Principle of action of general anesthesia

General anesthesia works on the central nervous system, but does not simply "numb" one or a group of nerves. Modern general anesthesia is the result of sedation, hypnosis, analgesia, muscle relaxants and many other different types of drugs.

Of course, general anesthesia has something to do with consciousness. Sedative hypnotic drugs in general anesthesia can produce the effect of loss of consciousness, but not all general anesthesia is completely without consciousness. We often say "anesthesia" generally refers to the general anesthesia endotracheal intubation, which is the most common way of anesthesia, the consciousness of anesthesia patients disappeared, in a state of "anesthesia", at the same time, under the action of analgesic drugs and muscle relaxants, disappear spontaneously breathing, muscle relaxation with convenient operation, so need to endotracheal intubation to assist breath with breathing machine. The process of spontaneous breathing has a part of the "plant nerve" function. However, in some cases, general anesthesia without endotracheal intubation may be used, which is also absent subconsciously, or at a low level of consciousness, and the patient will also be unaware of the anesthesia and the procedure, but at the same time can retain spontaneous breathing without the need for endotracheal intubation. This type of anesthesia is commonly known as "general intravenous anesthesia" and is commonly used during painless gastroscopy and abortion procedures.

The third problem is that the patient recovers consciousness during general anesthesia and is aware of the anesthesia and surgical process, generally known as "intraoperative awareness", which is a serious adverse event of anesthesia and will cause very bad mental and physical damage to the patient. Some of them can be identified as medical liability and accident. But there are also surgical awakenings, such as a recent brain-surgery operation in Ruijin Hospital that was described in the media, during which the patient was woken up to check his nervous system function.

Finally, anesthetic drugs generally act on the nerve conduction process, rather than a specific "anesthesia" of a functional area, at least the current general anesthesia is not able to do, so it is difficult to achieve the desired analgesic effect of surgery, respiratory depression is inevitable.

In fact, general anesthesia is a very complex process, and many mechanisms are not well understood.

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