General Anesthesia Procedure

Overview

General anesthesia uses a mix of medicines, called anesthetics, to make the patient feel as if they are in a deep sleep. This process ensures the person is unconscious and free from pain during surgery or other procedures.

The team often gives the medicines through a vein (intravenous anesthetic), and sometimes the patient breathes them in as gases (inhaled anesthetics) like isoflurane.

A trained medical team, usually led by an anesthesiologist or a certified registered nurse anesthetist (CRNA), controls these medicines and monitors the patient. They check vital signs, manage breathing, and keep the patient pain-free and safe during the procedure. There are several types of anesthesia:

• General anesthesia for full unconsciousness.
• Local anesthesia to numb a small area.
• Nerve blocks to stop pain in a larger part of the body.

Reasons for Use

Doctors choose general anesthesia when someone needs surgery that would be too painful or difficult to handle while awake. It keeps the patient asleep and free from pain during the process.

Some operations, especially those that last a long time or involve the whole body, require complete unconsciousness so the person does not feel anything. Situations where general anesthesia is needed usually include:

• Operations that last a long time.
• Surgeries that need muscle relaxation.
• Procedures likely to cause a lot of bleeding.
• Treatments that could affect breathing, heart rate, or blood pressure.

Other anesthesia types might be used for less complex procedures. For example, regional or spinal anesthesia can be used for operations on a smaller part of the body, and local anesthesia is sometimes enough for minor procedures.

Possible Dangers

General anesthesia is safe for most people, but some side effects and complications can still occur. Risks vary depending on each person’s age, medical history, and the type of procedure.

Possible Effects

• Nausea or vomiting during recovery.
• An upset stomach or urge to vomit (side effects that often pass soon after surgery).
• Temporary confusion or memory loss (amnesia).
• Breathing problems or trouble clearing the airway.
• Psychological distress, such as anxiety or symptoms like post-traumatic stress in serious cases.

Becoming Partially Awake During Anesthesia

Unintended intraoperative alertness—sometimes called anesthesia awareness—happens when a person becomes partly conscious while under general anesthesia. This problem is very rare, affecting about 1 or 2 people in every 1,000 who get general anesthesia. Most people who experience this do not feel pain, but some might feel pressure, movement, or even discomfort.

What Might Happen	How Often	Who Is at Higher Risk
Hearing noises	Rare (1-2/1,000)	Emergency surgeries
Feeling pressure	Rare	People with certain conditions
Stress or anxiety	Rare	Older adults

Increased Risk Factors

• Previous problems with anesthesia.
• Allergies to medications used during surgery.
• Obesity, sleep apnea, or other issues with breathing.
• Medical conditions, like diabetes, high blood pressure, or seizure disorders.
• Smoking or heavy use of alcohol or drugs.

The chances of experiencing awareness under anesthesia go up during emergency surgeries or when the body’s health is already at risk. Health professionals use various monitors and tools to limit these events, but sometimes they cannot prevent them.

Steps to Get Ready

Before the procedure, making healthy changes can help with both the surgery and recovery afterward. People should focus on positive habits, such as:

• Being active each day.
• Choosing nutritious foods and balanced meals.
• Getting enough sleep each night.
• Quitting tobacco use as early as possible.

Medicines play an important role in preparation. Make a complete list of all medicines, both prescription and non-prescription, including vitamins, herbal products, and other supplements. Some medicines need to be stopped a day or more before surgery, while others may need to be continued as usual.

The healthcare provider will decide what is safest. People with certain conditions, such as sleep apnea, should tell the care team. If you use a device at night for breathing, bring it to the hospital or surgery center. The medical staff may need to adjust care and keep a close watch on breathing during and after the procedure.

Before the procedure, the care team will give clear instructions about when to stop eating and drinking. Usually, no solid food or creamy drinks should be consumed after midnight before the surgery. Only small sips of clear water may be allowed up to a few hours before the procedure.

Table: Key Steps for Preparation

Step	Details
Increase activity	Engage in gentle exercise as permitted.
Eat healthy	Skip junk food and choose balanced meals.
Sleep well	Try to get 7-8 hours of sleep per night.
Stop smoking	Quit using tobacco for better recovery.
Review medicines	Share all medications with the doctor.

What You Can Expect

Before the anesthesia, a member of the anesthesia team will meet with the patient to talk about their health and any medications they take. They will ask about allergies, previous experiences with anesthesia, and when the patient last ate or drank. This discussion helps the team make safe choices for sedation and which medicines to use.

Checklist

• Health and medical background review
• Medication and allergy check
• Questions about last food or drink intake
• Previous anesthesia experience

What Happens While Asleep

When the procedure starts, the team gives anesthesia, usually through an IV or sometimes as a gas through a mask, especially for children. After the patient is fully asleep and unconscious, the anesthesia provider may put in a breathing tube to keep airways open and make sure the patient gets enough oxygen. During the whole procedure:

• The anesthesia team checks breathing, heart rate, blood pressure, and temperature using special monitors.
• The patient’s vital signs are watched closely.
• If needed, the team will adjust medicines, give fluids, or step in to fix any changes in blood pressure or breathing.
• Rarely, the team gives a blood transfusion if there is blood loss.

The anesthesia provider removes the breathing tube before the patient wakes up.

Vital Signs Table

Vital Sign	How It’s Monitored
Breathing	Oxygen mask/tube; monitor
Heart Rate	Heart monitor
Blood Pressure	Arm cuff/device
Temperature	Thermometer

Waking Up and Early Recovery

After the surgery, the team stops anesthesia medications, and the patient slowly wakes up. Sometimes in the operating room, but usually in the Post-Anesthesia Care Unit (PACU), also called the recovery room. They may feel sleepy, confused, or dizzy at first. Possible side effects include:

• Nausea or vomiting
• Dry mouth or sore throat
• Mild shivering
• Muscle aches
• Hoarse voice
• Blurry vision
• Itching
• Mild pain or discomfort

Nurses check on the person often, track their vital signs, and ask about pain or other side effects. They can give extra medication for pain or nausea to support a smooth recovery in the PACU before moving on to the next stage of care.