Anesthesiologists use a wide variety of drugs, in multiple combinations, in order to ensure that patients remain comfortable, relaxed and free of pain during surgery or other procedures. Drugs administered by anesthesiologists are categorized as follows:
- Local anesthetics: Block transmission of nerve impulses without causing unconsciousness.
- General anesthetics: Bring about a state of unconsciousness.
- Analgesics: Relieve pain of patients before, during or after surgery.
- Sedatives: Bring about relaxation/calmness in a patient and reduce anxiety; higher doses can also be used to induce sleep.
- Muscle Relaxants: Work to paralyze skeletal muscles in order to facilitate intubation or surgery.
While only certified anesthesiologists can administer certain types of anesthesia, such as general, epidurals and spinals, some physicians/surgeons can apply local anesthetics without the presence of an anesthesiologist.
General anesthesia places the entire body, including the brain, into a state of unconsciousness (sleep) during which the patient has no awareness and feels nothing, and will remember nothing of the surgical experience. General anesthesia is administered by injection or through a breathing mask, or sometimes both. In order to control your breathing, patients are intubated, which is the insertion of a flexible tube down the windpipe. The tube is inserted after the anesthesia is given and removed as you are waking up and breathing adequately. Upon awakening from anesthesia, patients may experience disorientation and/or a mild sore throat from the intubation.
Laryngeal Mask Airway (LMA) – When possible, the anesthesiologist will use a Laryngeal Mask Airway device instead of intubation because it is quicker and causes less discomfort for the patient. An LMA is a tube with an inflatable cuff that is inserted into the pharynx (the upper part of the windpipe).
Regional (or Local) Anesthesia
Regional anesthesia is the injection of a local anesthetic around major nerves or the spinal cord to block pain from a large region of the body, such as a limb. Regional anesthesia provides muscle relaxation as well as postoperative pain relief since its numbing effects can last 8 to 12 hours, depending upon the dose. This reduces the need for pain medicine after surgery, as well as other side effects of surgery, such as nausea. If necessary, you may also be given a mild sedative to help you relax or sleep during surgery.
Types of regional anesthesia are:
- Axillary Nerve Block – Local anesthetic is injected around the nerve that passes through the axilla (armpit) from the shoulder to the arm to numb the feeling in your arm and hand. Typically used for surgery of the elbow, forearm, wrist, or hand.
- Bier Block – Local anesthetics are injected intravenously to numb a limb, typically the arm, and then a tourniquet is applied to prevent the anesthetic from leaving the area. Typically used on surgeries of hand or arm that last less than an hour
MAC (Monitored Anesthesia Care)
Monitored Anesthesia Care (MAC) is the intravenous administration of mild sedatives to help a patient relax and relieve anxiety during minor procedures that do not require general anesthesia. These procedures, such as biopsies and colonoscopies, typically require the injection of a local anesthetic to numb the surgical site.