Anesthesia Associates of Southern Connecticut

General Anesthesia

This type of anesthetic is what most people are familiar with. The patient is put into a deep sleep for the duration of the procedure, then awakened at the end.

Typically, the patient is given some sedation en route to the operating room and made comfortable while monitors are applied. He or she is asked to breathe 100% oxygen through a mask for a few minutes prior to going to sleep. This is for safety reasons. Medication is given through the IV which induces deep sleep. At this point there are several things the anesthesiologist might do:

1. MASK ANESTHESIA - the anesthesia is delivered through the mask alone. This option is only allowable for very quick procedures such as ear tubes. If there is any possibility that the stomach is not empty, this technique cannot be used.

2. ENDOTRACHEAL ANESTHESIA - this involves insertion of a "breathing tube." The anesthesiologist will give medications that profoundly relax the muscles of the body. The vocal cords are then visualized with a laryngoscope and the tube is advanced through the vocal cords into the trachea (breathing tube). Once the breathing tube is secured, the lungs are completely protected, thus this is the only technique that is suitable in the event of a full stomach. The anesthesia is usually continued with an inhaled anesthetic supplemented by narcotic pain medications. Breathing is most often controlled by a ventilator until the end of the case. At the end of the case, the tube is removed at the same time that the patient is waking up. It is extremely uncommon to have any awareness of the breathing tube upon awakening.

3. LMA ANESTHESIA - the laryngeal mask airway (LMA) has revolutionized anesthesia. It is an inflatable device that fits into the back of the mouth and is connected to the anesthesia machine. The patient can breathe on his own and inhaled anesthetics are delivered through the LMA. It is much less stimulating than the endotracheal tube, there is reduced risk of trauma to the vocal cords, no muscle paralyzing agents are necessary, and generally less anesthetic is required. It cannot be used in a very long case or in the event of a full stomach.

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