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Dealing With Sedation And Consciousness 

by — Last updated: 2014-10-26 in Drugs & Medications

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Pain is a feeling that we are all afraid of, but thanks to the work of doctors, we don´t have to worry about it anymore. The introduction of anesthetics into the medical world has made surgical treatments not only pain free but also safer.

If the doctor has to perform a more invasive medical procedure that involves the exposure of a wider body area, for example the leg, the type of sedation to use would be regional anesthesia. But if the surgery comprises a more complicated procedure, such as the removal of a tumor or a kidney, general anesthesia would be used. Both of them involve the use of stronger dosis of anesthetic and the constant monitoring of the specialist. 

Regional anesthesia 

There are two types of regional anesthesia. The first one is called spinal anesthetic because it is applied in the subarachnoid space that surrounds the spinal cord and it is used to numb the lower abdominal, pelvic, rectal and lower limbs body regions. The second one, the epidural anesthetic, is similar to the spinal type but it is applied outside the subarachnoid space and is mainly used to sedate the lower limb region in women during labour and childbirth.

Both spinal and epidural anesthetics require constant infusions of the sedative substance, which are usually the same synthetic anesthetics used for local anesthesia, but in higher doses.

In order to avoid several injections in this area, the anesthesiologist leaves a small catheter during the first injection, through which it is possible to administrate more anesthetic if required.

Regional anesthesia involves more risks than the local one, because it is applied in a very delicate area of the nervous system and because it basically blocks the nerves of a wider body area, but the patient is constantly monitored by the specialist during the procedure. 

General anesthesia

General anesthesia causes a state of unconsciousness and the inability to move. This type of sedation is used in major surgeries and can be achieved by using inhaled anesthetics, anesthetics in solutions that are administered directly into the bloodstream or both.

How does it work? Scientists are not quite sure about the mechanisms involved in general anesthesia, but they believe it acts at three different levels of the nervous system.

First, it acts at the level of the spinal cord, affecting the ability of the patient to move; second, it blocks signals in the brain stem, causing unconsciousness, and third it reaches the cerebral cortex.

Because the patient is unconscious under general anesthesia, it is necessary to externally control the breathing process by introducing a breathing tube into the windpipe of the patient, to help him or her breathe during the surgery.
The administration of the sedative agent is administered constantly and is monitored during the whole procedure by the anesthesiologist.

See Also: Brain Recovery After Anesthesia

When the surgery ends, the administration of the sedative is ceased gradually in order to bring the patient into a conscious state again.

Just as any other medical procedure, anesthesia has intrinsic risks, specially related to unexpected allergic responses to the anesthetic; however, anesthesiologists are well prepared specialists that, after a complete evaluation of the health state of the patient and the type of surgery to be performed, will determine if the patient can undergo surgery and will monitor the patient´s state before the surgery starts, during the period of unconsciousness and until after the patient wakes up from anesthesia. 

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