Herzliya Medical Center
There are cases where you, as patients, could choose the anesthesia method. Thus, for example, if you suffer from dental anxiety, you could ask to consult the attending doctor and undergo the treatment under the effect of laughing gas (nitrous oxide used as a sedative) or even complete anesthesia. On the other hand, there are many cases where you won’t be able to determine the anesthesia type since those are predetermined – for medical, health or other considerations. Thus, for example, in certain urgent surgeries, local anesthesia would be preferred over general anesthesia, since the effect of the anesthetic is quicker: in general anesthesia, the effect is much slower and would require relatively long waiting, which is undesired in urgent cases.
In terms of the anesthetic, there is no difference, except for dosage of course. In terms of performing the anesthesia in practice – an anesthesia induction would usually performed (initial anesthesia is done in general anesthesia procedures, relatively common in surgical procedures in children) via special mask and not IV injection. In adult treatment, anesthesia via the vein is the most common.
In many cases yes. Over the years, medicine became ‘flexible’ about all that relates to pediatric treatment and consideration of their feelings and those of their concerned parents before the surgery. Therefore in many places, you could escort the child right up to the anesthesia induction stage so that he’s in a safe environment until his consciousness begins to blur. This way, it’s guaranteed that he’s not alone in an unfamiliar environment so long as he’s fully conscious.
In general and local anesthesia there is great importance to the role of the anesthesiologist: he’s the one in charge of optimal use of anesthesia, and he’s the one watching over you when you’re in the operation room – to make sure your body continues to function properly under anesthetics and that all vital indices are normal. Meeting with the anesthesiologist before surgery will give you an opportunity to ask questions about the anesthesia and how it’s done, and even hear from the doctor how it will be done. If you are parents to children, this meeting could even reduce anxiety for you and your child: the mere meeting with the anesthesiologist before the action will “break the ice” and calm you down.
The requirement to fast before surgery, in most cases, comes from the need for general anesthesia: such anesthesia causes relaxation of the entire body, including important internal systems, and the concern is that the content of the stomach would penetrate the lungs – as the reflexes that prevent it when we’re conscious are sedated and don’t work. Therefore, if you’re before general anesthesia, you’ll usually be asked to fast and come to the surgery with an empty stomach.
In general, the instructions are to not consume solid food (including gum/lollipop) on surgery day and to stop consuming fluids (water) about 3 hours before the surgery. Kids can continue to drink clear fluids up to 2 hours before the surgery.
Waking up from general anesthesia might be odd and confusing: the person waking up from anesthesia will deal with disorientation and usually won’t remember where he is or how he got there – at least for several minutes. Please remember that such anesthesia is often accompanied by various pains, such as throat pain, stomach aches and so on, so the experience might not be particularly pleasant. The presence of familiar people after waking up could help in those moments. If your child has surgery under general anesthesia, you’ll usually be called to the recovery room as soon as he wakes up.
As said, general anesthesia might be accompanied by various side effects like throat pain, stomach aches, dizziness, vomiting, muscle aches and more. In rare cases, tooth aches might also occur, and sometimes your body temperature might increase rapidly (Malignant hyperthermia syndrome). In local and regional anesthesia, the side effects are rarer – since you’ll remain awake throughout the procedure – but fatigue, vomiting, dizziness, and more might sometimes occur. Side effects often also characterize procedures that include sedation: headaches, dizziness, blurred vision and more.
Every medical action, including anesthesia, has various risks. A consent form for anesthesia is a form that you’ll sign before the medical procedure – usually in the preliminary meeting with the anesthesiologist – where you declare that you’re aware of the dangers involved in the type of anesthesia you’ll have. Signing the form must be done when you’re fully conscious, aware of the situation and understand well the things said to you and written in the form.