Anesthesia is the loss of sensation of the area to be treated or the entire body, with the help of drugs, in order to prevent the patient from feeling pain or pain during the procedure, and to prevent movements that may endanger the surgical procedure, before surgical interventions.

Anesthesia ?

Anesthesia is the loss of sensation of the area to be treated or the entire body, with the help of drugs, in order to prevent the patient from feeling pain or pain during the procedure, and to prevent movements that may endanger the surgical procedure, before surgical interventions.

Drugs used to provide sensory loss are called anesthetic drugs. These drugs block nerve transmission to the brain from the area to be treated or throughout the body.

Anesthesia procedure, especially general anesthesia, falls under the task of anesthesiologists specialized in this field and is a team work. Anesthesia team monitors the patient before, during and after anesthesia, provides pain management, supports, and intervenes where intervention is required.

Anesthesiologists evaluate patients before the surgical procedure. The patient’s diagnosis, general condition, vital signs, blood tests, cardiac radiographs, and the patient’s pre-operative evaluation can take the opinion of the relevant specialties, if necessary. In this way, it decides whether the patient is suitable for anesthesia and what type of anesthesia should be used. Applies anesthesia during the operation. Follows the patient during the operation. It intervenes when there is a problem in the patient’s vital values. At the end of the operation, he wakes the patient, monitors the pain or possible side effects and intervenes when necessary.

In a surgical procedure, the skill of the anesthesiologist as well as the skill of the surgeon affects the success of the operation.

Anesthesia procedures are medical procedures. It should be applied in accordance with medical rules. The vast majority are applied in healthcare facilities. Some local anesthesia procedures can also be performed outside the healthcare facility in emergencies and provided that necessary precautions are taken.

Types of anesthesia: 

  1. Local anesthesia: It is the anesthesia procedure in which a certain part of the body is anesthetized and the consciousness is fully open. Procedures such as dental treatments, skin biopsies, suturing wounds, cataract operations are performed under local anesthesia. Local anesthetics are used for this procedure. It is mostly applied under the skin, sometimes it can be applied on the skin as a spray or cream.
  2. General anesthesia: In larger procedures, local anesthesia is not sufficient for interventions on internal organs of the body. For this, the whole body must be anesthetized and the patient must be unconscious. This procedure is called general anesthesia. In this way, the patient does not feel pain, does not remember the procedure, and because he does not move, a more comfortable environment is prepared for the surgical team. Drugs used for general anesthesia can be given to the patient by breathing or intravenously.
  3. Epidural anesthesia: Although some surgical procedures are larger in terms of local anesthesia, the patient’s entire body does not need to be anesthetized and unconscious. With epidural anesthesia, the lower part of the body is anesthetized. This procedure is mostly used in cesarean section operations. The patient is conscious, knows and hears the procedure, but does not feel pain or pain.
  4. Spinal anesthesia: In large procedures performed in the lower parts of the body, it may be necessary to anesthetize the lower parts over the spinal canal instead of numbing the entire body. As in some knee cap surgeries, the lower back remains numb for about 3 hours in this procedure.
  5. Sedation: In some procedures, the patient does not need to be deeply put to sleep. The sedation process gives the patient a feeling of drowsiness, makes them feel sleepy and relaxes. Sometimes this method is used in dental operations, endoscopy, cardiac catheterization procedures where the patient cannot easily adapt to the procedure.

Anesthesia side effects: 

As with any drug, anesthesia can sometimes have side effects. These side effects can sometimes be serious enough to be life-threatening in the patient.

The anesthesia team informs the patient about possible side effects before the procedure. It tells the patient what to do to combat these side effects.

Allergic reactions, rarely anaphylactic, may occur with local anesthetics. Serious side effects are not uncommon, except for simple reactions manifested by swelling and redness in the treated area.

More side effects can be seen in general anesthesia, regional anesthesia such as epidural/spinal, and sedation. These side effects are usually mild and resolve quickly. But sometimes they can be serious.

Many factors such as the patient’s age, chronic diseases, smoking, being obese, the type of anesthesia used, the type of anesthetic drug affect the development of side effects or serious complications.

Possible side effects include:

  • Headache,
  • Dizziness,
  • Feeling faint,
  • Weakness, fatigue,
  • Chills, shivering,
  • Nausea, vomiting,
  • Pain in the procedure area
  • Itching,
  • Urinary problems,
  • Respiratory problems,
  • Cardiovascular problems.

Complications of the anesthesia procedure, which are rare but can be serious:

  • Inability to wake up (the patient hears and feels the surroundings but cannot wake up),
  • Atelectasis (deflating of part of the lung due to the intubation tube)
  • Malignant hyperthermia (fever is a serious reaction with muscle contractions),
  • Nerve damage,
  • Postop delirium.

general anesthesia ?

Anesthesia is a procedure that is applied in a controlled manner before the operation, ensures that the patient does not feel pain during or after the operation, provides orientation to the procedure, and increases the comfort of the patient. It can be applied as regional (local) or general anesthesia. Both can have some side effects. Commonly used anesthetic procedures are:

  • General anesthesia,
  • Local anesthesia,
  • Epidural anesthesia,
  • Spinal anesthesia,
  • Nerve blocks.

General anesthesia is a state of unconsciousness, in which the patient is put to sleep in a controlled manner. Under general anesthesia, the patient does not remember anything about the operation, does not feel pain or pain. It does not make any unwanted movements during the operation.

General anesthesia is mostly used in operations where the procedure is long, the patient will feel great pain during the procedure, and the body cavity is opened, such as internal organ surgeries. General anesthetic drugs are given intravenously and by inhalation. The patient stands motionless and numb. This is a great comfort for the patient as well as for the operating team. However, respiratory and cardiac support is needed under general anesthesia. Vascular access is opened to the patient and he is connected to the respirator. In addition, the patient is monitored to monitor the heart rhythm and blood pressure level.

The mechanism of action of general anesthetic drugs is not clearly known. However, the common feature of all general anesthetics is that they prevent signal transmission to the brain. This is the reason for the loss of sensation under anesthesia.

Reasons for general anesthesia: 

  • Long operations,
  • Procedures with excessive blood loss,
  • Operations affecting breathing.

 Preparation for general anesthesia: 

General anesthesia is an important procedure. The patient should be well prepared before the operation, followed well during the operation, and necessary precautions should be taken in terms of possible postoperative complications.

Before the operation: 

A good and detailed anamnesis should be taken from the patient, a detailed examination and necessary tests should be performed. Here, it is investigated whether the patient has a disease that may be a problem during anesthesia. Hypertension, diabetes mellitus, previous heart attack, COPD, heart valve diseases etc. are evaluated. It is investigated whether the patient is allergic to the anesthetic drugs used, antibiotics, or to substances such as gloves that he will come into contact with during the operation.

The history of smoking, alcohol, substance use, the use of other drugs (blood thinners, heart drugs, blood pressure drugs, etc.), previous operations and anesthesia experience during operations are questioned.

In the examination, the respiratory system and the cardiovascular system are evaluated. The focus of infection is investigated. In addition, since the patient will be intubated, the suitability of the mouth structure is checked. ECG, blood tests, pulmonary function tests, chest X-ray, bleeding tests may be requested from the patient.

All these procedures are standard patient preparation procedures. In some emergency operations, some of these may have to be skipped.

The anesthesia procedure to be performed is described to the patient. How to use the drugs and how to feed before the operation are explained in detail. If necessary, supportive treatment can be started to reduce the risk of aspiration.

During the operation: 

The patient is connected to the EKG device. A device is attached for oxygen saturation monitoring. Vascular access is opened to the patient. An anesthetic is administered to the patient either intravenously or orally. Then intubation is done. During the operation, vital signs such as the patient’s heart rhythm, number, blood pressure level, and oxygen level are monitored.

When the operation is completed, the anesthesia application is stopped. When the patient’s respiratory functions are restored, the intubation tube is removed. Depending on the size of the operation, supportive treatment (painkillers, antibiotics, etc.) is given.


The patient is taken to the intensive care unit. Respiratory functions, heart rhythm, blood pressure, fever are monitored. Awakened patients who do not develop any complications are taken to the service and followed up.

General anesthesia side effects: 

Some side effects may occur due to general anesthesia. These may be due to the operation or are mostly related to the anesthetic used. Most of the side effects go away in a short time. The anesthesia team may apply supportive treatment to relieve the patient for these side effects.

  • Nausea, vomiting,
  • Weakness,
  • Chills, shivering,
  • Memory problems,
  • Confusion,
  • Bladder problems, urinary incontinence,
  • Dizziness,
  • Headache,
  • Sore throat,
  • Heart rhythm problems,
  • Low blood pressure,
  • Respiratory problems,
  • Damage to the mouth and teeth due to intubation.

General anesthesia complications and risks: 

There are some complications and risks associated with the general anesthesia procedure. Some of these are rare.

  • Complications related to intubation and mask use (tooth damage, sore throat, facial edema, uvular edema, damage to the vocal cords, nosebleeds, dislocation of the jaw joint, etc.)
  • aspiration,
  • Nerve damage,
  • Allergy and anaphylaxis
  • Lung problems (bronchospasm, pulmonary edema, hypoxemia etc.),
  • Heart problems (heart attack, hypertension, hypotension, rhythm disorder etc.)
  • Deep vein thrombosis,
  • Pulmonary embolism,

These complications may be more common in smokers, obese patients, and those with additional chronic diseases.

Local anesthesia 

It is numbing or numbing a part of the body. Nerve transmission from that area to the brain is temporarily blocked. The person’s consciousness becomes clear. He hears, sees and understands what is happening around him. It does not feel pain during the procedure.

It can be applied to skin surfaces, mucous membranes, joint capsules. It does not require any special preparation before anesthesia application. Also, there is no problem of waking up from anesthesia. They are better tolerated than general anesthetics. It has less side effects and toxic properties.

It shows the effects of local anesthetics in a few minutes and lasts only a few hours. When the effect is over, all the senses return to their original state.

Local anesthetics block sodium channels on the nerve cell, reducing sodium entry. In this way, the action potential message is blocked.

The most commonly used local anesthetic is lidocaine.

Usage patterns of local anesthetics: 

  • By applying on skin or mucous membranes (to relieve pain in case of injury, burn, accident)
  • By injection, spray or brushing on mucous membranes (in the mouth and nose, such as dental surgeries),
  • Through drops (simple operations of the eye),
  • By infusion (urethra),
  • By injection into joint capsules.

Classification of local anesthetics: 

Local anesthetics are evaluated in three groups according to the level of effectiveness:

  1. Weak potency and short-acting local anesthetics (30-60 minutes): Procaine, chlorprocaine
  2. Local anesthetics of medium strength and medium duration (120-180 minutes): Lidocaine, prilocaine, mepivacaine
  3. Potent and long-acting local anesthetics (up to 600 minutes): Amethocaine, bupivacaine, etidocaine

Usage areas of local anesthetics: 

  • Topical use: It is applied to the skin or mucous membranes (mouth, nose, rectum, eyes, etc.), as a cream, gel, ointment, liquid and spray. Dermatological procedures, dental treatments, before injection applications, mouth ulcers, sore throat, prevention of vomiting reflex, etc.
  • Infiltration application: It is applied as an injection in surgical procedures of the mucosa or skin / subcutaneous deep tissues. Dental treatments, treatment of wounds, removal of moles, simple eye surgery, biopsy etc.
  • Intravenous regional use: It is used in the form of intravenous administration in short-term surgical procedures of the lower and upper extremities. Hand, foot, arm and leg surgery etc.
  • Central block: It can be applied into the cerebrospinal fluid (spinal anesthesia), epidural space (epidural anesthesia), or both areas (spinal epidural anesthesia). Cesarean vs.
  • Peripheral block: It is applied around the peripheral nerve and anesthesia is provided in the distal part.
  • Sympathetic block: It is applied around the sympathetic ganglia in the mouth, chest, stomach and intestines.
  • Application before intubation,
  • Antiarrhythmic application,
  • Systemic administration in acute or chronic pain.

Local anesthesia side effects: 

Local anesthetics are generally well tolerated and have few side effects. However, some undesirable effects may develop.

  • Allergic reactions,
  • Headache,
  • Dizziness,
  • Burning while urinating
  • Nerve damage,
  • Muscle damage,
  • Central nervous system damage (metallic taste, numbness of tongue or lips, tinnitus, nystagmus, speech disorders, disorientation, excessive breathing, depression, etc.)
  • Vascular system problems (tachycardia, bradycardia, hypertension, hypotension, etc.).