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What is general, regional and local 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.

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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.