Understanding Anesthesia

Most often, whenever patients hear that the surgery will be done under general anesthesia, their immediate response to us is, “Is it that serious?”.

The stigma that general anesthesia is risky and dangerous has always plagued consultation rooms and ORs whenever surgeons and anesthesiologists try to explain the merits of using this method of anesthesia over the others. Contrary to popular belief, however, General Anesthesia is one of the safest modes of anesthesia for patients.

In Cosmetic and Plastic Surgery in Thailand, patients often question the need for general anesthesia when they deem most procedures quite simple, and the incisions, normally quite small. The thing that patients sometimes fail to grasp is that their level of anxiety towards the procedure and their pain tolerance can affect how the procedure will take place. For instance, a lot of patients insist on having liposuction done under local anesthesia because they’ve read some promotional ads saying liposuction can be done that way. While it is really true, had any of those looking to have liposuction personally asked a patient who had done the procedure awake, how it felt doing so?

Though local anesthesia can block pain receptors so you will not feel pain, the sensation of movement against your body, the sound of clinking instruments, and the smell of cauterized tissue, can bring anxiety to some patients and this is something we try to avoid as much as possible perioperatively, because anxiety can affect your blood pressure, and therefore your bleeding tendency, and other possible complications.

General Anesthesia, administered by a Board Certified Anesthesiologist, is as perfectly safe as other forms of anesthesia, maybe even more, as long as all pre-operative preparations such as an honest and comprehensive medical history, food restrictions, smoking restrictions, and a list of other details are followed. A planned surgery such as cosmetic and plastic surgery in Thailand makes it all the more safer since patients will have time to modify their lifestyle, stop some medications and supplements that may have an adverse reaction to the anesthetics, and keep their body fit for faster recovery after surgery.

In a study showing the mortality rate for the use of general anesthesia, Dr. G.M. Woerlee found that the figures match to the mortality rate of a healthy woman giving birth, less than 10 in every 100,000 individuals. Now, why the notoriety with GA’s reputation? The use of General Anesthesia should only be done under the supervision of a Board Certified Anesthesiologist because while you are “asleep”, medications will be administered to you continuously to make sure your vital signs and airway are stable, and this cannot, and should not be done by your surgeon or any other medical professional without proper training. The danger is when another person, be it your surgeon, even the best surgeon, administers general anesthesia by him/herself, or any less certified medical professional for that matter.

Another infamous tale about General Anesthesia is the possibility of waking up in the middle of the surgery, in pain but unable to move or speak, which though true, is again, very unlikely with a certified Anesthesiologist because all medications administered should be monitored to make sure the patient is stable under the anesthesia.

Now why do we advocate general anesthesia over conscious sedation? Basically, we offer both techniques, but sedation is only best for short procedures, and since it can be done without an anesthesiologist, it is often more dangerous than general anesthesia. With sedation, there will be no monitoring of the airway, and there will just be your surgeon and the OR nurses, no anesthesiologist to monitor your vital signs, though in our center, it is standard practice to have a standby anesthesiologist even for patients just under sedation (most centers don't). Of course nurses and surgeons are well experienced to monitor such, but wouldn’t it be more assuring and a lot safer if you have another set of hands specifically monitoring your condition while you are under anesthesia?

For patients wanting to have surgery but are afraid of the anesthesia, of being put to sleep, and of what might happen when you wake up, always voice out your concerns to your surgeons because the only way they will be able to explain the procedure to you in the way you want to understand will be if you ask questions.

Surgery is always a risky procedure so before embarking on your journey to the Land of Smiles, Thailand, make sure you understand the procedure, the anesthesia, and the team involved in your surgery.

Good luck and see you in our center!