What better anesthesia: local, regional or general?

What better anesthesia

What anesthesia is better in this or that case? Every day, planning their new patients anesthesia, the anesthesiologist again and again have to look for the answer to this question. In fact, finding the best type of anesthesia is the first object of the anesthesiologists.

For making the final decisions are taken into account a lot of things – it’s kind of the upcoming surgery, and the patient’s health and personal experience of the anesthesiologist, and opportunities. Carefully weighing all of these factors, the anesthesiologist first determines the possible types of anesthesia , and then selects the best one option.

In general, the concept of “best anesthesia” includes many aspects, the most important of which are security, safety, ease, comfort and quality.

1. Safety anesthesia is determined by the severity of the risks and potential complications of anesthesia. Safest form of anesthesia is a local anesthesia , and the largest number of risks associated with general anesthesia . Occupies an intermediate position block anesthesia , but it is only possible when conducting operations on the limbs. Neuraxial anesthesia techniques, which include spinaland epidural anesthesia, in the scale of security occupy a special position. Thus, compared to general anesthesia, spinal (epidural) anesthesia has obvious advantages (fewer complications) only when performed in the elderly or in patients with disease of the respiratory and cardiovascular systems.

2. harmlessness anesthesia. At its core, this item is very similar to the previous one, that is all to say about the safety of anesthesia applies here. However, conducted operative analgesia may be the cause of not only the complications described in the article about anesthesia complications , but also a certain kind of effects, the occurrence of which is not always associated with anesthesia moved, for example, impaired memory, loss of hair, changes in tooth enamel, etc. .(Read more in the article about the dangers of anesthesia ). Therefore, from the perspective of safety best anesthesia in order of importance representing local, wires, spinal and epidural anesthesia.

3. Easy to anesthesia. Some types of anesthesia requires a large amount of equipment and medicines, and, moreover, are more complicated in terms of technical performance, while other types of anesthesia are characterized by their simplicity. Distribution of all types of anesthesia in order from simple to complex gives the following order: local anesthesia – spinal anesthesia – conduction and epidural anesthesia – a mask and intravenous anesthesia – endotracheal anesthesia.

If the planned operation is performed in the “big” clinic, the aspect of “ease of anesthesia” is not a big deal. In the case of the operation in a “small” hospital (for example, in the district center) is the most preferred embodiments of anesthesia will be simple forms of anesthesia.

4. The comfort of anesthesia. Despite the fact that some patients prefer during surgery did not hear and did not see (that is, be in anesthesia), the most comfortable are still local and regional anesthesia , since they do not have side effects such period of awakening from anesthesia as lethargy, drowsiness, dizziness, nausea.

Most physical satisfaction anesthesia seen with drugs for anesthesia, which leaves the body quickly, and thus contribute to the earliest possible spillage, such drugs include propofol, isoflurane and sevoflurane.

5. Qualitativeness anesthesia. In the hands of a layman any anesthesia can cause serious complications. Therefore, the concept of quality-of anesthesia is quite important and relevant. Details of this issue is disclosed in the article “The recipe of good anesthesia . ”

Thus, summing up the above, we can give the following answer to the question “what anesthesia is better? “. If the part of the operation and health of the patient has no contraindications , then the best kind of anesthesia is a local anesthesia, the second place is occupied by regional methods of anesthesia (spinal, epidural, and wiring), and only the third place belongs to general anesthesia (intravenous, mask, laryngeal, tracheal) .

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