Anaesthesia

Anaesthesia

The Greek word anesthesia means insensitivity. Modern anesthesia uses a combination of different anesthetics to induce sleep, eliminate pain, and relax muscles.
The anesthesia methods used in our clinic are
- general anesthesia, during which the patient is asleep, and
(Vollnarkose), hierbei schläft der Patient und
- regional anesthesia,
anaesthetisation of specific regions of the body
are used.
Which of these two procedures are used in your case depends on the location in your body, the kind of surgery and any previous illnesses. After weighing individual risks, we are also happy to accommodate your personal wishes.

The premedication consultation, the so-called consultation with the anesthesiologist, takes place on the day prior to the operation. t is important that you have completed the anaesthesia information sheet and that you provide the anaesthetist with detailed information on previous illnesses. Please provide current findings and doctors' reports, particularly in the case of coronary disease, lung disease, blood clotting disorders, convulsion, nervous or muscular disorders, allergies and intolerances.
Additional tests that cannot be carried out in our Clinic may be necessary to determine anaesthetic capability. Please ask the Clinic about this well in advance. We will be happy to answer any questions you may have. During the anesthesia consultation, we will then clarify whether general or regional anesthesia is an option for you.

The application of what is known as 3in1 plexus anaesthesia is recommended for postoperative analgesia after high tibial osteotomies. The puncture point is marked on the groin while the patient lies in the operating theatre before anaesthesia commences. This is followed by disinfection of the skin, sterile covering, and local anaesthetic. The puncture is effected by means of a stimulation needle. This needle releases electrical impulses at certain intervals to enable identification of the nerve to be numbed on the basis of muscle twitching. After successful localisation, an anaesthetic is injected, and the stimulation needle is removed.

Risks related to plexus anaesthesia
In rare cases, nerve damage can occur from bruising, infections and immediate nerve lesion. Permanent damage, such as paralysis and dysaesthesia, is very rare. General reactions to local anaesthetics are possible.
Other regional anaesthesia procedures, such as VIP (vertical infraclavicular brachial plexus anaesthesia) and intrascalene procedures, can also be used on an individual basis.

Spinal anaesthesia
Spinal anaesthesia refers to a neuraxial block, created by injecting a local anaesthetic into the spinal canal near the lumbar spine. The numbing results in both legs and the lower abdomen being numbed for a certain period of time. The spinal anaesthetic is administered from the back while sitting. After previous examination of the coagulation parameters and thorough disinfection of the puncture, sterile draping, and local anaesthetic of the skin, the spinal canal is punctured with an extremely fine and scarcely noticeable needle, and a local anaesthetic is injected. After injection, the needle is removed and the anaesthetic begins to take effect after 5 – 15 minutes.

Risks of spinal anaesthesia
In rare cases (1-3 % of patients), headaches may occur. Treatment may require patients to spend several days in bed. If bladder release is adversely affected, insertion of a catheter can be required. General reactions to local anaesthesia are possible. In very rare cases, permanent paralysis and reverse paraplegia can occur, caused by bleeding, infections or direct damage to the nerve.

General anaesthesia is a combination of narcotics, analgesia and myorelaxants to induce a sleep-like state. Patient's breathing usually stops during general anaesthesia and must be artificially maintained by means of a laryngeal mask or a tube. The anaesthetic drugs for induction and maintenance of anaesthesia, individually adapted to the patient,. are administered through a venous blood vessel, applying a continuous intravenous drip infusion. For this purpose, an infusion needle must be inserted before the anaesthetic. The anaesthetist monitors the anaesthetic during the operation.

Risks of general anaesthesia
Possible risks after anaesthesia are sickness and vomiting, bleeding, infections and venous irritation at the point of puncture. The laryngeal mask or intubation tube may cause throat pain, irritations with swallowing or damage to teeth or vocal cords. If the patient's stomach is not empty, severe pneumonia can be caused by aspiration (residue of the stomach content entering the lungs).
Heart and circulatory problems and allergic reactions to drugs and infusion solutions are possible. Please read the anaesthesia consent form for information and clarification.

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