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Derived from the Greek word an’es-the’ze-a, anesthesia can be defined as a condition resulting in the loss of sensation caused due to the depression of nerve function or neurologic dysfunction. It is one of the kinds of clinical specialities. If compared to the enormous medical speciality, anesthesia is young somewhere around 150 years. However the innovations and advancement are being carried out since 1950.  Anesthesia can be observed in various forms such as analgesia, paralysis, amnesia or unconsciousness. Anesthesia has got a wider approach in this era of medical treatment. It won’t be wrong saying it is a boon to the pain providing a relief throughout the surgery by using a combination of drugs called as anesthetic drugs making the patient totally unconscious and unable to feel the pain. It is oftenly used to relax you, block the pain and make you feel sleepy during the medical check-ups, medical tests or the surgery.

There are few points that should be kept in mind while selecting the type of anesthesia to be used 
Your past and current health: This incorporates different surgeries you have had and the medical issues you have, for example, coronary illness or diabetes. Tell your specialist in the event that you or any relatives have had a genuine response to soporifics or different drugs.
The type of surgery: For instance, you may require general anesthesia to guarantee your solace and wellbeing amid specific sorts of surgery. It is the most important factor. 
The results of tests: such as blood tests or electrocardiogram.

There are few points that should be kept in mind while selecting the type of anesthesia to be used

Your past and current health: This incorporates different surgeries you have had and the medical issues you have, for example, coronary illness or diabetes. Tell your specialist in the event that you or any relatives have had a genuine response to soporifics or different drugs.

The type of surgery: For instance, you may require general anesthesia to guarantee your solace and wellbeing amid specific sorts of surgery. It is the most important factor.

 The results of tests: such as blood tests or electrocardiogram.

  It can be applied for surgery of any region. It produces the anesthetic condition by suppressing the activity of central nervous system resulting in the unconsciousness. It is very safe and moreover in some cases patients have shown the better results under the influence of general anesthesia. Mostly used in the case of emergencies that may arise in the absence of epidural or spinal regional anesthesia for Cesarean.   However, in case of older adults with serious medical problems, there might be a slight risk of pneumonia or even stroke or heart attack. Smoking and seizures should be avoided.

Its affected is spread to the larger part of the body. It blocks the nerve impulse transmission within the targeted body part and the central nervous system, resulting in the loss of sensation to the targeted body parts. Special care is given during the selection of drugs. Widely used drugs are general anesthetics, hypnotics, sedatives, neuromuscular blocking drugs, narcotics and analgesic. They may have side effects like allergic reactions against the anesthesia used, difficulty in urinating, and decrease in blood pressure, nerve damage, severe headache or seizures in rare cases. Regional anesthesia can be further classified to Peripheral nerve blocks and Epidural and Spinal anesthesia. 
5.1. Peripheral nerve blocks: used for the specific part of the body by inhibiting the sensory perception such as numbing a tooth, procedures on the arms, hands, feet or legs.  It lasts longer then the local anesthesia. The effect of the anesthesia lasts much up to 3 day.
5.2. Epidural anesthesia: In this type of anesthesia the agent is injected into the epidural space of the spinal cord. It is widely used during the Labor pain; in fact it is the first preference. It results in the loss of sensation by blocking the signal transmission in nerve fibres or near the spinal cord. Local drugs used for this are bupivacaine, chloroprocaine, or lidocaine mostly used in combination with the opioids or narcotics. 
5.3. Spinal anesthesia: In this type, a local anesthetic drug is injected into the cerebrospinal fluid. However there is a large chance of hypotension as compared to the Epidural anesthesia. Spinal anesthesia is one of the most popular and widely used procedures with some of the complications too such as infections, hematologic complications, transient neurologic symptoms, hypotension and hypothermia.

It is having the temporary effect wherein stopping the pain in particular area of the body. One of the most commonly used local anesthetics is Novocain, which blocks the transmission of nerves to the pain area in the central nervous system. Patient will be under conscious state within certain time period.  t is used in minor surgeries, via injection to the affected site or allowed to absorb into the skin. It is less painful as compared to other anesthia.

The maintenance of safety is the main aim of the obstetric anesthetists. This is widely used during the labor pain. Bupivacaine is the most commonly used drug that produces the greater sensory block. The major goal of this treatment is to dramatically reduce the labor pain, allowing the parturient to participate in birthing experience, allowing ambulation by blocking the motor, minimal effect on the foetus and minimizing effects on progress of labor. Various types of labor analgesia are there such as pharmacological, non-pharmacological analgesia, regional analgesia and general analgesia.

A soporific workstation to be utilized for paediatric  anesthesia needs to meet various prerequisites and must  mull over the extraordinary physiological parts of  the different age gatherings of youngsters, from untimely infants to class youngsters. Various factors play a key role in the paediatrics anesthesia like airway and respiratory system, cardiovascular system, renal system, hepatic system, glucose metabolism, haematology, temperature control, central nervous system, psychology. Various practicalities are done for anesthetizing children like the pre-operative visit, pre-operative fasting and pre medication.

Anesthesia is used in the Cardiac surgery for providing relief from the pain arrest. It’s monitored through the ECG, Pulse oxymetry and the blood pressure. It can be formulated through the venous, arterial cannulation or by the other means such as indwelling urinary catheter, temperature probes, cross matched blood available or through the thoracic epidural anesthesia. The basic principle of cardiothoracic anesthesia is hemodynamic stability. Induction agents to be used should possess certain characteristics like the high dose opiates, modest dose propofol, should be muscle relaxant, and should be the modest dose propofol. There should be strict avoidance of nitrous oxide as it led to expansion of intravascular air bubbles, pneumothorax.

Dentistry and pain are correlated factors especially in the case of poor dentition that is often due to multiple extractions, periodontal diseases requiring surgery or symptomatic teeth requiring endodontic therapy. Local anesthesia is given in the dentistry. Local anesthesia interferes or rather interrupts the pathways carrying the stimulus information from the periphery of the body to the central nervous system and blocking the central nervous system. The anesthesia works here by blocking the sensory neural conduction of noxious stimuli from reaching the central nervous system. A reversible local anesthesia chemical agent is the most common method for achieving the pain control in dental practice. However the agent should possess certain basic properties specific actions, reversible actions with rapid onset and suitable duration, it should be non-irritant, without causing any permanent damage. However there are complications often which may be local effects as well as systemic effects.

With the advancement of anesthesia, there had been large improvement in the day care procedure, diagnostic and diagnostic of surgery and medical technology.  General anesthesia is used during surgery which is used for inducing unconsciousness. The medicines are given which can be either inhaled via tube or may be given intravenously. General anesthesia is used in many crucial surgeries like open-heart surgery, brain surgery or the organ transplantation. Depending on the patient’s medical condition and type of surgery, the suitable anesthesia is given. Sedatives and analgesic can also be used as part of anesthesia. Before giving the anesthesia, the anesthesiologist evaluates the medical condition and formulates the physical condition. 

When it comes to cesarean delivery, Regional anesthesia and general anesthesia are widely used. However, general anesthesia also can have some risk which can be avoided by the regional anesthesia.  Regional anesthesia is advantageous as it helps in the preservation of consciousness, avoiding the neonatal depression and the airway manipulation. The main aim of the cesarean anesthesia is to improve the outcome, identifying the difficulties, identifying the existing medical conditions, improving the safety by assessing and quantifying risk, allowing the planning of preoperative care and allaying the anxiety and fear. There should be proper examination of the pregnant women beforehand in order to ascertain the possibilities of any existing difficulties as they may causes the difficulties and may lead to neuraxial block, venous blockage etc. An ideal anesthesia used in the cesarean should be safe for the mother and baby, and should be comfortable for the mother. 

Anesthesia is used in the medication or treatment of various syndromes such as Williams’s syndrome, Gilbert’s syndrome, Marfan syndrome, Angelman syndrome, Down syndrome, Gitelmen Syndrome, Piriformis syndrome, Carcinoid syndrome and ehlers-danlos syndrome. Of the entire mentioned, Downs’s syndrome is the prevalent one which is the Trisomy results due to the chromosomal abnormality. Patients suffered with multiple congenital anomalies that affect nearly all of the organ system. A few parts of Downs’s disorder must be considered when arranging safe anesthesia encounters. Preceding organization of sedation or anesthesia, inside and out audit of current formative and restorative issues, hypersensitivities and medicines, and therapeutic and surgical history (counting anesthesia history) are important.

The aim of Perioperative medicine is to provide the best possible care for patients before, during and after the major surgery. Additional care is given to the patients who need it the most. There is proper assessment of the patients for surgery in order to optimise the treatment of co-existing medical disease. the claim to fame of anesthesiology has extended its training from being to a great extent limited to the working space to incorporate perioperative restorative practice in intense agony drug, postoperative and emergency unit, interminable torment pharmaceutical, and rest and palliative care solution

It may arise due to the trauma from the procedure related complications. Many patients are worried and tensed about the pain they will be receiving by the anesthesia during the surgical treatment. There is control from the aggressive pain. Here the aim is to prevent and reduce the pain by providing an alternative to general anesthesia. Anesthesiologist numbs the pain of the area needing surgery.  With the help of general anesthesia, nerve blocks are coupled and there is further reduce in post-operative pain. In some cases, opioids are also used. 

In this the patient is given extra care before, during and after surgical procedures supported Intensive Care Unit where critically ill or injured patients are monitored, treated and cared. There is a wide entire spectrum of anesthesia modalities, from general anesthesia to regional infiltrations, including anesthesia and proper after-care for complex cardiovascular diseases, procedures and surgeries. Patients are usually held in such facilities for a limited amount of time, and must meet set physiological criteria before transfer back to a ward with a qualified nurse escort.

It’s a pain that is present in a surgical patient after the completion of surgery or any procedure. It either may be the result of trauma from the surgery or any surgery related complications. Large variety of analgesic agents are used differently to treat the acute pain allowing the clinicians, specialists to tailor an analgesic regime that is specific to that patients pain, requirements and individual circumstances. For the proper treatment of pain various factors are considered like history of the pain, severity, effect upon the patient, type of analgesic agents to be used, and the most important one suitable method for delivery. Route of administration of these agents also play an important role.

Most of the pain is acute that is it may last for few moments, or temporary or may eventually go away. However in some cases when the pain last to three months or longer then the three months then it becomes the chronic pain. For example, after the treatment the surgical pain still continues then the nerves become hypersensitive and results to the chronic pain. Other factors also continues to the chronic pain such as arthritis, back and neck injury, fibromyalgia and musculoskeletal pain, migraine headache, limb pain or the shingles. Pain management is one of the major works of the anesthesiologist. Various steps are taken by the Anesthesiologists to treat the pain like prescribing the medication, rehabilitative services, pain relieving service, counselling patients and families.

Nowadays, critical care is provided by the anaesthesiologists usually in intensive care unit. The key role of anesthesiologist is to look after the ones dealing with the surgery along with the critically ill patients, young and old.  They often diagnose  and manage several disorders such as respiratory(breathing), cardiovascular(heart and circulation), neurological(brain, spinal cord and nerves), gastrointestinal(including metabolic and nutritional  support), and renal( kidney).  Anesthesiologists become experts in the management of unconscious state. Those associated with this field has not only the overall responsibility of the patients but also has to work collectively with distinct groups including the support network.

The main aim of the anesthesia management is to minimize the stress and the immune response while balancing and maintain the blood flow and oxygenation. Anesthesiologists should perform careful and detailed pre-anesthetic assessment prior to surgery (1-4 weeks). In some cases, by using the regional anesthesia certain complications can be avoided. Volatile anesthetics are effective in the maintenance of anesthesia. Muscle relaxants should be avoided. For safe anaesthesia it has been advised to uses propofol and remifentanil intravenously. For the pain control, use the regional anaesthesia, if they are showing minimal effects then opioids must be administered under the vigilant monitoring

One of the crucial skills of the anesthesiologists is airway management that is a part of general anesthesia. It allows the process of oxygenation and ventilation during the aesthetic gas delivery that is used for general anesthesia. There is a rare complications in airway management, but if any it may be life threatening. Before going through the treatment, there should be full assessment of the patient. Various techniques are applied for the airway management like facemask ventilation, pharyngeal airways, laryngeal mask airway, tracheal intubation and laryngoscopy.

Sedation (likewise alluded to as dissociative anesthesia or dusk anesthesia) makes trancelike, calming, anxiolytic, amnesic, anticonvulsant, and halfway created muscle-unwinding properties. From the point of view of the individual giving the sedation, the patient will seem lethargic, casual and neglectful, enabling offensive systems to be all the more effortlessly finished. Tranquilizers, for example, benzodiazepines are typically given with torment relievers, (for example, opiates, or neighbourhood soporifics or both) in light of the fact that they don’t independent from anyone else, give critical torment help.

Anesthetists and specialists are frequently looked with a tyke who has been as of late inoculated exhibiting for either crisis or elective surgery. The inquiry is then raised with respect to whether the anesthesia or the surgery will influence the safe reaction of the tyke to the immunization, or all the more truly. The immune response to surgery and anesthesia involves changes in neutrophil, NK and lymphocyte number and function. However in some cases, the effect is transient, and in some cases often affects the clinical outcome. Sequelae of inoculation, for example, fever, fractiousness, and so on are all around perceived and may convolute evaluation of a youngster building up these side effects in the perioperative period.

Once after the surgery there might be common side effects of anesthesia like nausea, vomiting, dry mouth, sore threat, shivering, sleepiness, physical injuries, reactions to drugs. While in some patients there might be damage in teeth. In some cases there are chances of allergic reactions against the medication such as rashes, anaphylaxis. Since the improved anesthesia medication and anti-nausea medication, there has been slight reduction in the patients showing the anesthesia side effects. Its highly recommended that the anesthesiologists should properly study and examine the patient’s medical condition to overcome all this risks and complications.

Anesthesia has helped in carrying out complicated surgeries successful like organ transplantation, renal transplant liver transplant. With these wide applications there has been much advancement in the anesthesia. Many technologies are trending like the most advanced one is the ultrasound devices for nerve localisation. Initially they were used for the diagnosis and monitoring but now days there had been increases in it usage in regional anesthesia for the monitoring of cardiac output. Being non-invasive in nature it’s very advantageous due to the reduce risk of infection. Non –invasive and minimally monitoring helps not only in the cardiac output but also in the blood pressure. Recent advancement in the field of airway management is videolaryngoscopy that helps in the enhanced visualisation during the incubation process. Pain and palliative care can be seen as upcoming super speciality of anesthesiology. In initial time period narcotics were used for the relief of pain however nowadays there is a possibility of using a formulation of saxitoxin, which can treat the acute and chronic pain. Various drugs can be formulated in the future using the technique of nanotechnology. Cellular robotics system like vasculoids can be used for the transport functions of the blood. Development of artificial platelets like clottocytes for providing relief during the emergency surgeries.