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Anaesthesiology and Intensive Care
The Main Techniques for Anaesthesia
General anaesthesia is the appropriate method for longer and more serious interventions, such as abdominal or cardiac surgery. During general anaesthesia, various medicines are used to trigger a state of sleep. When the patient is deeply asleep, the anaesthetist helps him/her to breathe using various devices, such as a mask or tube which are inserted into the mouth or into the trachea.
Sometimes, temporary difficulties with swallowing or temporary hoarseness may occur following general anaesthesia. Nausea and vomiting are other side effects, which can however be quickly treated. General anaesthesia can also be combined with epidural anaesthesia to treat post-operative pain.
This is a very light form of general anaesthesia during which the patient is just on the limit between sleep and wakefulness. He/she is breathing of his/her own accord, and can communicate with the anaesthetist if there are any problems. The anaesthetist will deepen the anaesthesia if necessary.
Spinal anaesthesia is a local anaesthetic technique involving an injection into the back. The patient is laid on his/her side and a local anaesthetic is injected in between two vertebra, into the fluid surrounding the spinal cord. In the following minutes, a powerful anaesthesia takes effect in the parts of the body situated below the navel, and the patient’s legs are completely paralysed for a few hours.
Sometimes, spinal anaesthesia can be accompanied by a temporary decrease in the patient’s blood pressure, together with nausea which can quickly be corrected. Headaches or difficulty in passing urine occur more rarely, and can be treated. Serious side effects such as infections or nerve lesions are extremely rare.
Spinal anaesthesia is ideal for interventions which have a well-defined duration and which are carried out on the lower half of the body, for example urological or orthopaedic surgery. It is also the favoured technique for caesarean sections, since it avoids any anaesthetics passing into the blood of the child, and allows the patient to experience the birth of her baby.
Like spinal anaesthesia, the epidural is a local anaesthetic technique. The position and preparations for it are the same. However, the anaesthetic is injected into a slightly more superficial location in the spinal column. Epidural anaesthesia can be carried out anywhere along the spine. Often, a small catheter is left in place after the intervention, which allows us to treat pain after the operation. The side effects are similar to those connected to spinal anaesthesia. This technique is most commonly used in obstetrics, to relieve pain during childbirth.
For surgery limited to one arm or leg, anaesthesia through blocking one or several nerves may be carried out. If necessary, a small catheter is inserted close to the nerves to prevent and treat pain during the days following the intervention.
For this type of anaesthesia, the nerves are located using an ultrasound or electrical impulse device. Using a fine needle, a local anaesthetic is then injected around the nerve. In some very rare cases, this technique can lead to complications, such as bleeding, nerve lesion or infection.