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ventilator
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Patient
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Breathing
tubes
Anesthetic agent
vaporizers
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The Journal of the American Medical Association JAMA PATIENT PAGE
General Anesthesia
G
eneral anesthesia is unconsciousness produced by medications. This allows for surgery and other treatments that
would otherwise be too painful or difficult to tolerate. During general anesthesia, a person is unconscious but is not
in a natural state of sleep. In the United States, anesthesia is provided by anesthesiologists (medical doctors with
specialized education in the evaluation and care of patients before, during, and after surgery, including pain management),
certified registered nurse anesthetists (nurses with additional education in the administration of anesthesia), and
anesthesiologist assistants (who are educated to administer anesthesia under the direction of an anesthesiologist).
MEDICATIONS AND GENERAL ANESTHESIA
FOR MORE INFORMATION
American Society of Anesthesiologists
www.asahq.org
Anesthesia Patient Safety Foundation
www.apsf.org
Malignant Hyperthermia Association
of the United States
www.mhaus.org
INFORM YOURSELF
To find this and previous JAMA Patient
Pages, go to the Patient Page Index on
JAMAs Web site at www.jama.com.
Many are available in English and
Spanish.
Janet M. Torpy, MD, Writer
Cassio Lynm, MA, Illustrator
Robert M. Golub, MD, Editor
1050 JAMA, March 9, 2011Vol 305, No. 10
Sources: American Society of Anesthesiologists, Anesthesia Patient Safety Foundation, Malignant Hyperthermia Association
of the United States, American Association of Nurse Anesthetists, American Academy of Anesthesiologist Assistants
The JAMA Patient Page is a public service of JAMA. The information and recommendations
appearing on this page are appropriate in most instances, but they are not a substitute for
medical diagnosis. For specifc information concerning your personal medical condition, JAMA
suggests that you consult your physician. This page may be photocopied noncommercially
by physicians and other health care professionals to share with patients. To purchase bulk
reprints, call 312/464-0776.
Some of the most common medications used to provide general anesthesia are
COMPLICATIONS OF GENERAL ANESTHESIA
A common side effect of general anesthesia is nausea and vomiting after surgery. Some
people may also have a sore throat and very occasionally damage to teeth, lips, gums, or
vocal cords from insertion of breathing tubes and airway devices. Less common and more
serious complications include malignant hyperthermia (a rare inherited muscle disease,
which can be triggered by some anesthetic medications), heart attack, stroke, or death;
these are more likely in patients who have heart problems, high blood pressure, diabetes,
kidney disease, or lung diseases. Very rarely, persons may become aware of events when
they are thought to be unconscious from general anesthesia; this is more likely during
emergency surgery if the patient is in shock, during open heart surgery with the heart bypass
machine, or because of medication error or malfunction of the anesthesia equipment.
PREPARING FOR ANESTHESIA
Follow the instructions given to you about what and when you may eat or drink
before surgery.
Confirm which of your regular medications you should or should not take before surgery.
If you smoke, try to stop for as long as possible before your surgery.
Tell your anesthesia provider about all medications you take, including dietary
supplements, herbal preparations, over-the-counter products, and illegal substances,
because they can affect your vital signs and interfere with anesthesia medications.
Ask questions of your anesthesia provider before the surgery so you know what to expect.
Propofol, which produces unconsciousness (induction of general anesthesia).
In smaller doses, it can be used to provide sedation (a comfortable state
without unconsciousness).
Benzodiazepines, which decrease anxiety right before surgery. Some
medications that reduce anxiety may also help block memory of events.
Narcotics, which prevent or treat pain.
Volatile anesthetic agents are inhaled in a gas mixture containing oxygen.
Sometimes, to avoid starting an intravenous (IV) line in infants and children,
a volatile agent is given through a mask for induction of general anesthesia.
Other medications include antiemetic agents (to protect against nausea and
vomiting), muscle relaxants, medications to manage blood pressure or heart
rate, and nonsteroidal anti-inflammatory drugs (NSAIDs).
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