Visão Geral da Anestesia e suas técnicas

Abstract

Introduction: Anesthesia allows surgical and other interventional procedures to be performed quickly and safely, producing analgesia (pain control), absence of anxiety (or absence of consciousness with general anesthesia [GA]), and adequate muscle relaxation. A critically important aspect of perioperative anesthetic care is the maintenance of physiological homeostasis (e.g., hemodynamic stability, oxygenation, ventilation, temperature). Objective: to discuss the overview of anesthesia. Methodology: Literature review from Scielo, PubMed, and BVS databases, from April to June 2024, with descriptors “Overview” and “Anesthesia”. Articles from 2019-2024 (total 25) were included, excluding other criteria and choosing 05 full articles. Results and Discussion: Prior to elective anesthesia for noncardiac or other surgical interventions, all patients are evaluated by an anesthesiologist to assess medical status and readiness for the planned procedure, assess potential difficulty with airway management, implement strategies to reduce risk, create an anesthesia plan, and communicate with the patient. Anesthesia care may include provision of general anesthesia (GA), neuraxial anesthesia via spinal or epidural techniques, peripheral nerve blocks, intravenous regional anesthesia, or monitored anesthesia care (MAC) with conversion to GA if necessary. Factors that affect selection of appropriate anesthetic techniques for an individual patient include surgical requirements for performing the procedure, anticipated duration of surgery, patient comorbidities and preferences, plans for providing postoperative analgesia, and provider experience and preferences. General anesthesia - GA provides hypnosis/unconsciousness, amnesia, analgesia, and immobility or muscle relaxation as appropriate for the procedure, as well as autonomic and sensory blockade of responses to noxious surgical stimuli. The three phases of GA are Induction; Maintenance; and Emergence. Neuraxial anesthesia and analgesia techniques (e.g., spinal, epidural, or combined spinal-epidural [CSE]) involve placement of a needle and/or catheter between the vertebrae for injection of medication into the subarachnoid space (for spinal anesthesia) or the epidural space (for epidural anesthesia). Peripheral nerve blocks—upper extremity blocks, lower extremity blocks, digital nerve blocks, and nerve blocks of the trunk, neck, and scalp. They are widely used for surgical anesthesia as well as postoperative paraanalgesia. IVRA, also called Bier block, is an alternative to peripheral nerve blocks for short procedures (i.e., 30 to 45 minutes), usually in the hand and forearm (e.g., carpal tunnel release, Dupuytren's contracture release, wrist fracture reduction). Conclusion: General anesthesia is a procedure performed to deeply sedate the patient. It is necessary to prevent the patient from feeling any discomfort or pain during surgery. The medications render the patient unconscious, promote muscle relaxation, and cause amnesia and insensitivity to pain.