Our expert is the Head of the Department of Anesthesiology and Critical Care Therapy of the Moscow Research Institute of Pediatrics and Pediatric Surgery, Doctor of Medical Sciences, Professor Andrey Lekmanov.

1. You can see "the other world."

Anesthesia has nothing to do with clinical death.

2. You can wake up in the midst of the operation.

This topic is discussed with bated breath by anxious patients. In principle, the anesthesiologist can wake the patient on purpose, but he will never do this. He has a different task. And the patient himself cannot wake up ahead of schedule.

3. You can become mentally retarded from anesthesia.

Special tests show that memory, attention, ability to memorize ... after any general anesthesia are reduced. This effect lasts from two weeks to several months, but only a specialist can catch a decrease, since these violations are minimal.

4. Each anesthesia takes 5 years of life.

Some children have already received 15 or more anesthesias before the year. Now they are adults. Count yourself.

5. The body pays for anesthesia for the rest of its life.

Like any drug therapy, anesthesia works for a certain period of time. There are no long-term effects.

6. With each new operation, an increasing dose of anesthesia will have to be applied.

No. For severe burns, some children are given anesthesia up to 15 times in 2-3 months. And the dose is not increased.

7. With anesthesia, you can fall asleep and not wake up.

In the foreseeable past, and even more so in the present, all patients woke up.

8. You can become a drug addict from anesthesia.

In 40 years of work, I have seen only one case where a child with persistent pain was mindlessly drugged for three months in a row and made him addicted. I have never seen such patients.

9. After anesthesia, a person will be inhibited for a long time.

No. In the US, 70% of surgeries are performed in a one-day hospital (the patient arrives for surgery in the morning and leaves home in the afternoon). The next day, the adult goes to work, the child begins to study. Without any concessions.

10. After anesthesia, you can fall into a short-term rampage.

Can. But this is an individual reaction, which is extremely rare with modern anesthesia. Once upon a time, about 30 years ago, when ether anesthesia was still used, excitement was a normal reaction both to entering and exiting it.

Especially a lot of excitement is caused by the need to use anesthesia, if we are talking not about adult patients, but about a child.

I woke up and I don't remember anything

Formally, patients have every right to take part in the choice of anesthesia. But in reality, if they are not specialists, it is difficult for them to exercise this right. We have to trust the clinic. Although it is useful to understand what doctors offer you.

If we talk about children, today it is considered the norm (in Russia - in theory, in Europe and in the USA - in practice) that any surgical intervention should be performed under general anesthesia. It consists of three components. The first is anesthesia or sleep. In the West they say "hypnotic component". The child does not have to attend their own operation. He must be in a state of deep medical sleep.

The next component is analgesia. That is actually anesthesia.

The third component is amnesia. The child should not remember what immediately preceded the operation and, of course, what happened during it. He should wake up in the ward without any negative memories. Abroad, by the way, patients can sue doctors and win the case without any problems if they received a mental trauma as a result of the operation, despite the fact that it could have been prevented. This is not a whim, since we are talking about obsessive fears, sleep disturbances, attacks of hypertension and chills. There should not be any painful impressions!

Sometimes an additional fourth component of modern anesthesia is required - myoplegia, relaxation of all muscles during "major" operations on the lungs, abdominal organs, intestines ... But since the respiratory muscles also relax, the patient has to do artificial respiration. Contrary to idle fears, artificial respiration during surgery is not a harm, but a blessing, since it allows you to dose anesthesia more accurately and avoid many complications.

And here it is appropriate to talk about the types of modern anesthesia.

Prick or mask?

If you want to relax the muscles, you have to do artificial respiration. And with artificial respiration, it is reasonable to apply anesthesia to the lungs in the form of gas, either through an endotracheal tube or through a mask. Mask anesthesia requires more art and experience from the anesthetist, while endotracheal anesthesia allows for more accurate dosing of the drug and better prediction of the body's response.

An intravenous anesthetic may be given. The American school insists on inhalation, the European, including Russian, on intravenous. But children are still more often given inhalation anesthesia. Just because inserting a needle into a baby's vein is quite troublesome. Often, the child is first put to sleep with a mask, and then a vein is punctured under anesthesia.

To the delight of pediatricians, superficial anesthesia is increasingly being introduced into our practice. A cream is applied to the site of the upcoming injection of a dropper or syringe needle, after 45 minutes this place becomes insensitive. The injection is painless, the little patient does not cry and does not beat in the doctor's hands. Local anesthesia as an independent type for children is rarely used today, only as an auxiliary component during large operations, to enhance pain relief. Although earlier under it even appendicitis was operated on.

Today, regional anesthesia is very common, when an anesthetic is injected into the region of the nerve and provides complete anesthesia of the limb, hand or foot, and the patient's consciousness is turned off by small doses of hypnotic drugs. This type of anesthesia is convenient for injuries.

There are also other types of anesthesia, but some of them are outdated, some are used extremely rarely, so it is not necessary for patients to delve into these subtleties. The choice of anesthetic is the prerogative of the doctor. If only because a modern anesthesiologist uses at least a dozen drugs during an operation. And each drug has several analogues. But you do not need to bring your ampoules to the doctor. The law forbids it.

Good afternoon, dear readers. Recently on Instagram discussed the topic of drugs and faced with a number of unpleasant life situations that subscribers experienced, which they certainly want to discuss.

Plastic surgeon Azizyan V.S. comments:

Subscribers' comments confirmed the validity of patients' fears. For me, of course, it is surprising to hear such stories, since in my practice, working with professional anesthesiologists, I have not heard of such situations. All this suggests that somewhere something was not taken into account. Especially when it comes to elective surgery. When it is possible to examine the patient from all sides before the operation, talk, etc.

Modern anesthesiology is not just an injection into a vein or a tube. Often it is a combined, multicomponent (combining various drugs and gases) anesthesia. Thus, the doctor achieves a sufficient depth of anesthesia and comfort for both the patient and the surgeon! With properly selected drugs, according to the principle of synergy and tactics, intraoperative awakenings and pains are excluded.

In the postoperative period, drugs are also used to reduce the gag reflex.

For ourselves and our patients, before the operation, we discuss with the anesthesiologist what anesthesia will be, what I will do. At different stages of the operation, where the likelihood of pain is greater (for example, placing an implant under the muscle), the anesthesiologist can adjust the patient's condition, achieving a more comfortable state.

Therefore, based on the above, I want to say: it is better to discuss all issues before the operation. And I wish that general anesthesia for everyone passes like a good dream!)

We continue the conversation about the fears of patients. One of the most popular fears in my experience is fear of anesthesia or general anesthesia. Patients have heard a lot about those single cases of using general anesthesia that ended in one or another complication, and are very frightened by these cases, so I very often hear: “I'm afraid of anesthesia”, “I'm afraid of surgery under anesthesia”,. Let's start with the fact that against a few cases with a sad outcome, there are millions of cases of successful operations without any complications: it's like the statistics of plane crashes, when no one thinks that tens of thousands of flights take off and land safely every day, but everyone remembers the sensational single plane crashes that make people afraid of flying, while according to statistics, the plane is the safest mode of transport. Therefore, I will try to tell you about the stages of anesthesia and answer some of your questions, and I hope that at least some of you it will help to cope with the fear of general anesthesia.

“I'm afraid of anesthesia before the operation. What to do?"

General anesthesia (or actual anesthesia) acts on the central nervous system, suppressing its impulses. Both inhalation and intravenous means are used to immerse the patient in deep sleep. This manipulation requires the participation of a qualified anesthesiologist and junior medical personnel.

Anesthesia c literally translates from Greek as “without feeling”: a person’s ability to feel his body is reduced, up to the cessation of perception of information about the world around him and his own body. anesthesia, from the Greek - "numbness", "numbness" - artificially induced inhibition of the central nervous system, muscle relaxation, inhibition of a number of reflexes - characteristic of sleep (narcosis - falling asleep, Latin). The addition of the word "general" to "anesthesia", already embedded in the concept itself, thus does not clarify anything. It is correct to say "general anesthesia" or simply "anesthesia".

How does anesthesia take place? Warning, or can you fall asleep "suddenly"?

Classical anesthesia consists of three stages:

• Dive into sleep. The anesthesiologist puts you into a state of deep sleep with the help of special drugs. In the process of immersion in the state of anesthesia, you are talking with the doctor, and gradually falling asleep, you stop seeing or hearing anything. However, immersion in sleep is not pain relief, that is, even in a dream a person will feel pain. And surgical aggression is very painful, so the second stage of anesthesia follows.
• Anesthesia. At this stage, the anesthesiologist will give you pain medication. Injected potent drugs (analgesics) suppress the transmission of pain impulses from the peripheral nerves to the brain, and the person does not feel pain.

It is important to talk about drugs here. Many people ask if narcotic drugs are used in general anesthesia, and whether it is possible to become a drug addict after their one-time use. Yes, in some cases (not always!) narcotic drugs are used by the anesthesiologist, but it is impossible to become addicted to drugs as a result of their one-time use. In order to become a drug addict, the systematic use of a narcotic substance for quite a long time is required.

• Muscle relaxation or muscle relaxation. At the last stage of immersion in anesthesia, the anesthesiologist injects drugs that help to relax the muscles: often, even during immersion in medical sleep, the muscles remain tense, which can interfere with the operation. Therefore, you need to relieve muscle spasms with medication.

Can drug overdose happen?

Experienced anesthesiologists-resuscitators with whom we work know their business very well, and with great accuracy calculate the dosage of all drugs that are used during the operation. The anesthesiologist is in the operating room all the time while the operation is in progress, and very carefully monitors the patient's condition, controls all indicators in order to administer an additional dose of this or that drug in time if he sees that its effect is ending. However, these doses have been verified by many years of practice, and the likelihood that an experienced anesthesiologist will critically exceed the dosage of a particular drug is negligible.

How is the recovery from anesthesia?

When the operation is completed, the anesthesiologist brings the patient out of deep sleep, gradually turning off the supply of drugs, and monitors his condition in all respects (breathing, heart rate, blood pressure) until the patient fully regains consciousness. Depending on which drugs were used, the recovery from anesthesia can take place in different ways: at different intervals and in different sequences, sensitivity, consciousness and the ability to move independently return to you.

Why is anesthesia so expensive?

When performing an operation under anesthesia, an anesthesiologist is present in the operating room on a permanent basis, who makes responsible decisions, selects drugs and calculates the dosage, and the anesthetist is his assistant, who performs all the necessary medical manipulations to immerse the patient in a state of anesthesia: fills and places droppers with drugs, measures blood pressure, etc. When immersed in anesthesia, a lot of consumables are used (disposable needles, syringes, wipes, droppers, gloves, etc.), as well as several types of medications. All this adds up to the cost of the service.

By the way, in my case, anesthesia costs 16,500 rubles. It's not that expensive.

Why is general anesthesia dangerous?

Of course, any surgical operation carries certain risks, which should always be evaluated by the patient and the doctor when deciding whether to perform the operation. However, given the vast experience that has accumulated in the field of general and plastic surgery to date, all the risks associated with the use of general anesthesia are weighed and minimized. And if general anesthesia carried a real and serious threat to the health of patients, it would not be used so widely in surgery.

Most of the accidents that occurred during the use of anesthesia were due to the fact that in the event of complications, the patient could not be provided with emergency care because the necessary resuscitation equipment was not at hand. However, now, without exception, all plastic surgeries in Russia are carried out in clinics that have all the necessary equipment and intensive care doctors.

If you have other questions, you can ask them in the "" section.

The usual trip to the doctor for many is a lot of stress, not to mention the operation. Fear of surgery is a defensive reaction of the body, and is a fear of something unknown ahead. At the same time, people cannot express exactly what exactly scares them: the operation itself, the rehabilitation period, hospital walls, or something else. Already having a referral for a surgical procedure in their hands, almost all patients ask themselves the question: how to overcome the fear of surgery?

Reasons for fear of surgery

• One of the main causes of preoperative phobia is complete obscurity. The patient knows his diagnosis, approximately knows what he will do, and this is where all the information ends. Not every surgeon will explain to the patient on his fingers what is happening in his body, how the operation will take place, what specific actions he will perform, how many days the recovery of the body will continue. The main task of the surgeon is to professionally perform his work, and all mental anxieties should be calmed by a psychotherapist.
• The absolutely opposite reason for the fear of surgery is the excessive awareness of the patient both about his illness and about the methods of its treatment. Currently, on the Internet you can find a lot of information about any disease and methods of getting rid of it. It is not always worth trusting the articles you read, each case is individual and requires a professional assessment by the attending physician. Having read about how surgery should be carried out, how anesthesia is done and other points, patients begin to panic fear of the operation.
• The third reason for fear is anesthesia. Some patients are afraid that anesthesia will have a bad effect and they will feel pain, others are afraid of the possible negative consequences of anesthesia. Surely many have heard the conventional wisdom that one dose of anesthesia for several years shortens a person's life. Well, another group of people who are afraid of surgical intervention is the fear of not waking up at all after anesthesia.

It is unlikely that doctors will be able to remember at least one person who would not be afraid of surgery. The only difference is that many people try to overcome their phobia and go through this stage of treatment, while others, on the contrary, experience real panic attacks at the mere mention of surgical intervention. There are frequent cases in medical practice when patients voluntarily refused surgery because of their panic fear.

How to overcome fear

Each person is given the right to choose whether to agree to the operation or not. If we are talking about a small cosmetic procedure, say, removing burn marks, then nothing threatens the patient's life in case of refusal. But most often, surgical intervention is performed for medical reasons and refusal to do so can lead to serious complications. If a patient simply needs an operation, for example, removal of a malignant tumor, but because of the fear of the upcoming procedure, the patient refuses surgical treatment, he must write his own refusal of the proposed treatment. Thus, doctors do not take responsibility for the unfavorable outcome of the disease.

After weighing all the pros and cons, the patient understands that he simply needs the operation, but what to do if horror fetters the whole body? Psychologists give a number of recommendations on how to get rid of the fear of surgery.

get distracted

Usually, the fear of surgery reaches its peak the day before the procedure. In order not to completely go crazy, you need to try to get distracted. Watch an interesting movie in the evening, read your favorite book, in a word, let your thoughts be occupied with anything, but not tomorrow.

Pray

Skeptics will certainly chuckle and scroll through this paragraph. But for some, prayer brings emotional peace, and with its help, many people really get rid of the fear of the operation. It is not necessary to go to church or remember the exact text of the prayer, you can simply mentally turn to God and ask for a good outcome of the procedure.

Assess the situation realistically

Calmly think, what exactly are you afraid of? If anesthesia is the cause, try talking to an anesthesiologist. Tell us about your fear, and a competent specialist will reassure you by telling you how anesthesia will be applied. According to statistics, only one person out of several hundred thousand dies from improper anesthesia, and every tenth from bursting appendicitis.

Think Positive

If you can’t drive away thoughts about the upcoming operation, try to translate your thoughts into a more positive direction. For example, a woman cannot have children for many years, and the upcoming surgery gives her a chance to become a mother. Think about the future baby and the fear of the operation will subside a little.

Don't escalate the situation

How not to be afraid of an operation if the roommates tell horror stories all evening about surgeons forgetting a scalpel or a roll of cotton wool in the patient's body? Ask to change the subject or watch a movie on the laptop through headphones. Don't use your computer to look for "unsuccessful transactions in the last few years" and the like.

Take a sedative

Do not forget that you can take any sedative drugs only after consulting with your doctor! Only he will tell you what you can drink and what you can not. In any case, a decoction of mint, chamomile, motherwort or other medicinal herbs will not interfere.

Preparing for the operation

To overcome the fear of surgery, the patient must be calm and confident in the professionalism of the operating surgeon. The patient must understand that the operation is the only way to recover from the disease, and the sooner it passes, the better. For the upcoming procedure, you need to prepare not only morally, but also from a practical point of view. Choose a clinic in which competent specialists work, because a favorable outcome of the event depends on the professional skills of the doctor. If possible, go through preoperative preparation. It mainly includes:

• Delivery of all necessary tests long before surgery;
• Give up bad habits at least a couple of weeks before the procedure;
• Do not go to the bath and do not do other cosmetic procedures at least a week before surgery;
• Keep a diary of changes in general well-being, body temperature and blood pressure;
• Follow your diet. You should not eat fatty and salty foods, carbonated drinks, chocolate and other sweets before the operation. It is necessary to give preference to lean meat, vegetables and fruits.

It is not necessary to hide information about other chronic diseases from the attending physician, this can lead to complications both during the operation and after it. If some moments still alarm you (bad tests, negative reviews about the surgeon), you should not submit to circumstances. Perhaps your fear is a signal to take some action: change a doctor or clinic, retake tests, or treat another disease. Poor health can also serve as a basis for postponing the date of the surgical procedure.

It is quite possible to overcome the fear of the upcoming surgery and anesthesia, for this you need not to panic, but really weigh everything. Collect information about the practicing surgeon, follow all the doctor's orders, do not search the Internet for information about unsuccessful operations, in a word, do not get hung up on the upcoming procedure. Thousands of people lie down on the operating table, as afraid as you are, and in the end everything goes perfectly. If there is no alternative treatment, trust your doctor and put all worries away.

Today, many patients, having read horror stories on the Internet, are afraid of anesthesia. The greatest fear, of course, is anaphylactic shock. What is it? - This is an individual reaction of the body to the drug. In order to identify whether the patient has an intolerance to it or not, we conduct a thorough examination before each operation.

First of all, we find out if the patient has allergic reactions. Then we collect a complete set of tests: clinical and biochemical blood tests, coagulogram (blood clotting), electrocardiogram and fluorography.

In the event that there are at least slight deviations from the norm, we will definitely refer the patient for additional examinations. This may be monitoring the rhythm of the heart, ultrasound of the vessels, etc. Moreover, even if all the indicators are normal, before the operation we give antihistamines: diphenhydramine or suprastin. In general, we do not allow the patient to have surgery until we are sure that he will tolerate anesthesia well. Thus, anesthesia is not a threat to the body, but rather a way to protect the patient from microoperative trauma.

Anesthesia is of two types:

• local, when the patient is conscious, but does not experience pain in the area of ​​the operation;
• general anesthesia or anesthesia, when the patient is immersed in

Local anesthesia in plastic surgery is performed by the surgeon himself. It is used for only one type of operation - lifting the upper eyelids. In general, the procedure is similar to a visit to the dentist. A patient comes to the doctor, the area around the eyes is anesthetized with an injection, and then the operation itself is performed: a small incision is made above the eyelid, excess skin and a hernia inside the eye are removed, and finally sutured. All this time the patient is conscious and can talk.

Some doctors do under local anesthesia and plastic surgery of the lower eyelids. However, it is better to perform it under anesthesia, since it is emotionally difficult for the patient to watch the doctor wielding a scalpel in front of his eyes.

All other operations are performed under intravenous anesthesia, which is performed by an anesthesiologist. And here it is extremely important that he be as competent and experienced as a plastic surgeon. In the case of such a professional tandem, the operation for the patient will be as painless as possible.

Anesthesiologist Tatyana Langovaya believes that an experienced specialist always adheres to the principle of noli nocere - do no harm.

Many myths about anesthesia, such as the myth that hair falls out after anesthesia, have nothing to do with reality. Modern preparations allow the patient to reach the ward on their own within 2-3 minutes after the operation, and after 10-12 minutes they are completely eliminated from the body. In this case, the patient does not experience any nausea, dizziness, or confusion. Moreover, anesthesia does not affect the activity of the kidneys, liver, heart and brain.

In addition, spinal anesthesia is used today in a number of operations, for example, in abdominoplasty (tummy tuck). During it, the patient is conscious, but does not experience fear or anxiety, and his torso is completely anesthetized. Thus, modern technologies make it possible to carry out operations with anesthesia without harm to the patient's health.