Arguably one of the most important aspects of all kinds of surgery, anesthesia is used not only to prevent pain during surgery, but to ensure a safe procedure for all concerned.
Stanford Plavin explains that there are three main types of anesthesia used, depending on the surgery: local, regional, and general. Each requires a careful balance of the right drugs, administered by an anesthesiologist, for the most appropriate, pain-free care.
Types of Drugs Used During Surgery
There is a myriad of drugs on today’s market, and the anesthesiologist’s job is to select the right ones for the specific surgery.
Local Anesthetic
For routine procedures, such as stitching a wound or taking a small biopsy, a local numbing agent is applied to the area and once the procedure is finished, it wears off relatively quickly.
Drugs such as Lidocaine, Mepivacaine, and Bupivacaine are examples of amino amides local anesthetics, that work by blocking nerve impulses and thus numbing the area for the required time.
There are similar drugs, belonging to the group amino esters, and they include Procaine and Tetracaine. The main difference between the two groups are the complex effects they have on the body’s system, so the anesthesiologist must decide on the correct drug for the procedure.
Regional Anesthetic
When numbing a larger area, such as from the waist down, a regional anesthetic is used, and the patient remains conscious.
A common use for a regional anesthetic would be an epidural for a woman in labor, and this is usually administered using such drugs as Bupivacaine or Lidocaine, along with opioids, including Fentanyl and Sufentanil.
General Anesthetic
The most complex is general anesthetic, where the patient is put to sleep for the duration of the procedure. An anesthesiologist must balance sedative drugs with analgesics, the drugs that prevent pain.
Propofol is most used to send a patient to sleep, via an IV in their arm. It allows the patient to continue to breathe by themselves. Other drugs include Midazolam, which helps a patient relax, and can be given even before they have entered the operating room.
Pain relief administered during and after surgery can range from Acetaminophen (known in many places as Tylenol) to stronger narcotics like Morphine and Fentanyl.
For lengthy, complicated surgeries, inhalant drugs are used to not only send a patient to sleep but ensure they have no memory of the surgery. These drugs include Sevoflurane and Desflurane.
Deciding Which Drugs to Use
Anesthesiologists are fully trained doctors who have specialized in anesthesiology medicine. The decisions they make on the drugs they use are based on a complex mix of factors.
The anesthesiologist examines the details of the intended surgery, such as the length of time anesthesia will be needed. They determine what kind of anesthesia is required (local, regional, general) and in what dose.
They must also consider existing medical conditions, allergies, or possible interreference from other drugs when performing anesthesia.
All these factors ensure a procedure that is as efficient and pain-free as possible, leaving the patient with better chance for a swift recovery and no long-lasting effects.
