or fluid loss during surgery. In this regard, the previous history of major health concerns of the patient such as myocardial infarction, heart failure, valvular disease, angina, high cholesterol level also needs to be evaluated.
Types of Anesthesia
Anesthesia medicine is primarily divided into three types on the basis of purposes it is going to be applied. This medicine is an integral part of surgery which includes cuts and stitches. However, in the cases of a very small stitch on any body part, there is no such use of applying anesthesia as few stitches can be given to the patient in a conscious state.
Same way for certain medical procedures of surgery it is required for the patient to fall asleep for the very long duration as pain and stitches thereof remain too stressful to bear in the situation of the earlier gain of consciousness in the mid of processing time. So that on the basis of these important points anesthesia is divided into the following types.
Local Anesthesia
Local anesthesia is applied in the cases where very few stitches are required to give a patient and don’t include any further processing other than some stitches. As the anesthesia is provided on a very specific place where treatment will conduct so it is named accordingly.
In these cases, a whole body or a bigger portion of the body need not require to get numb for the treatment. For example, in order to fill a cavity, only that particular area of teeth is needed to be numb not the whole mouth.
Likewise, for some stitches in foot area not the whole leg portion of the body needed to be unconscious or numb, only anesthetic application in the foot is enough for the purpose.
Regional Anesthesia
Regional anesthesia is a little bit similar to the local anesthesia as in both the condition its patient remains conscious. However regional anesthesia is given in the cases of surgery of an especial body part in order to protect the patient from pain and discomfort caused by the surgery.
The numb area or proportion of body will be bigger than the local anesthesia cases but the patient will remain conscious during the processing. For example, in cases of leg surgery, your entire lower body part will remain numb for a longer duration.
In these cases, anesthesia blocks certain nerve group so that it won’t feel any pain related to that specific group of nerves or spinal epidural are given to numb a long area of the body till the surgery process conducted and even for some more hours to protect the patient from pain.
General Anesthesia
General anesthesia is the bigger form and type of anesthesia than the local and regional anesthesia. It is applied in very specific cases of surgery where the whole body is needed to be numb in order to start and process the surgery.
Within a few seconds, the person who gets this anesthesia sleeps down completely by losing his or her sense of consciousness. This type of anesthesia is vital for surgical cases where surgery time is a bit longer and indulge a huge amount of pain even after the processing.
This kind of anesthetic medication is given through veins via injection which makes patient fall sleep instantly. General anesthesia has some major side effects so it is very important that it is given by any specialist anesthetic nurse or assistant under the supervision of specialists anesthetic surgeon in order to avoid the risk factor.
Important Components for a Safe Anesthesia
Anesthesia is in one way a big medium of life savior which helps to make a big to small surgery process successful without any pain or discomfort. However, along with its huge benefits, it is quite risky as well as because of any minor mistake during the time of giving anesthesia can cause a risk of death or any major side effects too.
So it is very important that all safety measures remain available at the operating place where anesthetic medicine is provided to the patient to avoid such big risks. Some important components that help to enable a safe anesthesia processing possible are mentioned below.
Airway Management
For a safe anesthesia use, it is very important that the anesthesia provider has hands-on skill in airway management which involves breathing and oxygenation providing skills. In the open airway management, pulse oximetry close monitoring of oxygen saturation are conducted.
Along with pulse oximetry, capnography monitoring is done side by side which involves monitoring of carbon dioxide in the gases which is used for respiration. This safe processing has made the anesthesia much safer than its very initial stages of inception and has reduced or prevented the mortality rate to a great extent.
Cardiac Anxiety
In the cases of major surgeries especially which involves the use of general anesthesia one common side effect risk remains too high which is Myocardial depression. An unsafe anesthesia use can lead a life-threatening condition to the patient who has some underlying diseases or having unstable hemodynamic or hemorrhage.
Countries where an old form of anesthetic is used such as halothane, there myocardial depression side effects lies at a very high rate. However, the availability of some important rescue medications can prevent the occurrences of such cardiac anxiety leading to a safer anesthesia application for successful and safe surgery and recovery.
Perioperative Management or Care
Another important component that makes the anesthesia application in a very safer mode with easier recovery includes perioperative management or care. This includes a complete period of testing, diagnosis, operation functions initiated from the admission time of the patient to surgery and recovery thereafter in a safer form.
Proper management of the perioperative process is vital for safer use of anesthesia without developing any side effects thereafter. For this, the responsible personnel of the concerned medical department should evaluate the thorough medical history of the patient before the surgery date.
Also, post-operative care is too an integral part of the perioperative management which includes constant watch on patient’s condition until the next 30 days from the date of surgery and anesthesia application.
This important anesthesia management process takes care of very minute things such as cost-effectiveness so that the patient would not have to go through highly expensive screening tests before the surgery.
Its clear-cut policy is to get an optimal outcome with the least input. Evaluation of Comorbidities is done strictly which refers to the existence of more than one disorder at the same time along with the primary health disorder for which surgery is planned.
Apart from that, the perioperative care includes the pain management care too which involves proper assessing of pain caused by surgery and thereafter. This is very important as because in many cases in the lack of proper pain management or ignorance towards the pain generated by the surgical process the chances of mortality remains too high if the patient finds them unable to survive the pain.
So for considering the importance of all these important aspects and side effects caused by the anesthesia used during the surgical process, it is very important that there should be professional perioperative care in order to apply safe anesthesia during the surgical process.
With endless benefits out of safe anesthesia application, we can say that anesthesia role in the surgical process is immense and later one cannot be imagined without a modernized, well managed and highly effective anesthesia medicines for processing a safe operation.
[expand title=”View Article Sources“]
- https://www.ncbi.nlm.nih.gov/books/NBK333510/
- https://www.openanesthesia.org/overall_preoperative_evaluation_anesthesia_text/
- https://study.com/academy/lesson/what-is-anesthesia-definition-types.html
[/expand]