General Anesthesia
It is called general anesthesia to create a temporary loss of consciousness and decrease in reflex activity by administering various drugs to the patient via respiratory and intravenous lines without any change in vital functions. General anesthesia application; It causes temporary loss of consciousness, prevents the patient's awareness during the operation, provides comfort to the patient during the operation by eliminating the pain, and facilitates the surgical intervention by reducing reflex activity and muscle relaxation. During general anesthesia applications, all muscles, including the muscles that allow the patient to breathe, are paralyzed.
During the procedure, the patient's breathing takes place with a respirator. The person performing the anesthesia regularly monitors the vital signs of the patient during the procedure. Examination of parameters such as blood pressure, heart rate, and oxygenation rate is of great importance in terms of ensuring a safe surgical procedure. The purpose of general anesthesia, which provides a reversible loss of consciousness and desensitization to pain, is to provide appropriate surgical conditions and to ensure that the patient loses consciousness and does not feel any pain during the operation.
Before the application of anesthesia, the person is monitored, followed up and controlled. In addition, it is the duty of the anesthesiologist to maintain the health and safety of the patient. In general anesthesia, various drugs are administered alone or in combination. There is a preparatory phase before anesthesia. The preparation phase for anesthesia is called preanesthetic medication or premedication. Premedication Application Purposes It is used to calm the patient, to relieve their worries and fears about the operation, to facilitate and accelerate the induction, to eliminate the effects of the anesthetics to be given (nausea, pain, allergy, etc.) It is used to reduce the dose of the surgical anesthetics to be administered. general anesthesia; It is administered by intravenous (intravenous injection, TIVA), inhalation (breathing, VIMA). Intravenous anesthetics are anesthetic drugs that are administered into the veins to create anesthesia. Inhalation anesthetics are administered to the patient by airway. The anesthetic gas taken from the lung first comes to the alveoli, where gas exchange is provided in the lung. It passes from the alveoli to the blood. It is distributed to the brain and other tissues through the blood. When it reaches a certain concentration in the brain, then the anesthetic effect occurs. The anesthesiologist monitors the health status of the person throughout the surgery and reduces or increases the amount of medication according to the situation. After general anesthesia is given, the patient is in a deep sleep state and does not feel what is happening. The anesthetist then intubates the patient by administering muscle relaxants. By means of intubation, the patient is connected to the anesthesia device and artificial respiration begins, and thanks to this method, the pressure in the airway, the amount of anesthetic drugs in the person's body are constantly monitored. The effect of an ideal anesthetic should start quickly and end quickly. The longer the effect of the anesthetic substance lasts, the more its effects on the systems will continue. There are 3 basic periods of general anesthesia application. 1. Induction Phase: This is the phase where anesthesia begins. Essentially, this is the only period the patient can remember.The induction phase is the phase in which all systems begin to be affected. The most serious effects will undoubtedly occur in the respiratory system and the circulatory system. It is a stage that cannot breathe on its own after the administration of drugs, needs artificial support in this regard, and due to the suppression of protective mechanisms, dramatic changes occur in the patient's vital signs. In order to keep these dramatic changes under control; The effects of the drugs that cause these changes, the mechanisms of these effects and the precautions to be taken to prevent these results should be known. 2. Maintenance Phase: Following the initiation phase of anesthesia, it is the phase in which the patient is now unconscious and delivered to the surgical team with airway patency provided. The phase in which anesthesia continues is the maintenance phase. The maintenance phase is a phase in which follow-up and precautions are intense. The patient is connected to the anesthesia machine, respiratory functions are provided artificially by the machine, there is an ongoing surgical procedure. 3. Sobering Phase: It is the phase in which anesthesia is terminated and the administration of anesthetic drugs is completed. The most important issue that needs to be especially sensitive during the recovery phase is complications related to the respiratory system. In this stage, complications that will prevent the patient from performing respiratory functions for different reasons; should be carefully considered in terms of its types and approaches. At the end of the operation, the anesthesia drugs used are terminated and the patient's breathing and reflexes are restored under the supervision of the anesthesiologist. At the appropriate time, the patient leaves the ventilator. When his breathing completely returns to normal and he regains consciousness, he is taken from the operating table under the observation of the anesthesiologist and taken to the recovery room. The patient is relieved of pain in the recovery room, warmed up, and sent to his room comfortably by taking some precautions against nausea and vomiting.