search
close
Departments
It is dangerous to administer anesthesia when there is food or fluid remaining in the stomach. This is because there is a risk of the stomach contents refluxing and flowing into the lungs, causing aspiration pneumonia. As a general rule, at our hospital, patients must not eat or drink anything from midnight on the day before surgery, and are allowed to drink fluids (water, tea, and clear water) up until two hours before entering the operating room.
There are some medications that you will need to take until the morning of the surgery, and some that you will need to stop taking. If you are currently taking any medications, please inform your anesthesiologist.
Smoking has a negative impact on surgery and anesthesia. It increases the risk of complications such as pneumonia and slows wound healing. Quitting smoking for at least one month is necessary to eliminate the negative effects, but quitting smoking at any time is effective in reducing complications, and the earlier you quit, the more effective it is. To increase the safety of surgery and anesthesia, be sure to quit smoking before surgery. Passive smoking is also harmful, so we ask that your family members also quit smoking. If the smoking ban is not respected, anesthesia may be refused and the surgery may be canceled.
On the morning of your surgery, you will be given an IV infusion in the operating room or on the ward.
Anesthesia can be broadly divided into two types: general anesthesia, which puts the patient into a completely asleep and unconscious state, and spinal anesthesia, epidural anesthesia, conduction anesthesia, local anesthesia, etc., which puts the patient into a conscious state but does not feel pain.
Most of the anesthesia we anesthesiologists administer is general anesthesia. There are also anesthesia methods that combine both (for example, general anesthesia + epidural anesthesia). Depending on the area of surgery, some surgeries require general anesthesia, but there are also surgeries that can be performed with either general anesthesia or spinal anesthesia, such as surgeries on the lower body.
This is an anesthesia method that completely renders you unconscious. The surgery begins and ends without your knowledge. There are two ways to start anesthesia: by having medication administered through an IV drip to put you to sleep (intravenous anesthesia), or by having anesthesia administered through a mask to put you to sleep (inhalation anesthesia). In most cases, adults are anesthetized using the former method. The latter is a method mainly used in children. During anesthesia, a tube (called an endotracheal tube) is inserted through the mouth (or nose) into the trachea at the back of the throat to provide artificial respiration.
It is also called spinal anesthesia. It is a lower body anesthesia. It is used for surgery on the lower body, such as the thigh, knee, foot, bladder, uterus, anus, etc. The lower body is numb and you do not feel pain, but you remain conscious.
The procedure involves having the patient lie on their side or in a seated position, and an anesthetic is injected into the lower back into the sac surrounding the spinal cord. After about 5 to 10 minutes, numbness will spread from the lower limbs to the abdomen. Once this has spread sufficiently, surgery will begin, but numbness will remain for several hours after surgery.
This is a type of anesthesia similar to spinal subarachnoid anesthesia. It is called this because the anesthetic is administered outside the sac (called the dura mater) that surrounds the spinal cord. It is injected into the back or lower back, and a soft plastic tube about 1 mm in diameter is placed through it. The anesthetic is administered through this thin tube, so it is also effective against post-operative pain.
In many cases, this is combined with general anesthesia. In lung surgery performed through thoracotomy, surgery on the stomach, gallbladder, liver, pancreas, intestines, uterus, etc. performed through abdominal opening, or hip surgery, this method of general anesthesia plus epidural anesthesia is often used.
This type of anesthesia may be combined with general anesthesia during upper or lower limb surgery or abdominal surgery. It is performed before or during general anesthesia. In many cases, the position of the needle is confirmed using a recently developed ultrasound device. A thin tube may be placed, similar to epidural anesthesia.
It is performed for minor surgeries on the eyes, nose, or limbs, but is rarely performed by an anesthesiologist.
Once you enter the operating room, you will be transferred to the operating table, where you will first be fitted with an electrocardiogram, a blood pressure monitor, and a finger cap to measure oxygen levels. If an IV drip is administered in the operating room, it will be inserted into a vein in your hand. A needle will be inserted through the area where a painkiller patch has been applied beforehand. (In the case of spinal subarachnoid anesthesia or epidural anesthesia, you will then be given an anesthetic injection into your lower back or back while lying on your side or sitting. You will also receive a painkiller injection beforehand.)
After this, you will finally be put under general anesthesia. A mask will be placed over your face to circulate oxygen, and an anesthetic will be administered through an IV drip to begin the anesthesia. You will remain conscious until this point.
Everything that follows will be done completely without your knowledge. What will be done is to insert a tube for artificial respiration (tracheal tube) from your mouth (or nose) into your trachea, insert a tube from your mouth or nose into your stomach, insert a tube through your urethra to measure urine output, insert a thin tube into an artery in your wrist to continuously measure your blood pressure, and insert an IV tube into a large vein in your neck or below your collarbone. These procedures may not be performed depending on your physical condition and the type of surgery, or they may be performed before the anesthesia has fully taken effect. After this, your body will be positioned to make it easier for the surgery, your skin will be disinfected, and the surgery will finally begin. Of course, you will remain asleep.
Now the surgery is over. It's time for you to wake up from anesthesia. With modern anesthetics, you will wake up quickly once the administration is stopped. You will be asked to "open your eyes, hold your hands, take a deep breath, and open your mouth," so please do as instructed. Once we have confirmed that you have fully recovered from the anesthesia, the tracheal tube will be removed and you will be returned to the ward.
(However, in cases of major surgery such as heart surgery, long-lasting surgery, or when the patient's breathing is not satisfactory, there are cases where the patient is moved to the ICU without waking up from anesthesia and still on artificial respiration.)
We will explain about postoperative pain. If you have had epidural anesthesia, you will continue to receive a strong painkiller through a thin tube that has been left in place, even after you return to the ward, so you should feel very little pain. If you have had spinal anesthesia or general anesthesia alone, you will likely experience some pain as the anesthesia wears off. Painkillers will be administered via suppositories, injections, or intravenous drips, so please let us know as soon as possible. We may also use a device that allows you to press a button to inject painkillers yourself. It is not good to endure pain. To prevent postoperative pneumonia, please take slow, deep breaths and cough to expel phlegm.
This is about the anesthesia complications you are most worried about. Thanks to advances in anesthetic drugs and monitoring equipment, the safety of anesthesia has improved dramatically in recent years. As a result, the frequency of anesthesia-related complications has become very low, but they are not zero.
During general anesthesia, a tube is inserted into the trachea through the mouth (or nose), which can damage teeth. This is especially true for loose teeth or the sole remaining tooth. Please remove any removable dentures before surgery. Be sure to inform the hospital about any loose teeth. After surgery, it is relatively common for patients to experience hoarseness or a sore throat, but these usually improve within 2-3 days. In rare cases, hoarseness may persist and require treatment at an otolaryngology clinic.
After general anesthesia, you may experience persistent nausea or even actual vomiting. This is more common in women and those prone to motion sickness. This is related to the patient's constitution, the area of surgery, and the painkillers used during and after surgery. There are anesthetic and painkiller methods that are less likely to cause nausea, so if you have suffered from postoperative nausea in the past, please feel free to ask.
After general anesthesia, your lungs will not expand properly, and you will produce more phlegm and it will be harder to cough it up, making you more susceptible to lung complications such as pneumonia. To prevent this, practice deep breathing before surgery. Be sure to quit smoking. After surgery, take repeated deep breaths and cough to expel phlegm. Your efforts after undergoing surgery are the most important thing.
This is a very rare but serious complication associated with general anesthesia. During anesthesia, body temperature rises rapidly, reaching over 40°C, causing muscles throughout the body to stiffen. This condition can run in families, so if anyone in your family has developed this condition, please be sure to speak up. Recent statistics show that the incidence rate is 1-2 cases per 100,000 cases of general anesthesia, with a mortality rate of approximately 151 TP3T. Incidentally, our hospital performs approximately 3,300 general anesthesia cases per year.
After surgery using spinal anesthesia, it is relatively common for young people to experience headaches when getting up. This is caused by cerebrospinal fluid leaking from the hole where the needle was inserted. Please lie down in bed with a low pillow. If you are okay with taking food by mouth, please drink plenty of fluids. This usually gets better in about a week.
In the case of spinal anesthesia, the numbness in the lower body usually goes away within a few hours, but in rare cases, a tingling sensation or muscle weakness may remain the next day or later.
With epidural anesthesia, the medication will continue to be administered for 1 to 4 days after surgery.
Therefore, during this time, you will feel numbness around the surgical wound. You may also experience nausea and itching as side effects of the analgesic. These symptoms will disappear once the injection of the medication has stopped. As with spinal anesthesia, in very rare cases, you may experience a tingling sensation or muscle weakness the day after. Also, although very rare, infection can occur through the indwelling tube, or blood can accumulate at the puncture site, causing nerve damage. Therefore, if you experience any abnormalities such as numbness or weakness in your lower limbs, please report it immediately.
Even with epidural anesthesia, there is a chance of about 2.5% of puncturing the dura mater and causing cerebrospinal fluid to leak out. In this case, as with spinal subarachnoid anesthesia, headaches occur when getting up. Compared to spinal subarachnoid anesthesia, the needle used is thicker, so the headache is often more severe. Recovery is waited for with rest and intravenous drips, but if improvement is difficult to see, a treatment called an epidural autologous blood patch may be performed.
If you remain motionless for an extended period of time, blood flow may become stagnant, causing blood clots (blood clots) to form in your blood vessels. These clots are most common in the veins of the lower limbs. If a large clot breaks off and blocks a blood vessel in the lungs, it can cause sudden respiratory failure and cardiac arrest. Care is required for approximately one week after surgery. Recent statistics in Japan indicate that the incidence of pulmonary embolism is approximately three cases per 10,000 surgeries, with a mortality rate of approximately 10% if it does occur. To prevent blood clots from forming, you will be asked to wear special socks before surgery, and a device that massages the soles of your feet will be used during and immediately after surgery. Even if you are unable to walk immediately after surgery, be sure to actively exercise your legs.
This is a strong allergic reaction that occurs when the body overreacts to an administered drug. It is known as shock. It can occur with any drug. If you have previously had an allergic reaction to a drug or injection, or if a family member has had an allergic reaction, please be sure to tell us.
It has been reported that intraoperative and postoperative myocardial infarction occurs very rarely in those who are at high risk, such as those who have had a myocardial infarction before. A recent survey in Japan found that the incidence of cardiac arrest during surgery is 3 to 4 cases per 10,000 cases.
It has been reported that cerebral infarction and cerebral hemorrhage during and after surgery occur very rarely in people who are already at high risk, such as those who have previously experienced cerebral infarction or cerebral hemorrhage.
Liver and kidney function may decline after surgery, but unless you already have a disability, it is very rare for the decline to be severe enough to require treatment.
If complications occur, and an emergency is required, the anesthesiologist will take appropriate measures during or after the anesthesia.
