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What are the different kinds of anesthesia?

Surgeries (and many procedures) often utilize anesthesia services to provide some combination of unconsciousness, sedation, and/or amnesia, as well as analgesia (pain relief) and immobility.

Prior to determining the most appropriate anesthetic plan, your anesthesiologist will attain a medical history and airway exam. The type of anesthesia primarily depends upon the surgery being performed; however, your medical history may require modification of the type of anesthesia. Under certain circumstances, your preferences, as well as the surgeon’s and anesthesiologist’s, may be accommodated. Prior to your procedure, your anesthesiologist will discuss an anesthetic plan that is best for you and provide informed consent, including risks and benefits. The different types of anesthesia include:

  • General anesthesia temporarily makes a person totally unconscious and provides total amnesia, as well as varying levels of analgesia. The induction of anesthesia typically begins with an injection of medicine into the vein that gets the patient off to sleep within 1-2 minutes. Subsequently, an airway device is placed in the trachea or immediately above the vocal cords to assist with the patient’s breathing. The patient is then kept anesthetized by a carefully balanced combination of both inhaled and intravenously injected drugs.
  • Monitored anesthesia care (MAC) with sedation can reduce anxiety and pain, provide partial or total amnesia, and variable degrees of awareness. Typically, medications are administered intravenously. The patient remains breathing spontaneously and an airway device is not needed. Supplemental oxygen is provided. I have often heard this referred to as “twilight” but prefer to describe it as being comfortably drowsy with little recollection of a patient’s time in the operating room.
  • Regional anesthesia, which includes spinal anesthesia, epidural anesthesia and peripheral nerve blocks involving the arms or legs, eliminates pain following an injection of local anesthetic medication near large groups of nerves to temporarily block pain signals from reaching the brain. Regional anesthesia can be used for surgery on selected regions of the body, either alone or in combination with sedation or general anesthesia. For knee surgery, your anesthesiologist might determine that a regional, epidural, or spinal anesthesia may be beneficial.
There are three main types of anesthesia: general, regional and local.

General anesthesia temporarily makes a person unconscious so that the entire body feels no pain. Typically, it begins with an injection of medicine into the vein that gets the patient off to sleep. The patient is then kept anesthetized by a carefully balanced combination of both inhaled and intravenously injected drugs.

Regional anesthesia, which includes spinal anesthesia, epidural anesthesia and peripheral nerve blocks involving the arms or legs, eliminates pain following an injection of local anesthetic medication near large groups of nerves to temporarily block pain signals from reaching the brain. Regional anesthesia can be used for surgery on selected regions of the body, either alone or in combination with general anesthesia. If you need hip or prostate surgery, your anesthesiologist might determine that, in your particular case, epidural or spinal anesthesia may be preferable.

Local anesthesia may be used to numb only a small area of nerves at the site where the surgeon plans to operate, such as for cataract surgery. During local and regional anesthesia, patients often receive intravenous drugs for sedation so that they can be comfortably drowsy during surgery and remember little of their time in the operating room.
Stuart A. Linder, MD
Plastic Surgery
There are 3 different types of anesthesia available. The first is local anesthesia with the direct injection of agents such as lidocaine or marcaine into the surgical area to be anesthetized. The next is regional anesthesia by epidural, spinal, or peripheral nerve blockade. Last, general anesthesia involves the brain as well as the body. Patients are usually intubated with either an endotracheal tube or a laryngeal mask airway and admisitered inhalant agents concurrent with intravenous pain medications including fentanyl and diprivan. 
Anesthesia is used during surgery so you will feel no pain or discomfort. Three types of anesthesia are generally used: local, regional, or general. Each type usually attempts to block the process through which pain sensors are sent from the affected nerves to the spinal cord and to the brain.

Many anesthesiologists use local anesthetics and regional blocks during surgery. This choice may help reduce the chances of various complications in certain patients. These types of anesthesia may be of particular benefit to those with heart or lung problems (but not necessarily discuss options with your anesthesiologist).

A local anesthetic (nerve block) will block nerve sensations in a specific area of the body. A spinal or epidural block involves numbing usually a larger area with an anesthetic such as lidocaine. It may involve putting a catheter into the epidural space in the spinal column. This catheter will enable the doctor to anesthetize a larger portion of the body and to continue injecting local anesthetic or administer continuous infusion for a long period of time -- even into the post-operative period. The epidural infusion into the post-operative period (after surgery) may enable you to participate more in pain control, physical therapy, and rehabilitation in efforts to speed recovery.

General anesthesia, which produces an unconscious state, affects your entire system and takes time to wear off. It can very rarely have dangerous side effects for some, but if properly done, it is extremely safe to use. 
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The first and mildest type of anesthesia is local anesthesia, which is a shot that just numbs a specific body part. Above that, "twilight anesthesia"—or conscious sedation—produces a sleep that's not as deep as that caused by general anesthesia (which brings slumber so deep a respirator often controls your breathing), but in either case you'll remember nothing of the surgery afterward. And that's good because the things we talk about in the O.R....
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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.