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Without pain and fear

Past and present

In the common sense, anesthesia refers to various methods of pain relief during surgical operations. In such cases, the human body partially or completely loses sensitivity, which means that the feeling of pain does not bother you. During anesthesia, the patient can be both conscious (so-called analgesia) and unconscious.

People tried to achieve the “insensitivity effect” to pain back in ancient times - they beat the patient on the head with a club, forced him to breathe kerosene, and poured wine into a vein. The first anesthetics ("painkillers") were marijuana, alcohol and opium. However, the results that were achieved were more than modest. Only since the 1840s did anesthesia become an independent branch of medicine. This happened mainly thanks to the efforts of American scientists who constantly experimented with ether.

Since then, the quality and safety of anesthesia have increased many times over. This was facilitated by the emergence of new pharmacological drugs and the improvement of monitoring equipment.

Why is anesthesia needed?

Despite some absurdity of this question, the answer to it is not as simple as many people think. First of all, eliminating pain means protecting the patient’s body from surgical trauma and surgical aggression. As anesthesiologists joke, “they protect the patient from the surgeon.”

Indeed, effective anesthesia is an essential condition for the smooth course of the operation itself and even the postoperative period. This happens because any surgical intervention causes complex disorders in the functioning of various organs of the patient. Blood flow is disrupted. Associated chronic diseases may worsen. And the more difficult the operation, the more serious the biochemical, hormonal and functional changes in the body.

However, undesirable reactions begin to occur even at the preoperative stage. The patient's psychological stress alone can cast doubt on the success of the upcoming operation. And the task of anesthesia is to reduce the impact of such unfavorable factors.

Moreover, many people simply cannot do without anesthesia. Each of us has our own “sensitivity threshold”, so for some patients even dental treatment is contraindicated without anesthesia. Not to mention that there are operations during which a person can die from painful shock.

Conscious but no pain

Analgesia as a type of pain relief is used for relatively simple surgical operations: when removing warts, teeth, and small tumors. The person remains conscious. A chemical (anesthetic) is injected into the surrounding nerves that will be used during surgery.

Local and regional anesthesia are mainly used.

As for the complications accompanying these types of anesthesia, there are few of them, and most are allergic in nature. However, the possibilities of such forms of pain relief are quite limited. For example, regional anesthesia should not be used for operations on the neck or head, as this can lead to cessation of breathing and circulation.

The main "aggressor" is the operation

General anesthesia is called anesthesia. This condition is characterized by loss of consciousness, memory and lack of response to external stimuli.

In the early stages of the development of anesthesia, general anesthesia was carried out with one narcotic substance, that is, mononarcosis was used. However, this effect on the body resulted in frequent complications and even deaths. Over time, mononarcosis was replaced by combined general anesthesia. It made it possible to significantly reduce the toxicity of pain relief, as well as supplement it with some important components: analgesics, psychotropic substances, muscle relaxants. Thanks to this, modern anesthesia is more gentle on the central nervous system of patients and allows operations to be performed more efficiently.

Of course, certain harm from anesthesia exists, as well as various complications are possible, but they are often greatly exaggerated by rumor. It is necessary to understand that the main “aggressor” during surgery is the surgical intervention itself, and not anesthesia.

General anesthesia can be administered to the patient by inhalation and non-inhalation methods. For example, intravenously, intramuscularly, rectally, etc. But it is impossible to say unequivocally which method is preferable. The choice of drugs for both general and local anesthesia and the method of their use depend on the condition, age of the patient, as well as the upcoming operation.

FROM THE HOURS

Member of the Presidium of the Board of the Federation of Anesthesiologists and Reanimatologists of Russia, Doctor of Medical Sciences, Professor Igor NAZAROV, speaks about the consequences of anesthesia:

- The main dangers of anesthesia today lie in the so-called “human factor”, and not at all in the drugs used. There is no ideal pain relief, and in such a situation, the qualifications of the anesthesiologist play a key role. It depends on her how smoothly the operation will go. After all, it is not enough to introduce narcotic substances; it is also necessary to regulate and maintain the vital functions of the body. And here, of course, experience is of great importance. As practice shows, up to 80% of complications after anesthesia are errors in the doctor’s work. An experienced anesthesiologist can foresee most possible side effects, which means he should try to avoid them.

Before the operation, the doctor needs to have a conversation with the patient, study concomitant diseases, talk about the chosen type of anesthesia - mentally prepare the patient for the operation. Naturally, the personal qualities of the anesthesiologist are also important here. The doctor must inspire confidence and reassure the patient. To some extent, a doctor must be a psychologist. After all, kindness and sympathy sometimes work better on a patient than any sedative. Humanity in general is of great importance for a doctor.

When I just started working, we received a baby with such illnesses that we couldn’t even take him for surgery for a long time. But when they did operate, the child’s condition was so serious that the surgeons immediately informed the parents: there was no chance. The surgeons left the operating room, and we, anesthesiologists, spent the whole night trying to stabilize the condition of the unfortunate baby. By the morning, when the parents were already in mourning, the baby still “came to life.” But the most interesting thing happened later. Twenty years later, while giving an “A” to an excellent student, I heard unexpected gratitude: “Thank you, you saved me twice. The first time was when you took the exam without a special album. And the second time was twenty years ago.”

BY THE WAY

Quite often in speech and on the pages of printed publications you can come across the phrase "general anesthesia". In fact, it is the same as "butter oil". The word "anesthesia" itself is already a synonym for general anesthesia, and "general anesthesia" simply does not exist.

FACT

Some clinics use hypnosis as an alternative to anesthesia. The same mechanism is at work here: “switching off” the cerebral cortex. However, no research has yet been conducted to confirm the effectiveness of hypnosis as a pain reliever. In addition, only 15% of patients are completely hypnotizable, 60% can only be partially put into hypnotic sleep, and 25% of patients are not hypnotizable at all.