2) Who gives General Anaesthetics?
In Canada, most anaesthetics are given by doctors who, after completing their medical training, take additional training in anaesthesia. Some dentists are also trained to give anaesthetics. Nurses cannot give anaesthetics in Canada, although they do in the USA. In Canada and the UK, doctors who give anaesthetics are called 'anaesthetists'. In the USA, they are called 'anesthesiologists', to separate them from nurse anaesthetists.
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Accidents can still happen, but modern monitors usually ensure
that any problems are picked up at an early stage. Older and sicker
patients now undergo surgery, but with care, and perhaps with a few
days in an Intensive Care Unit, most of them can be got through even
major surgery.
There are a few things you can do to decrease your anaesthetic risk:
Links:
3) How does the Anaesthetist give a General Anaesthetic?
Preparation
First of all, the anaesthetist must know what operation you are having, and
some things about you and your health. After reviewing your medical chart,
the anaesthetist will ask you a few questions to get details of any problems,
and to check on your past experience with anaesthetics. The anaesthetist
may also want to perform a brief examination. For example, he may want to
have a look at your mouth and teeth to ensure that it would be easy to
insert a tube into your windpipe, if this is needed.Monitoring
Next, the anaesthetist and operating room nurses will ensure that you are
properly monitored throughout the anaesthetic. In Canada, this means
following the Canadian Anaesthetic Society Guidelines. Most countries have
similar recommendations. The routine monitors are:
In addition to all these mechanical monitors, and the alarm systems built
into the anaesthetic machine, the anaesthetist remains with the patient
from the time the patient goes to sleep until he or she is safe and stable
in the recovery room.
Types of General Anaesthesia
Anaesthesia can be divided up into three parts: sleep, absence of pain, and
absence of movement.
The simplest anaesthetic consists of a single drug which can produce all
these effects for a short period of time.
However, it is usual to start with an injection of a drug to put you to
sleep and to follow on with anaesthetic gases to continue the anaesthetic.
You must be able to breathe during the anaesthetic, so often a
tube of some sort will be placed in your mouth. This may
be a simple piece of curved hollow plastic called an "oral airway",
or a more complicated tube such as a "laryngeal mask airway" or an
"endotracheal tube". For some operations, muscle relaxants are required
to paralyse the patient during surgery. Often, a powerful
analgesic (pain killer) will be added to
the mixture.
How do I wake up?
This depends on the type of anaesthetic. Short acting drugs simply wear
off. Anaesthetic gases are replaced
by air or oxygen. Muscle relaxants, and sometimes the powerful pain
killers, may need special drugs to reverse their effects.
Once you are sufficiently
awake, any tube in your mouth can be removed. You will stay in the
Recovery Room for an hour or two until you are completely awake. You
should remember not to operate machinery or drive a car for 24 hours
after your anaesthetic.
4) How Safe is a General Anaesthetic?
Modern anaesthetics are extremely safe. Thanks to the excellent modern
monitors, better drugs, and the training of
modern anaesthetists, anaesthesia is getting safer all the time. For healthy patients,
anaesthesia is so
safe that it is difficult to measure the degree of risk any more.
People with serious heart, lung or other disease, obviously,
have an increased risk.
© John Oyston, 1995
Individual copies may be made for personal use. For multiple copying
or commercial use, or to suggest subjects for this section, please contact
Dr. Oyston by sending an e-mail to
(This was originally on the Orillia Soldiers' Memorial Hospital Department of Anesthesia page)