What is it - a modern anesthesia? Horror stories and horror films of
“And it will not be sick?“ Often any doctor concerning surgery should hear such question. And quite often this question is followed by recognition: “I operation am not afraid, me of an anesthesia terribly!“
Is interesting that fears happen mutually exclusive. One demands “the general anesthesia“: “I do not want anything to see, I want to hear nothing, to me it is terrible“. As a rule, it when it is fine possible to manage local anesthesia.
And another, on the contrary, demands local anesthesia: “I am afraid to fall asleep and not to wake up. The doctor, I is patient / patient. To me only not to sleep!“ On a twist of fate, it almost always in situations, when local anesthesia it`s really too much.
Fears and prejudices of patients - a subject for the separate poem, but here I will address them as I tell about modern anesthesia.
Stepping on a throat to own song, I will pass the story about the most interesting and dramatic history of modern anesthesiology. I will be extremely practical and pragmatic.
All types of anesthesia at surgeries and different painful or extremely unpleasant manipulations can be divided into three groups.
The general anesthesia is, as a matter of fact, and there is an anesthesia.
Regional anesthesia - when is anesthetized only a separate site (region) of a body.
Local anesthesia is an anesthesia of very limited site, that place where operation is made.
Borders between these groups are washed very away, but for convenience we will adhere to this simple classification so far.
So, anesthesia (synonym: the general anesthesia) - the state caused by means of pharmacological means and which is characterized by loss of consciousness, suppression of reflex functions and reactions to external irritants that allows to carry out surgeries without dangerous consequences for an organism and with full amnesia of the period of operation.
What stands behind this definition from the medical encyclopedia?
First of all, it is protection of an organism of the patient against factors of surgical aggression .
By the way, the professional motto of anesthesiology - of Regens - defendo - means “operating - I protect“, and a symbol - a ship steering wheel.
, is How effective this protection and she is how dangerous on herself?
About efficiency of anesteziologichesky protection can be judged by what of contraindications to an anesthesia is not present presently .
Thus, question: “ the Doctor, and unless is possible for me an anesthesia? “ or “And I will be able to transfer an anesthesia?“ - just it does not make sense. In any state and at any associated diseases it is always possible to choose effective and safe anesthesia for the patient. It is especially important to understand this moment when it is about the emergency, life-endangering situations. The earlier the patient will fall into hands of the anesthesiologist, the it is more at him than chances to survive.
Nevertheless an anesthesia - very serious and responsible action, and risk to die “of an anesthesia“ exists. For the emergency operations it is estimated as 1:200000, and for planned operations at rather healthy people - 1:500000.
In other words, risk to die on the way to hospital - from a car accident or the icicle which fell on the head or a brick - is 25 times higher than risk to die of an anesthesia at the emergency operation.
The most entertaining that “anesthesia“, per se, no. There is a set of very different methods, the general for which is switching off of consciousness of the patient.
Depending on a condition of the patient (understanding as “state“: age, sex, weight, existence or absence of associated diseases, existence or lack of allergic reactions or intolerance of drugs, the relation with smoking, alcohol, drugs or toxins, the mental status and still many other things) the anesthesiologist selects what is most effective and safe for this patient.
“Takes away an anesthesia 5 (10, 15) years of life?“
Some patient - for example, to people with heavy burns - before recovery it is necessary to transfer tens of surgical actions. Proceeding from the most optimistic horror story - 5 years, on a sort were written to them mafusailova years! Here if not these reptiles in green...
Actually, there are no data on influence of an anesthesia on life expectancy . Here about influence of cigarettes or rich rolls - is.
“And suddenly I will wake up during operation?“the Risk of such unpleasant complication is quite real
and is estimated (on different sources) from 1:10000 to 1:50000 cases of the general anesthesia.
The distinct tendency to decrease in probability of such trouble is observed. New anesthetics and new control methods minimize probability of early awakening. “It is awful
when smother a mask!“It is really awful
. Even to read about it is horror takes.
Do not read!
At the beginning of anesthesiology, at the time of Morton, Pirogov, Macintosh or Zhorov (the author of the first Soviet capital guide to anesthesiology) purely mask monoanaesthesia - air or chloroform was applied. It was really extremely unpleasant for the patient and it is outright dangerous.
Presently the induction (“lulling to slip“) is made by intravenous administration of the corresponding preparations: gently, safely and it is even pleasant for the patient.
the Well-known mask, certainly, is present at the operating room, but this graceful bagatelle from transparent plastic does not even bear a faint resemblance to the scarecrow from a wire and a gauze which remained far back in the past.
“An anesthesia does not affect addicts and alcoholics?“Works with
. This category of sufferers has many medical problems including anesteziologichesky. But on the majority of them the justice is found long ago, and some manage to be bypassed.
Safe and reliable anesthesia for these sinners is real not less, than for the righteous persons who are not using any muck.
“The doctor, you is better for me a mask make an anesthesia. I have no veins. Each analysis - torture! “
Yes people at whom hypodermic veins are very badly visible - owing to features of the constitution or after numerous intravenous pricks, or after injuries (burns and to that similar) are.
From all medical specialties this problem the smallest for anesthesiologists. We “bech have no place“. Patients with an experience know that when in office it turns out sick “without veins“, call to the aid the anesthesiologist. And it does.
the Anaesthesia at pregnancy
Yes, it is very serious! Danger in this situation not so much for future mother, how many for a fruit.
It is proved that applied to an anesthesia of substance do not possess teratogenny activity , that is do not cause uglinesses in the child. However danger consists in early interruption of pregnancy. And the pregnancy term is less, the this risk is higher. Especially it is high in the first three months - to 11%.
Not the anesthesia, per se, and the stress transferred by the pregnant woman, and some situations is dangerous during operation and an anesthesia, not very dangerous to mother here, but able to ruin a fruit.
Therefore, if an opportunity without harm or danger to life to delay operation is, then it is necessary to delay it .
And at impossibility of such delay, on degree of safety stand:
- local anesthesia;
- regional anesthesia;
- general anesthesia.
Further when it is told about all these methods, it will become clear how to make a conscious and right choice.