Types of Anesthetics

There are 4 types of anesthesia:

1. General Intubation

You are put to sleep via an intravenous medication, and your respiration is assured via a plastic tube gently slipped down your windpipe. With just the right amount of intravenous medication, it is possible to wake up rather quickly and be on your way home in just a few hours.

2. Spinal or Epidural

A local anesthetic is injected in your lower back. This is below your spinal cord, and as such paralysis is not a realistic complication. With this approach, you can remain wide-awake if you so desire, or you can receive intravenous sedation which ”knocks you out,” though not as deeply as with “general” anesthesia. It may take a few hours for the spinal to wear off, and in the meantime you must stay in the recovery room.

3. Local Anesthetic

A Novocain-type of medication is injected directly into the knee. In my experience, this is the least reliable type of anesthesia. Because there are many nooks and crannies in the knee, the medication may not reach each and every spot. The person opting for this has to be willing to accept the possibility of some pain and has to understand that they may require some intravenous sedation. How long one stays in the recovery room after a local depends strictly on how much added sedation was given during the surgery.

4. Diaphragm LMA (laryngeal mask airway)

A variation of general and local, a LMA is placed in the back of the throat and connected to a ventilator. This is essentially general anesthesia without a tube down the windpipe. Depending on which anesthesiologist you speak to, this technique combines either the best or the worst of both worlds

In my experience, these options are all approximately equal except for the local anesthetic, for the reasons listed above. If the anesthesiologist has a strong preference for one approach or the other I tend to go with that approach. The anesthesiologist is one person I hate to cross….