Anesthesia

Anesthesia is the use of medications (called anesthetics) to keep you from feeling pain or discomfort during medical procedures. Anesthetics temporarily block nerve signals to your brain.

It works in different ways. Some anesthetics numb specific parts of your body. Others numb your brain so you can sleep through more invasive surgeries.

Every year, millions of people in the U.S. safely receive anesthesia. Complications are rare but include issues like allergic reactions and memory problems.

Types of anesthesia

The anesthesia your healthcare provider uses depends on the type and scope of the procedure. It also depends on your overall health and any prior reactions to anesthesia. Options include:

• Local anesthesia: This numbs a small section of your body. It can be topical (like a gel) or an injection. It’s for minimally invasive procedures, like dental work or a skin biopsy. You’re awake during it.
• Regional anesthesia: This blocks pain in a larger part of your body, like a limb or everything below your waist. Examples include an epidural during childbirth or an arm block for hand surgery. You may get regional anesthesia by itself or in addition to sedation.
• Monitored sedation: Also called “twilight sleep,” sedation relaxes you. You may be drowsy or fall asleep. Procedures that often use it include wisdom teeth removal and colonoscopies. You won’t be completely unconscious. But you likely won’t remember the process.
• General anesthesia: This makes you unconscious and blocks pain and touch sensations throughout your body. Providers use it for more invasive procedures or surgeries, like those that involve your head, chest or abdomen.

How should I prepare for anesthesia?

Make sure your healthcare provider has a current list of the medications and supplements you take. Certain drugs can interact with anesthesia or increase the risk of complications. Also, let them know if you’ve had a negative reaction in the past or if any of your biological relatives have.

Depending on the type you’re getting, your provider may give you specific instructions. For example, you need to fast for eight hours before getting general anesthesia.

What happens during anesthesia?

During anesthesia, a healthcare provider:

• Gives you one or more types of medications
• Monitors your vital signs, like your blood pressure and pulse
• Identifies and treats any issues, like an allergic reaction or a change in vital signs

How long anesthesia lasts depends on the procedure. Your provider will determine your dosage based on your needs and how long the surgery takes.

If you’re getting a local anesthetic, the provider doing the procedure often gives it to you (like a dentist). For more complex procedures, an anesthesiologist or certified registered nurse anesthetist (CRNA) will administer the anesthetics. They’ll monitor you before, during and after surgery.

What are the side effects?

Most anesthesia side effects are temporary and go away within 24 hours, often sooner. Depending on the type you get, you may have the following after anesthesia:

• Nausea and vomiting
• Itching
• Chills and shivering
• Muscle aches
• Fatigue or drowsiness
• Headache
• Pain, tenderness, redness or bruising at the injection site
• Constipation
• Sore throat (if you had a breathing tube while unconscious)
• Difficulty peeing (if you had regional anesthesia from the waist down)
• Confusion or delirium (this may last several days in people over 65)

What are the risks and complications?

Anesthesia complications are rare but can include:

• Allergic reactions: You may be allergic to certain anesthetics. It can cause symptoms like hives or flushing, swelling and difficulty breathing soon after you get the anesthetic.
• Anesthetic awareness: You’re aware of your surroundings under general anesthesia, but are unable to move or communicate.
• Local anesthetic systemic toxicity (LAST): LAST can develop within minutes of receiving local anesthetics. It causes serious nervous system and heart issues.
• Malignant hyperthermia (MH): This is an inherited syndrome that causes issues, like increased heart rate and breathing and a high body temperature.
• Nerve damage: Injections may damage nerves, causing temporary or permanent pain, numbness or weakness.
• Postoperative cognitive dysfunction: Some people have long-term memory and learning problems after procedures that require general anesthesia. It’s more common in people over 65 and those who have congestive heart failure, Parkinson’s disease or Alzheimer’s disease.

Your care team will act quickly if you develop any sudden complications. They know how to manage these issues.

What should I do after getting anesthesia?

After local anesthesia, you can typically return to work or most activities unless your healthcare provider says otherwise. You’ll need more time to recover after regional anesthesia, general anesthesia or sedation. If you had any of those three types, you should:

• Have someone drive you home.
• Rest for the remainder of the day.
• Avoid driving or operating equipment for 24 hours.
• Avoid alcohol for 24 hours.
• Only take medications or supplements approved by your provider.
• Avoid making any important or legal decisions for 24 hours.

When should I call my healthcare provider?

Call your healthcare provider if you have any of the following symptoms after anesthesia:

• Difficulty breathing or swallowing
• Extreme itching, hives or swelling
• Long-lasting numbness or paralysis
• Slurred speech