Dr. J. Arthur Saus, M.D.

That question is too broad and non-specific to provide any kind of meaningful answer. Please explain your concern, or re-word the question to address some specific area of concern. Is this question about a specific anesthesia agent, or is this question directed toward changes in lung physiology as it relates to anesthesia? Is this question related to one specific inhalation anesthesia agent, or to oxygen administration during anesthesia, or even to positive pressure ventilation, instead of anesthesia agents at all? Does this relate to someone with perfectly healthy lungs prior to anesthesia, or does it relate to someone with specific pre-existing lung problems? Quite honestly, the best answer for each individual, is to have a very open and honest discussion about any concerns with your anesthesiologist for your particular surgery prior to the time of anesthesia administration. J. Arthur Saus, M.D. FASA

I wouldn't recommend getting a colon biopsy with the use of only local anesthesia.

Personally, I think a liver biopsy would be much more risky without anesthesia, unless you are talking about just a needle biopsy, which would just be a needle placement through the skin and into the liver to get a fe w cells of the liver, rather than getting a piece of it, as a biopsy would be.

General Anesthesia is not as likely to cause any liver problems now, as in the past, and currently the risk of liver problem occurring strictly due to administration of an anesthetic are very low. Previously, when Halothane was a commonly used inhalation anesthetic, the risk of acquiring liver problems was greater, but even then the risk was a low percentage possibility. Numbers for the risk of Halothane causing hepatitis were generally quoted as around 1 occurrence in about 6000 to 1 in 20,000 uses of Halothane. Even then, most of the cases of hepatitis that occurred following use of Halothane were in people who were older than 40 years of age. When Halothane Hepatitis occurred, it was often lethal. Fortunately, Halothane is rarely used in the United States now, since better (and safer) inhalation anesthetics have been developed.

No, a colonoscopy is not "done under local anesthesia". Generally, the term Clocal anesthesia implies numbing a specific small area of skin, while the term regional anesthesia generally means to apply anesthesia to one set of nerves that are in close proximity to each other, which may often result in anesthesia to a larger area than the smaller area implied by administration of a Clocal anesthetic. A colonoscopy involves exposure of a larger area of the body than a simple local anesthetic could anesthetize. Although colonoscopy is generally not considered to be particularly painful, it would usually be described as uncomfortable for someone undergoing this procedure with no anesthesia of any kind. In general, colonoscopies are performed after administering some degree of sedation to the patient, and this sedation would typically be maintained throughout the procedure.

Typically it is general anesthesia. Other approaches such as sedation (but not completely a general anesthetic) or a spinal anesthetic are possible, but a general anesthetic is usually the most practical approach. It is typically not a very long surgical procedure.

The anesthesia for root canal procedures I have had done were simply injections of local anesthesia by the dentist. There was no need for any other kind of anesthesia.

In most cases, it would be a general anesthetic for breast augmentation or breast reconstruction surgical procedures. But regional anesthesia techniques may be quite useful to reduce postoperative pain.

J. Arthur Saus, M.D. FASA

I think the best response to this question is, "Would you like to be awake during this procedure?"

There are options for anesthesia for a varicocele surgery, and these options could allow a patient to be either under general anesthesia (i.e., totally "asleep") or numb in the area of surgery and awake. The best approach is to discuss this with your Physician Anesthesiologist prior to the procedure, and for you two to come to a decision about which approach would be best for you and the surgeon performing the procedure.

Since the question is "Can You get general anesthesia," the answer is yes, it would certainly be possible. But since this is a procedure that lends itself to performance with nothing more than local anesthesia, the more important question would be, "Why would you want to have general anesthesia for a procedure that usually does not require more than a local anesthesia injection?"

There is really nothing you can actively do to "flush anesthesia out of your body." All anesthetic agents are chemicals that are either injectable medication of inhalation gases. As such, removal of these medications rely on normal mechanisms of liver and kidney function to remove them from the body. Well, OK. Inhalation anesthesia gases also depend on pulmonary mechanisms (i.e., breathing them out) to remove them. But there is really nothing an individual can actively do to remove these medications any faster than the normal clearance mechanisms. Someone with compromised liver, kidney, or lung functions may find a small increase in the amount of time to clear them from the body, but even in those situations, there is nothing to actively change, which will remove them any faster.

This is a much broader question that it appears you intended to ask. There are many different types of "blood thinners" and there are different approaches to anesthesia. The correct answer to your question depends on the combination of your medical problem for which you are taking these "blood thinner" medications, the specific "blood thinner" and any other medications you may also be taking, and the specific surgical procedure and anesthesia that will be used. There can be no single complete answer for your question, even though I trust you felt you were asking a simple, straightforward question. This is something that should be discussed in detail with your anesthesiologist prior to surgery in the pre-op evaluation. The answer must be tailored specifically for your individual situation.

Although there is n nothing about a CT scan that requires anesthesia, it is important for the patient to be perfectly still during the time the CT images are obtained. For a 2 year old child, it is unlikely that the child will remain perfectly still long enough for a CT image to be obtained. For that reason, anesthesia is often administered to a child who is having a CT scan, just to enable the patient to remain perfectly still so that those CT images can be obtained.

The answer depends on the exact type of anesthesia medication used. Anesthesiologists and Nurse Anesthetists pay close attention to the patient's response to anesthesia, and judge when to discontinue administration of anesthesia, so that the patient emerges from anesthesia at the correct time when there is no longer the need for the patient to be in the state of general anesthesia.

There is no way to answer this simply, and it appears from the question that a simple answer is what is being sought. The amount needed will vary from one individual to the next. Yes, the amount of drug administered per Kg of body weight is a good starting point to accomplish sedation, but in addition to considering body weight, different individuals have a different tolerance (or sensitivity) to propofol or any other anesthetic agent. The amount of a drug needed to accomplish sedation will also depend on the intensity of the stimulus for which the sedation is provided. A minimally painful stimulus will require less drug to achieve sedation, but a greater, more intense, stimulus will require a larger amount. This is part of the reason why there is a well trained individual, either a Nurse Anesthetist or a Physician Anesthesiologist (possibly with the assistance of a certified Anesthesiology Assistant) continually monitoring the patient, and adjusting the amount of anesthesia (whether it is propofol or some other anesthetic agent) throughout any procedure for which medications are administered for sedation.

The answer depends on exactly what is meant by your question, and there is no east, straight answer. If you are asking if the mechanism inside the ears, which transduces the sounds coming into the ears into a neurologic signal for the brain to interpret as sound still works, then the answer is yes. However, the ability to transmit that information along the neural pathways and into the brain so that there is a conscious recognition of being able to "hear" and even to understand what those "sounds" mean, then the answer is probably no, if the patient in question is heavily sedated. Under light planes of sedation, certainly in most situations the lightly sedated person can hear and even understand sounds. Think of this as the situation when someone had a couple of drinks of an alcoholic beverage...in that situation, certainly, a person can still hear and understand spoken language, and often even respond correctly to many questions. However, as the degree of intoxication from ingestion of alcoholic beverages becomes greater, the ability to understand and respond appropriately becomes progressively lost. This not only occurs with ingestion of alcohol into the body, but also occurs in a similar manner whenever other sedation agents are administered. At some point, the level of sedation becomes intense enough that the individual will lose the ability to understand the sounds and to respond to them, even though the sounds may still come into the ears and be transmitted to the brain.

The most simple and direct answer to this question is that a "ring block" is a subcutaneous injection of a regional anesthetic agent that completely encircles an appendage to the torso, such as a finger, toe, arm, leg, or other body part in such a manner that it creates numbness beyond the area where that "ring" of local anesthesia is injected around that "appendage" or "extremity."

There are many factors that influence the duration of anesthesia. The first, and probably the most obvious, is that the duration of action depends on exactly which anesthetic agent was injected. Some agents are intended to provide only a short duration of anesthesia, while others provide much longer durations. But the answer becomes even more complex, as it depends on the removal of the anesthetic agent as well. Some anesthetic agents (i.e., "anesthesia drugs") are "cleared" or removed fairly rapidly from the site in which they are deposited, while others are made to resist that removal, and that resistance to removal also deals with reducing the rate of various mechanisms that would otherwise remove them fairly quickly. Specific "local" or "regional" anesthetic agents may also have other drugs added to them to retard the body's ability to remove them from the location in which they are injected, thereby prolonging the anesthetic duration. But beyond the characteristics of the drug itself, the rate of clearance of an anesthetic agent also depends to some extent on patient characteristics such as temperature, blood flow to the area in which the anesthetic was injected, etc. In summary, there is no easy answer to what appears on the surface to be an easy and straightforward question, as the true answer is "it depends.," and it depends on multiple factors which are considered by the person (physician, nurse, or other healthcare professional) administering the anesthetic agent.

There are alternatives to just about everything in life. However, I can't imagine that anyone would want to submit to surgery willingly, without the administration of some type of anesthesia.

There are many different agents used in combination for modern anesthesia. Certain opioids are frequently one component of that combination. There are ways in which an anesthetic agent can be administered however in which opioid medication may or may not be included. The bet manner in which to address this concern however, is to have a discussion with your Physician Anesthesiologist prior to the administration of anesthesia for your specific reason, whether it is a surgical procedure or something else.