In general, there are four types of anesthesia that are routinely used, oftentimes in combination with one another.
At UnaSource Surgery Center, a physician anesthesiologist in conjunction with a nurse anesthetist work as a team to provide all four types of anesthesia as follows. A combined approach ensures patients at UnaSource Surgery Center receive the most effective and comfortable anesthesia experience possible, leading to minimal narcotic use, earlier ambulation, and faster recovery times.
1. General Anesthesia
The first type is called general anesthesia and is the type that most people often think of when the word anesthesia is used. It entails a patient being entirely unconscious, either with anesthetic gases or IV medications.
While unconscious, a patient’s normal physiologic functions (such as breathing) can be altered and may subsequently require assistance from such tools as a ventilator, an endotracheal breathing tube, or a laryngeal mask airway (LMA). Some medications are often used to relax muscles, prevent nausea, and treat pain.
A skilled and highly trained provider will monitor the heart rate, blood pressure, oxygenation, and other vital signs. The biggest advantage to general anesthesia is the complete lack of awareness the patient has throughout the procedure.
2. Monitored Anesthetic Care
The second type of anesthesia often used is termed monitored anesthetic care (MAC). This can be further subdivided into minimal, moderate, and deep sedation.
- With minimal sedation a patient is usually put in a more relaxed state but is awake enough to follow commands. Certain procedures require minimal sedation so that patients are able to move muscles voluntarily.
- Moderate sedation entails feeling quite drowsy and even sleeping through some of the procedure. However, a patient is quick to be arousable and may have minimal memory of the procedure.
- During deep sedation a patient is generally asleep but not unconscious and is able to maintain breathing on their own. The biggest advantage with this type of anesthetic is that it typically has the fewest side effects and the quickest recovery time.
3. Regional Anesthesia
The third type of anesthesia is regional anesthesia. This type is divided into two categories: neuroaxial and peripheral nerve block.
- With neuroaxial anesthesia, usually called a “spinal” or “epidural”, an anesthetic is induced into the spine to largely numb the chest, abdomen, or lower extremity.
- With a peripheral nerve block, nerves are selectively targeted using ultrasound guidance to numb one particular region (hand, shoulder, knee, etc.) to reduce sensation to only that particular area.
Depending on the type of “numbing agent” used, the body part can be numb for 12-36 hours. Oftentimes, a pain pump can be inserted with a peripheral nerve block to provide pain relief up to five days after surgery. The biggest advantage to a peripheral nerve block is excellent pain control with minimal side effects.
Here at UnaSource Surgery Center, a peripheral nerve block is commonly used for pain control in lieu of more harmful medications, such as narcotics, and in conjunction with either a general anesthesia or monitored anesthetic care (MAC) for a multimodal anesthetic approach.
4. Local Anesthesia
The fourth type of anesthesia is local anesthesia. This is ideal for smaller, shorter, and less invasive procedures such as mole or suture removal. Traditionally, a physician will use a short-acting local anesthetic and apply it directly to the site of operation. The site will be numb to touch for approximately 2-6 hours, and typically motor function will be unaffected.
— Carl Roehling, DO