General anaesthesia
General anaesthesia is administered using intravenous drugs through a previously applied intravenous cannula. The patient falls asleep soon after drug administration. To ensure correct ventilation, a tube is placed in the trachea or throat. An anaesthesiologist or a nurse anesthetist remains with the patient throughout the whole surgery, controlling
his/her vital functions. Owing to the connected equipment, it is possible to precisely determine how the body reacts to anaesthesia.
Complications of general anaesthesia.
Sometimes patients feel sleepy after anaesthesia or may suffer from vomiting or nausea. Throat irritation resulting from application of the intralaryngeal tube usually ceases after 1-2 days after the procedure. Sometimes there may be an allergy to general anaesthesia, which usually ceases after administration of anti-allergic drugs. Serious complications during general anaesthesia are often related to the general condition of the patient before the procedure; therefore it is important that your anaesthesiologist is informed about all health problems before the procedure.
Conduction anaesthesia
During conduction (local) anaesthesia, a part of the body e.g. legs or an arm are temporarily defi cient in locomotor and sensory function because the drugs affect nerves which are conducting pain and motor impulses.
Subarachnoid anaesthesia (spinal insertion)
Preparation of a patient for this type of anaesthesia is identical as in case of general anaesthesia. The patient is connected to controlling equipment and a drip. Anaesthesia (insertion) can be applied while the patient is sitting or lying on a side. Application of subarachnoideal anaesthesia is not more painful than insertion of a regular venous catheter. Upon drug administration, legs start to feel warm and go numb. After a while, the lower part of the body is numb and no moves are possible. The patient can be conscious or can ask for a soporifi c drug. An anaesthesiologist or a nurse anesthetist remains with the patient throughout the whole surgery. Depending on drugs administered, anaesthesia may take three to six hours. Pain appears when anaesthesia ceases.
Complications of subarachnoideal anaesthesia.
- Insuffi cient anaesthesia: in this case, an anaesthesiologist additionally administers a drug intravenously to improve the degree of anaesthesia; sometimes general anaesthesia may be necessary.
- Low pressure: most commonly involves nausea and vomiting; drug administration and transfusion of additional liquids eliminate these negative effects.
- High anaesthesia: most commonly involves numbness of hands and/or diffi culties in breathing; oxygen administration usually helps.
- Diffi culties in urination: sometimes occur during the fi rst postoperative period and result from anaesthesia of urinary bladder.
- Headaches: triggered by outfl ow of cerebrospinal fl uid through the place of insertion; prevented by application of very thin needles and fl at positioning of the patient during the fi rst period after the surgery.
Extradural anaesthesia.
Most commonly, it is applied together with catheterisation to the extradural space in order to provide anaesthesia for longer procedures and analgetic treatment during the postoperative period. The procedure is identical as in case of subarachnoideal anaesthesia.
Brachial plexus block.
This type of anaesthesia is applied to anaesthetise in procedures involving an arm and a hand. It consists of local anaesthesia of regions of nerves constituting
the brachial plexus. Depending on the procedure, insertion is performed in the side area of the neck or in the armpit. Preparation for brachial plexus block is the same as in case of other types of anaesthesia. Equipment controlling cardiac activity is connected; a drip needle is placed in a vein in the hand that will not undergo the surgery. To precisely determine the place of brachial plexus path and administer drugs, needles with electrostimulation are used. When the arm becomes numb or involuntary movements occur upon the needle, this means that the needle is in the right place. Then, an anaesthesiologist administers a drug. Anaesthesia becomes active about 20-30 minutes after drug administration.
The patient can be conscious during the procedure or can ask for a soporifi c drug. Depending on drugs administered, anaesthesia may take 3 to 6 hours.
Complications of brachial plexus block
- Insuffi cient anaesthesia: additionally, an intravenous analgesic or general anaesthesia can be applied.
- Postoperative fi nger numbness: in principle, ceases after a few weeks; results from nerve irritation by the local anaesthetic.
- Toxic reactions: triggered by incidental administration of local anaesthetic to a nearby artery or vein; most typical symptoms include: metallic taste in mouth,trembling around mouth, drowsiness, vertigo, anaesthesia of lips and tongue.
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