Making good choices about anesthesia, from the June 2015 Harvard Women's Health Watch

From stitching up a cut to bypassing a coronary artery, most operations aren't possible without anesthesia. It is designed to keep you comfortable during a procedure that otherwise might be hard to tolerate physically, emotionally, or both. There are many types of anesthetic available, and the type chosen can affect your recovery. While doctors make some of the decisions about which type of anesthetic to use, patients often have a say, too, according to the June 2015 Harvard Women's Health Watch.

"Anesthesiologists have four goals: to see that you have no pain, that you're drowsy or unconscious, that your body is still so that the surgeon can work on it, and that you aren't left with bad memories of the procedure," says Dr. Kristin Schreiber, an anesthesiologist at Harvard-affiliated Brigham and Women's Hospital.

There are four main types of anesthesia:

  1. Local anesthesia. Anesthetic medication is injected near the area to be treated. Its effect is limited to a fairly small area.
  2. Regional anesthesia. Anesthetic medication is injected near clusters of nerves to numb a larger area, or region, of the body.
  3. Neuraxial anesthesia. Anesthetic medication is injected near the spinal roots, numbing an even larger part of the body than regional anesthesia. Epidural and spinal anesthesia are included in this category.
  4. General anesthesia. A combination of intravenous and inhaled drugs brings on unconsciousness and the inability to feel pain.

Regional and neuraxial anesthesia can also induce different levels of sedation. Minimal sedation means being relaxed but aware of what's going on. Moderate sedation causes a "twilight sleep" — drifting in and out of consciousness, but able to easily be aroused. Deep sedation is similar to the effects of general anesthesia — being fast asleep and unlikely to remember anything.

Read the full-length article: "What you should know about anesthesia"