Types of Anesthesia and Medical Consent in Surgery Explained: Busting Anesthesia Myths

Over the years, I have encountered many anesthesia myths and those "witchy" drugs. While I enjoy a good story, when it comes to anesthesia and surgery, facts should take center stage. So, buckle up—we're about to bust some common anesthesia myths.

Am I Doomed to General Anesthesia?

For those who assume general anesthesia is the only option: it's not! There are multiple types of anesthesia, categorized in various ways. However, these five categories are widely recognized among anesthesiologists:

1. Monitored Anesthesia Care (MAC)

MAC is provided by an anesthesia team when deeper levels of pain relief and sedation are anticipated [1]. It is commonly used for shorter, less painful procedures.

2. Sedation

With sedation, you may feel relaxed or even lose consciousness, but you can be awakened with repeated touch or verbal commands [1].

3. General Anesthesia

Under general anesthesia, you are completely unconscious, and no external stimuli can wake you until the anesthetic wears off. You lose consciousness, awareness, and memory of the procedure [2].

4. Regional Anesthesia

This technique numbs a specific area of the body, from a single toe to both legs or even half of the neck. While it may seem magical, it involves extensive medical training, local anesthetics, and, sometimes, ultrasound guidance. Regional anesthesia is often used for limb surgeries and post-surgical pain relief. Epidurals, subarachnoid blocks and peripheral nerve blocks are part of this broad category.  

5. Combined Anesthesia

When general anesthesia is paired with a regional technique, such as an epidural or a nerve block, it is called combined anesthesia. This approach can enhance pain control and reduce the need for higher doses of general anesthetic. For example, in major abdominal surgeries, a combination of general anesthesia and an epidural may be used.

Who Decides the Type of Anesthesia?

Contrary to popular belief, surgeons do not dictate the anesthesia plan. While they may provide input, the ultimate decision lies with the anesthesiologist. Several factors influence the choice, including:

• Type of surgery (location, duration, complexity, surgeon expertise, and preference)

• Patient health (history of complications, comorbidities, fitness level, etc.)

• Anesthesiologist's expertise and preference

• Available resources (medical devices, drugs, equipment)

• Patient preference

  
  

Medical Consent and Your Role in the Decision

Medical consent is a legal requirement for any invasive procedure. It safeguards your autonomy, ensures ethical medical practice, and protects both you and healthcare providers. Before any procedure, you have the right to be informed about [3]:

• The intended procedure

• Potential risks

• Possible benefits

• Alternative options

While your preference matters, it's essential to consider your anesthesiologist's advice. They have extensive training and experience assessing surgical risks and prioritizing patient safety. If you have concerns or fears about a proposed technique, speak up! Your anesthesiologist can help manage anxiety and clarify any doubts.

Conclusion

Now that we've busted some anesthesia myths, you know that general anesthesia is not the only option. So, you can rest easy—you are not "doomed."

Curious about why general anesthesia is safe and not as scary as some think? Stay tuned for the second “episode” of Busting Anesthesia Myths.

References:

[1] Statement on Continuum of Depth of Sedation: Definition of General Anesthesia and Levels of Sedation/Analgesia. https://www.asahq.org/standards-and-practice-parameters/statement-on-continuum-of-depth-of-sedation-definition-of-general-anesthesia-and-levels-of-sedation-analgesia

[2] Moody OA, Zhang ER, Vincent KF, et al. The neural circuits underlying general anesthesia and sleep. Anesthesia & Analgesia. 2021;132(5):1254-1264. doi:10.1213/ane.0000000000005361

[3] Informed Consent | AMA-Code. https://code-medical-ethics.ama-assn.org/ethics-opinions/informed-consent

Assessed and Endorsed by the MedReport Medical Review Board