General Anesthesia

General anesthesia makes you unconscious and blocks pain sensations throughout your body. It allows you to undergo complex surgeries or medical procedures. It’s a controlled and reversible process that feels kind of like a deep sleep.

General anesthesia involves a combination of medications that:

• Make you unconscious
• Block pain (analgesia) and reflexes
• Relax muscles
• Cause temporary memory loss (amnesia)

You receive these through an IV or as an inhalable gas through a mask. They work by blocking nerve signals to your brain and changing the activity of brain chemicals (neurotransmitters). But they also affect essential functions, like breathing and blood pressure.

Every year, millions of people safely receive general anesthesia for medical procedures. But because of its effects, it has certain risks. That’s why anesthesia specialists oversee this procedure. Anesthesiologists and certified registered nurse anesthetists (CRNAs) have specialized training to give you the correct dose and monitor your health before, during and after going under.

Stages

The stages of general anesthesia include:

• Stage 1 (induction): You get anesthetics. You begin to feel their effects, but are still conscious. Your breathing is slow and regular. This stage ends with the loss of consciousness. It lasts only for a couple of minutes.
• Stage 2 (excitement): You have uncontrolled movements and a rise in blood pressure and heart rate. You still have airway reflexes (like gagging). Fast-acting medications make this stage very brief.
• Stage 3 (surgical anesthesia): This is the target stage. The medical procedure begins and continues at this stage. Your movements stop and breathing slows. Your care team can put a breathing tube in your throat because you no longer have airway reflexes.

In rare cases, there’s a fourth stage in which you have too much anesthetic in your body (overdose) and stop breathing. Your anesthesia provider will act quickly to return you to stage 3 if it happens.

How do I prepare for general anesthesia?

If you have a planned surgery that requires this type of anesthesia, you might need to meet with an anesthesia provider days before the surgery date. They’ll go over your medical history and the medications and supplements you take. All this information helps ensure a safe anesthesia procedure.

Your provider may tell you to stop taking certain medications or supplements before going under. They’ll also recommend other ways to improve your health leading up to surgery. Better health before general anesthesia and surgery can help improve your recovery. Be sure to follow their specific instructions.

You should also be prepared to:

• Avoid food and drinks for eight hours beforehand.
• Quit smoking to reduce breathing risks, even if it’s just for 24 hours before.
• Have someone drive you home after.

What happens during general anesthesia?

During general anesthesia, your anesthesia provider:

1. Gives you anti-nausea drugs to prevent nausea and vomiting after the procedure.
2. Gives you one or more types of medication through an IV or inhalable gas.
3. Waits until you reach stage 3 of anesthesia.
4. May insert a breathing tube into your throat to ensure you get enough oxygen.
5. Monitors your vital signs throughout the procedure.
6. Identifies and manages issues, like an allergic reaction or a change in vital signs (if they happen).
7. Stops the anesthesia when the procedure is over.
8. Removes the breathing tube at the end of the procedure as you start to wake up.
9. Monitors you as you recover.

Without general anesthesia, many surgeries would be intolerable or impossible. This type of anesthesia is generally safe. But it carries some risks and complications. Overall, complications are rare but may include:

• Allergic reactions: You may be allergic to certain anesthetics. It can cause symptoms such as hives or flushing, swelling and difficulty breathing soon after you get the medication.
• Anesthesia awareness: You “wake up” during surgery. You may be aware of your surroundings but are unable to move or communicate.
• Malignant hyperthermia (MH): This is a rare inherited syndrome that causes issues like increased heart rate and breathing and a high body temperature.
• Postoperative nausea and vomiting (PONV): Nausea and vomiting are common after procedures that use general anesthesia. But intense or prolonged vomiting can lead to surgery recovery complications.

Deaths related to anesthesia are rare. Other health complications are more likely to happen if you have poor overall health and/or the surgery is very complex or long. For example, you may be at risk of a heart attack or pneumonia. Some people have long-term memory and learning problems, called postoperative cognitive dysfunction. It’s more common in people over 65 and those who have congestive heart failure, Parkinson’s disease or Alzheimer’s disease.

General anesthesia recovery

Once your medical procedure is done, you’ll go to a recovery room. Your care team will continue to monitor you. You’ll slowly wake up. It tends to take one to two hours for general anesthesia to wear off.

You may feel groggy and disoriented. It’s also common to have emotional swings as you wake up, like crying, laughing or agitation. But you may not remember this.

Side effects of general anesthesia are common and usually brief. They may include:

• Nausea and vomiting
• Chills and shivering
• Sore throat (due to having a breathing tube in your throat)
• Confusion (postoperative delirium)
• Muscle aches
• Itching

You may have pain from the medical procedure. Your anesthesia provider will help manage this.