Storia

In human history, man has always had to deal with the elimination of pain sensitivity. In antiquity, in order to avoid pain, it was customary to narcotize patients by compressing the carotids in order to make them faint or even with blows to the head. Later, we switched to using herbs or other types of substances such as hashish, opium or alcohol. Only in the eighteenth century could medical research begin to make use of more sophisticated substances such as nitrous oxide or diethyl ether. Thanks to the subsequent developments in the use of this last substance, there will be the real birth of anesthesiology, which must be dated to around the middle of the nineteenth century. The recognition of these techniques will come a few decades later, at the end of the century. In the mid-twentieth century, anesthetic studies are already very close to what we consider today as anesthetic methods.

Types of anestesia 

There are various ways in which anesthesia can be practiced and the choice of method must be defined case by case depending on the intervention to be performed and the state of the patient.

In general, there are two types of anesthesia: general anesthesia, which completely “sleeps” the patient’s body, and loco-regional anesthesia, where the effect affects only a part or region of the body.

General anestesia 

General anesthesia is the type of anesthesia which consists in the total inhibition of pain sensitivity and state of consciousness. It is used in operations that require total unconsciousness of the patient and prolonged muscle relaxation. It is administered before an intervention through an intravenous injection or a tracheal tube, but also both ways. For the entire duration of the operation the anesthetizing drug will be continuously administered to the patient by one of these two routes. During this anesthesia the patient is completely asleep and does not feel any pain or record any memory of the intervention.

loco-regional anestesia

Loco-regional anesthesia, or more simply local anesthesia, sensitivity is inhibited only in one part or region of the body, so that pain does not reach the brain. This anesthesia is practiced by injecting the anesthetic drug directly near the nerves that bring sensitivity to the area undergoing surgery. For example, by operating a foot, the nerves of the leg will be anesthetized. Local anesthesia has several advantages: this includes the lack of unconsciousness and fewer side effects compared to general anesthesia.

The most common operations performed under local anesthesia are:

• Interventions on the arm, hand, leg, knee, foot.
• Gynecology interventions.
• Painless birth.
• Caesarean section.
• Interventions in the abdomen
• Interventions in the anus
• Urology interventions

Types of loco-regional anesthesia

Loco-regional anesthesia can be of various types and, even in this case, the choice of the right anesthesia depends on the procedure to which the patient is subjected and his state of health.

Anestesia subaracnoidea, more commonly called spinal anesthesia, it is a type of local anesthesia performed by injecting a dose of anesthetic into the subarachnoid space, in the liquid part surrounding the spinal cord and nerves. It is indicated for operations in the lower abdominal region and lower limbs.

Peridural anesthesia

Peridural anesthesia, also called simply epidural, is a type of anesthesia very similar to the spinal one, in which however the anesthetic is injected out of the subarachnoid space. It is the most commonly used anesthetic for painless childbirth.

Nerve anesthesia

Nerve anesthesia is a type of local anesthesia in which the anesthetic drug is injected directly near the nerve that carries sensitivity into the area to be operated. It is used in surgical operations related to the limbs (arms, forearm, hand, thigh, leg, foot).

Local anesthesia

Local anesthesia is the simplest and has the least room for maneuver. In this type of anesthesia the drug is injected into the area to be operated so that there is no sensitivity to pain. It is used for small or localized operations on the surface of the body.

The choice of anesthesia

The choice of anesthetic drug will be established by the anesthesiologist after a preliminary interview held with the patient who will have to undergo an operation or a procedure that requires the use of anesthetic tools. During this interview questions will be asked to the patient in order to understand their lifestyle, any allergies, important diseases that are not indicated in the medical record, if he uses drugs, etc. The anesthesiologist will use these data, crossing them with the importance of the intervention, to choose the type of anesthetic best for the operation.