For all surgical interventions in all age groups, the Anesthesiology and Reanimation Unit of the Ankara HRS Women’s Hospital carries out anesthesia applications 24 hours with a holistic approach that includes the examination of the patient and preparation for the surgery in all aspects, and handling pain therapy and vital problems during and after surgery.
Anesthesia is used in diagnostic and therapeutic applications in any surgical procedure it is required. As a word, anesthesia means absence of senses, torpor. It can also be defined as the temporary disappearance of the senses and some reflexes by drugs administered, in addition to loss of consciousness, for the patient not to feel pail during the surgery, without any change in vital functions.
General Anesthesia
It is the state of decrease in conscious, reflex and activity, and of the removal of pain, by the inhibition of transmission at the brain level temporarily without making any change in vital functions. General anesthesia, if there is no accompanying advanced health problem in the patient (e.g., severe liver, kidney failure, severe obstructive pulmonary disease, etc.), can be applied in almost all types of surgery. The risks and unwanted effects (such as nausea, hypertension, and arrhythmia) have been minimized thanks to modern equipment, medicine and medical staff.
Regional Anesthesia
It is the inhibition of the transmission at the spine level. It has two types, spinal and epidural.
Spinal Anesthesia
It is the injection of local anesthetic medicine into the primal fluid; the total numbness of the region under the belly (below the waist). The patient is awake in spinal anesthesia. The effect of spinal anesthesia lasts for two to four hours. Although not common, it may sometimes cause unwanted effects such as hypotension or headache. It can be safely used in interventions such as Hernia repairs, prostate surgeries, leg surgeries (varicosis, arthroscopy, etc.).
Epidural Anesthesia
It is the narcotizing of the nerves by applying a catheter to administer the local anesthetic and narcotic agent outside the spine. The pain below the level it is applied is removed. In painless delivery and caesarean section, regional anesthesia is preferred because of the comfort and safety it provides to the mother and baby. Since it allows the mother to remain awake during caesarean section, the mother is able to hold her baby immediately after birth. Painless birth being the most common, it is used in caesarean section, hip and knee prosthesis, foot and leg operations, and the controlling of postoperative pain. Unwanted effect are face more rarely than in general anesthesia. Regional anesthesia that allows the patient to leave the hospital earlier; can cause, although rarely, side effects such as hypotension, inadequate anesthesia, total spinal anesthesia. Regional anesthesia is applied in cases of active bleeding, severe hypertension, allergy to materials used, and infection in the region, low platelet count and neurological problems.
Local Anesthesia
Local anesthesia is especially preferred in surgical interventions at small areas. Here, only the region to be intervened is narcotized and the patient’s conscious is kept open. The local anesthetic substance is injected around the area to be surgically intervened with the help of an injector, and the nerve areas there areas are numbed. This is also called infiltration anesthesia. The surgical intervention may be done after waiting for three to five minutes. This method is preferred in cases such as evacuating abscesses, closing small skin incisions with sutures. Depending on the properties of the anesthetic used, the effect of anesthesia passes after a certain period of time.There are forms of the local anesthetic substances that are in the shape of sprays or creams. Here, the body is anesthetized from the surface without the body being penetrated by an injector or otherwise, and this is also called ‘topical’ anesthesia. These, when applied to the region to be anaesthetized a few minutes before, also prevent the pain to be felt. They can also be used prior to applying a catheter, drawing blood. Sprayed local anesthetics are also used for numbing the throat during endoscopy or bronchoscopy.
Preparation of the patients for operation and afterwards
The patient who requires surgery, for no matter which reason, must be seen and examined by an anesthetics expert.
The anesthesiologist, in his visit of the patient before surgery, listens to the patient’s short biography and inquires if the patient has had an operation before, if he has had a serious illness such as jaundice or tuberculosis, if he has a systemic ailment or if he uses regular drugs.
After this inquiry, test and analyses such as blood count, blood tests, sugar, urea, liver enzymes, kidney tests, electrocardiography, and lung graphy are performed. If necessary, consultation is requested from expert doctors of other branches.
And at the final stage, the patient is told about the type of anesthesia to be applied, the risks and the duration of the operation; his questions are answered and kept informed. Especially for patients with fear of narcosis, certain medicine called “pre-medication” are administered for reducing fear and soothing purposes.
For children, relaxing medicines mixed with fruit juice are used so that they do not feel uneasy. After surgery, some problems such as surgery pain, nausea, coughing and headache may be seen depending on the type of anesthesia and operation. However, these problems are eliminated by timely interventions.
Things to pay attention to prior to surgery:
The patient who will receive anesthesia needs to fulfil the following requirements:
- Must be hungry when entering surgery.
- Should not take blood thinners, starting 2 weeks before surgery.
- If smoking, should stop smoking; quit smoking for his health.
- Tell his doctor about the medications used and the health problems in the past.
