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What is anesthesia

The word comes from greek "anaistesia" which means, literally "insensitivity."

that wants to indicate a state of insensibility to pain and emotional stress that this is associated.

The first drugs used to relieve pain were opium, and alcohol .... blow to the head (remember in western movies?), but caused many problems. see history of anesthesia

In 1779 it was used for the first time nitrous oxide (called "exhilarating gas" because it was causing euphoria), more 'practical but effective to weak. Only in 1846 was introduced into clinical practice allowing the ether to obtain a complete anesthesia, with insensitivity to pain (analgesia) and loss of consciousness (hypnosis), it is necessary to eliminate the stress that the act involves operating and I remember one unpleasant moment.

There are two types of the local and general anesthesia.

Local anesthesia is characterized by the fact that abolishes the sensitivity is only a fraction of the body and the patient remains awake.

General anesthesia is characterized by loss of consciousness and sensibility of the whole organism. It is awarded to the anesthetic general administration of inhaled or injected directly into the venaraggiungono cerfvello and block nerve centers.

The choice of anesthetic to use is made on a case by case basis. The general principle is to ensure maximum comfort to the patient and the surgeon the best working conditions. The decision is taken after the anesthesiologist visited the patient (visit anesthesia) to make sure of his general condition, mental status, function of certain organs and systems, dealt with and discussed the folder clinuca clear set the surgeon 's administrative attention to be performed (location, estimated duration, special needs etc.).



general anesthesia


is currently the most widely used type of anesthesia. It is used in those procedures that require the patient's unconscious, long-term, prolonged muscle relaxation and for which it is impossible to use local anesthesia.
During general anesthesia the entire body is paralyzed, the brain is asleep and the patient does not feel anything and does not remember anything about the operation.

Before anesthesia is cannulated a vein usually the boom (finding of a venous access) with needles that may have different diameters and shall give the administration of fluids to balance imposed fasting from the night before surgery.

General anesthesia can be administered by intravenous injections GENERAL ANESTHESIA INHALATION somminisrando or through a tube placed in the trachea, gaseous anesthetics in the form of steam or using INHALATION ANAESTHESIA GENERAL ANAESTHESIA GENERAL BALANCED both ways.

After anesthesia was initiated by a powerful hypnotic sleep quickly and pleasant patient is given a constant steam anesthetic or a drug by intravenous infusion pumps in a special way to keep the patient adequately anesthetized for the whole ' surgery. Breathing is controlled by a sophisticated automatic machine (the automatic respirator) through a tube placed in the trachea. This tube is removed when the patient is awakening from anesthesia. The anesthesiologist throughout the surgery controls all the vital signs of the patient (batito rate, blood pressure, heart rate, body temperature, oxygenation, respiratory parameters), administered the anesthesia drugs and other medicines useful for correcting any amendments parameters monitored, liquids and eventualmete decide whether or not to transfuse the patient.
After the surgery the patient is observed until full recovery of consciousness, before being sent to bed. During this phase you will be given oxygen through a mask and, if necessary, medications or fluids to keep you from any complications. This period can last for a few rare cases, and also work a few hours and may include a phase of confusion before the full normalization. For some major surgery can be planned that the patient is sent at the end dell'itervento for a period of time in intensive care.

Once awake the patient feels pain in the operational area if the anesthesiologist had not set an adequate pain therapy. In some cases you may feel a slight discomfort throat, and sometimes nausea or vomiting.




The regional anesthesia


Many patients even if aware of the safety of general anesthesia remain frightened by the news that appear distorted, at times, in newspapers and on television about some accident due to 'anesthesia. The fear to undergo general anesthesia, sleep and stay in a state of unconsciousness is not the only reason why regional anesthesia had an 'increase. The development of sophisticated technologies, a local anesthetic drugs safer and more thorough knowledge of the functioning of local-regional anesthesia has increased the interest of doctors in these techniques.
With regional anesthesia only a specific region of the body is anaesthetized the pain coming from it is blocked and does not reach the brain. This is done by injecting anesthetic directly near the nerves that carry the sensitivity to the area affected by the intervention. For example, if you must work hand are anesthetized only the nerves of the arm. There are some advantages
nell'anestesia loco-regional. These are the elimination of pain without loss of consciousness, such as fewer side effects after general anesthesia (sore throat, nausea, vomiting and disorientation).
Be aware it may be advantageous for example during the experience of cesarean delivery or when the patient is afraid to undergo general anesthesia and sleep. After surgery in regional anesthesia pain relief can last a few hours without the need for other drugs. The regional anesthesia may be chosen for different types of operations and for specific areas of the body.
However, be aware that the potential complications of anesthesia regional anesthesia, although small and rare, they can be just as great as those from general anesthesia, as in other medical therapies


subarachnoid anesthesia

Also known as spinal anesthesia, is a type of regional anesthesia that is performed by injecting a small dose of anesthetic into the subarachnoid space where there is the fluid that surrounds the spinal cord and its nerves. In practice, the pain impulses from the nerves are blocked before they reach the brain and the patient can be operated safely. When surgery is over and the anesthetic begins to run out the patient regains movement, sensitivity, and later the painful sensations. Until a few years ago about 5% of patients undergoing subarachnoid anesthesia had a headache after the procedure. Currently, the use of thin needles special needles Whitacre, the headache is almost gone. Subarachnoid anesthesia was immediate action and duration up to three hours is safe and is especially suitable for operations on the lower abdomen and lower limbs. Interventions for lower limb, with the so-called selective subarachnoid anesthesia, you can even anesthetize only the limb to be made.





epidural anesthesia
It 's a similar type of anesthesia spinal anesthesia except for the fact that anesthetics are injected into the subarachnoid space outside epidural space. It is painful because it is preceded by a piccolola local anesthesia in the thoracic or lumbar puncture site. Compared with spinal anesthesia allows technicians to take very long because the medication can be repeated over time without having to resort to more bites. It has the advantage that the anesthetic can be determined, from time to time, as needed and the duration of the intervention, using a thin plastic tube (catheter) placed in the puncture site. It is called continuous epidural anesthesia because the anesthetic administration is not interrupted. In fact the tube after the operation, allows the anesthesiologist to give more drugs to combat pain due to injury and to provide maximum comfort for the patient. Often postoperative catheter is connected to a small hand-held device the size of a walkman said pump, which provides the administration of a predetermined amount of drug
is the method of choice for painless childbirth, but in this case we speak of analgesia and anesthesia. Patients must be able to keep it moving and then the muscle strength needed in the expulsive phase of birth.






peripheral nerve block is a type of regional anesthesia is commonly used for surgical gl'interventi arm, forearm, hand, thigh, leg and foot. The local anesthetic is injected directly around the nerve that carries the sensitivity to the area to be made often to detect exactly where the nerve to inject the local anesthetic is used a small device that is connected to said stimulator needle and sending tiny electric shocks determines the the movement of the muscles innervated.

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History of anesthesia

man has always tried to cope with the pain caused by any action on his body, too bad that the first anesthesia were used in the strict Only in recent times: "exhilarating gas" (from 1789), morphine (1805) and chloroform by 1831. The Roman scholar Celsus stated that the ideal surgeon tic "... be brave ... and act fast ...". Again in 1800 we quickly appreciated the surgeons, a virtuoso in this direction was Dominique-Jean Larrey during the Battle of Borodino in Russia, at the service of Napoleon's troops, he made two hundred amputations in twenty-four hours (about one every seven minutes). The ancient Egyptians already knew that the cold inhibits blood circulation, but for general anesthesia techniques adopted somewhat rudimentary strangulation until unconsciousness and "hit on the head." In addition to physical methods, even in times old were used opium, hashish or alcohol, for example, opium has been documented since 3500 BC by the Sumerians who used it to relieve toothache.

The church, unfortunately, after the fall of the Roman Empire banned every practice painkillers. The monks of Monte Cassino in the ninth century, however, had a recipe for a Spongia somnifera (soporific sponge), which once aspired to open. Surely it is the curious method of seamen in the sixteenth century, big cigars introduced into the rectum before undergoing surgery (massive absorption of nicotine that causes shock). The famous Swiss alchemist Paracelsus (also present in Ferrara), already in 1540 had managed to fall asleep hens with ether, the man had to wait until 1846 instead.

When Horace Wells, dentist, in 1844 used chloroform as an anesthetic was laughed at, and think that is still used today in the operating room.

Finally, in 1848 in Edinburgh for the first painless childbirth was used chloroform and the baby was born that another could not be called if no anesthesia!