Why is intubation necessary for general anesthesia

1. What are outpatient anesthesia and anesthesia?
In the case of outpatient anesthesia, the patient comes shortly before the agreed surgery date, has an operation and goes home after a certain period of follow-up. This approach has the advantage of a minimal length of stay.

2. Does the patient have to present to the anesthetist before the procedure?
The consultation with the consent for the anesthesia must take place beforehand, so that the patient has time to think about it. This is required by law and serves to protect personal rights. The process and possible risks of the procedure are discussed. A physical examination will also take place.

3. What else does the patient have to bring with him on the day of the operation?
In addition to the insurance card, the patient must bring the declaration of consent to the anesthesia with them, unless it has remained in the patient's file. Furthermore, important preliminary findings such as doctor's letters, allergy and medication passports should be brought with you, if these were not already available for the preliminary discussion. If discussed, the patient must bring an ECG, X-ray or current laboratory values ​​from the family doctor. However, this depends on the state of health and the extent of the intervention.

4. Is there anything else to consider before the operation?
Of course, the principle of sobriety applies. In the event of vomiting during anesthesia with the escape of gastric juice / contents into the lungs, pneumonia and lung failure can occur. The patient must be sober to be anesthetized! He must not eat any solid food or smoke for at least 6 hours before the start of anesthesia. He can also drink some still mineral water or tea up to 2 hours before the start of anesthesia. Slightly different limits apply to children.

5. What happens to the medication you take regularly?
In the preliminary discussion with the anesthetist, it is clarified which medication should be taken further.

6. How does a cold affect the anesthesia?
If the state of health has deteriorated acutely, the doctor must be informed immediately.

7. What happens immediately before the anesthesia?
After registering, the patient is provided with a surgical shirt and locks his personal belongings in a closet. Jewelry, contact lenses, and expendable valuable items should be kept at home. The patient is then accompanied to the surgery room. Blood pressure meter, EKG and finger clip, which measures the oxygen saturation in the blood (pulse oximetry), are connected here. The anesthetist will once again check the documents, such as the declaration of consent, laboratory values, ECG and X-rays, before the patient gently falls asleep.

8. How is the anesthesia initiated?
First, a venous access is made. Through this access the patient receives the sleeping pills and also other medications that are necessary for performing the anesthesia. The anesthesia is usually continued with anesthetic gases.

9. Does every patient get a ventilation tube for anesthesia?
No. With general anesthesia, the patient sleeps so deeply that he has to be artificially ventilated during the operation. There are three different methods of ventilation for general anesthesia. Inserting a breathing tube (intubation), using a larynx mask or a face mask.
There are only a few operations in our center for which we need a ventilation tube (bottom left) . These are, for example, some dental interventions and certain operations in the nasopharynx. The patient sleeps so deeply that he does not feel the insertion of the tube. The tube is removed before the patient is fully awake.
Temporary difficulties in swallowing and hoarseness may occur after intubation. Long-term complaints are very rare and usually resolve over the next few months. Tooth damage is seldom but possible, especially with loose teeth, despite the most careful approach.
The majority of operations are performed with the help of a larynx mask (top right). This is inserted into the sleeping patient's throat and surrounds the larynx. The larynx mask is placed above the vocal cords and does not pass through them. The advantage is that hoarseness or difficulty swallowing almost never occurs. Furthermore, the patient can even breathe through the larynx mask during anesthesia.

A face mask is used for short procedures (top left).



10. What are the risks of anesthesia?
The most common complications of anesthesia are nausea and vomiting (up to 10% of anesthetics), hoarseness when using a ventilation tube (up to 10%), drop in blood pressure (3%), cardiac arrhythmias (1%), too high blood pressure (1%) , as well as confusion after the operation (0.5%).
However, in the field of outpatient anesthesia, these figures are well below these figures due to the short duration of the operation and the type of operation.
Overall, it can be said that the development of new drugs for anesthesia in the last 15 years has made a huge leap towards safe and comfortable anesthesia. These drugs are only used in the outpatient area by specialists in anesthesiology who are very familiar with the effects and side effects.
The better the general physical condition, the lower the risk of complications. There is an increased risk of anesthesia in patients with severe comorbidities and previous illnesses.
The type and duration of the operation also have an influence. Small and short-term interventions have a lower risk than large operations.
Major surgical interventions include, for example, those that open the chest or extensive abdominal operations.

11. How is the patient observed during anesthesia and what are the safety measures?
The introduction of new surveillance techniques has made anesthesia very safe. During the operation, the blood pressure is measured continuously, the ECG is monitored and the oxygen saturation in the blood is checked with a finger clip (pulse oximetry). This enables the anesthetist to detect any changes at an early stage and to take action.

12. How long does the operated person have to stay there after the anesthesia?
After the anesthesia, the patient is monitored for another 2 to 6 hours in order to rule out undesirable after-effects.

13. Is there anything else to consider after the anesthesia?
The patient must not actively drive, make important decisions, or use machines for 24 hours. He should rest first and not exert himself excessively. If problems such as excessive pain arise, the operating doctor or anesthetist should be contacted.