Anestezia

Anestezia, or anesthesia, is the medical practice of producing controlled, reversible loss of sensation, and sometimes consciousness, to enable painful or invasive procedures to be performed safely. It encompasses several approaches aimed at eliminating pain, preserving vital functions, and ensuring patient comfort during surgery or diagnostic tests.

Anestezia is commonly categorized into general anesthesia, regional anesthesia, local anesthesia, and procedural sedation. General anesthesia renders the patient unconscious and often requires airway management. Regional anesthesia blocks sensation to a larger region of the body via neuraxial or peripheral nerve blocks. Local anesthesia numbs a small area. Sedation may accompany regional or local techniques.

A typical perioperative course includes preoperative assessment, planning, induction of anesthesia with intravenous or inhaled agents, maintenance with a combination of drugs, and emergence as medications wear off. Common agents include propofol for induction, volatile agents such as sevoflurane or desflurane for maintenance, opioids for analgesia, and neuromuscular blockers to facilitate surgery.

Monitoring during anesthesia involves continuous recording of heart rate and rhythm, blood pressure, oxygen saturation, end-tidal CO2, temperature, and ventilation. Airway management ranges from a mask to a laryngoscope and endotracheal tube or supraglottic devices. Regional anesthesia uses ultrasound guidance for nerve blocks.

Safety in anesthesia relies on patient selection, meticulous monitoring, dose calculation, and readiness to manage complications. Potential risks include airway complications, cardiovascular instability, postoperative nausea and vomiting, nerve or tissue injury, allergic reactions, medication side effects, and, in predisposed individuals, malignant hyperthermia.

Historically, anesthesia emerged in the 19th century with the use of ether and chloroform, leading to modern guidelines emphasizing patient safety. Anesthesia practice is regulated by professional societies, certification, and ongoing quality improvement to minimize risks and improve outcomes worldwide.