A general anaesthesia is an induced condition of unconsciousness and analgesia. The type of general anaesthesia that is most frequently applied at the Schüchtermann-Klinik is the so-called „totally intravenous anaesthesia“ (TIVA). For this we use a combination of selected and individually dosed medication (soporifics, analgesics and muscle relaxants) that is injected into a vein. In special cases this type of general anaesthesia is supplemented by modern anaesthetic gases which are inhaled through an anaesthetic system.
The planning of the anaesthesia commences already on the day of admission to hospital when the anaesthetist visits the patient to discuss and inform about preliminary medication. After the anaesthetist has studied all relevant findings, examined the patient’s physical constitution and talked to the patient, he determines the best individually adjusted anaesthetisation process. The patient must agree to be anaesthetised and needs to sign the corresponding forms. The anaesthetist prescribes the preparatory medication for the evening before surgery and for the day of surgery. This so-called preliminary medication will help the patient to relax and trigger a pleasant sensation of fatigue.
When the patient arrives in the anaesthetisation room first of all we apply some electrodes and sensors to monitor, for instance, heartbeat and respiration. Thereupon, after giving a local anaesthetic, we insert two small catheters into the patient’s arm. One catheter, which is inserted into a vein of the forearm, is used for the infusion of medication and liquids. The other small catheter, which is placed in an artery at the wrist, serves to continuously measure the patient’s blood pressure.
The soporifics administered at the beginning of the anaesthesia will take effect within 15 to 30 seconds and cause the patient to fall asleep quickly and comfortably. After falling asleep the anaesthetist will support the patient’s breathing by means of a respiratory mask. When the patient is fast and soundly asleep, the airwaywill be protected by introducing a hose (endotracheal tube) into the windpipe (intubation) or into the throat (larynx mask). During anaesthesia the patient is given artificial respiration through these hoses.
Subsequently, the anaesthetist will take further measures intended to monitor and protect the patient comprehensively. One of these measures is, for example, the introduction of a catheter into a vein near the heart. Thereafter, a self-retaining urinary catheter and a temperature probe and possibly a stomach tubewill be applied. In order to monitor the brain functions, immediately before starting surgery the team of anaesthetists will apply special adhesive sensors to the patient’s head, which measure the brain activity(EEG) and the oxygen saturation in the brain.
SAFETY THANKS TO THE MOST ADVANCED MEDICAL EQUIPMENT
The anaesthetist monitors the patient throughout surgery by means of the most sophisticated and advanced medical equipment. Such monitoring includes regular blood testing. On average, during the anaesthesia about 80 different patient values are ascertained, which provide detailed information about the various body functions. Thus, it is possible to individually and safely control the anaesthesia. All patient values taken are recorded by EDP.
GENERAL ANAESTHESIA: NECESSARY AND SAFE
Without general anaesthesia a great number of life-saving surgeries would be rendered impossible. Particularly for heart surgery it is indispensable to apply general anaesthesia .
In Germany alone approx. 6,000,000 general anaesthesias are performed every year; nowadays a general anaesthesia is a safe routine procedure. Advanced anaesthesia standards and anaesthetics practically rule out any serious anaesthesia complications, so the risk involved in anaesthesia is very low.