Anesthesia Glossary

Singular: Analgesic
Pain relievers. There are many different substances known for the treatment of pain, and numerous different preparations and generics are available. However, based on their effects, pain relievers can be roughly categorized into three groups:
After surgeries and tooth extractions, combinations of several different pain relievers are often necessary initially.

• Mild pain relievers: e.g., Aspirin®, Paracetamol (e.g., Panadol®, Dafalgan®, Tylenol®, etc.), Novalgin®
• Moderate pain relievers: Nonsteroidal anti-inflammatory drugs (NSAIDs)
• Strong pain relievers: Opiates

After surgeries and tooth extractions, combinations of several different pain relievers are often necessary initially."inzahl: Analgetikum

By administering pain and/or sedative medications, the patient is placed into a light twilight sleep for an uncomfortable examination or procedure under local or regional anesthesia, so they are hardly aware of the ongoing procedure. During this, they are monitored and cared for by the anesthesia team (Monitored Anesthesia Care).

Synonym: Medical History
A comprehensive listing of all health-related disturbances (illnesses, injuries, etc.) that have occurred in a patient's life, along with their treatments, to the fullest extent possible.

The word "Anesthesia" originally comes from Ancient Greek and roughly means "not feeling anything." Today, the term has several meanings:
1. The suppression of consciousness and pain sensation for the purpose of conducting surgeries and medical procedures. It can be categorized into general anesthesia, regional anesthesia, and local anesthesia.
2. A common but not entirely accurate term for the medical specialty known as Anesthesiology.

The term Anesthesia induction refers to the process of administering anesthesia to a patient at the beginning of a medical procedure or surgery. During anesthesia induction, the patient is gradually put to sleep or rendered unconscious to ensure they do not feel pain or discomfort during the procedure. This process is carefully controlled by an anesthesiologist or anesthesia provider.

Anesthesia risk is a term used to describe the specific, very low risk associated with anesthesia procedures today. It should be distinguished from the specific risks associated with the surgical procedure itself and those that may be caused by the patient's condition and behavior.

The anesthesia team consists of highly trained medical professionals, including anesthesiologists and anesthesia nurses, who specialize in administering anesthesia and monitoring patients throughout surgical procedures. Their primary responsibilities are to ensure the patient's safety, provide appropriate anesthesia care, and manage any complications that may arise during the surgery.

Nurse with additional training (Advanced Technical College) in Anesthesiology. Correct professional designation: Dipl. Expert in Anesthesia Care NDS HF (Anesthesia Team).

Medical specialty (Board-certified Anesthesiologist FMH), which includes all anesthesia procedures, their preparation, and postoperative care, the maintenance of vital functions during surgical procedures and examinations, as well as subfields of intensive care medicine, emergency medicine, and pain therapy.

Synonyms: Narkoseärztin / -arzt, Fachärztin / Facharzt für Anästhesiologie (Anästhesie-Team). Medical doctors who specialize in anesthesiology, commonly referred to as anesthesiologists, accompany their patients throughout the entire anesthesia process and provide support before, during, and after medical procedures.

Anesthetics are all medications used to induce anesthesia.

• General anesthetics (synonym: anesthetic agents, narcotics) cause a shutdown of consciousness in the brain, thus producing general anesthesia.
• Local anesthetics cause a temporary interruption of nerve impulse transmission within the nerves. Depending on where they are injected into the body, they create insensitivity to pain in larger (regional anesthesia) or smaller (local anesthesia) areas while consciousness is maintained.

Medications containing substances that can kill bacteria. Bacteria can cause various infections in the body. In certain procedures, prophylactic administration of antibiotics is necessary to prevent infections from occurring during the procedure. (Antibiotics do not work against viruses and fungi!)

I apologize for the previous confusion. "Antiemetika" is the German term for "antiemetics," which are medications used to prevent or relieve nausea and vomiting. They are often used before or after anesthesia or during chemotherapy to control these symptoms.

Synonyms: Antithrombotics, Anticoagulants, Blood Thinners
Anticoagulants are medications that more or less strongly suppress the ability of blood to thicken and thereby seal leaks in blood vessels in case of injuries. There are many different reasons why such drugs may be prescribed to a patient. Often, anticoagulants need to be temporarily discontinued or replaced with less potent medications before surgeries. This is typically determined by the surgeon (possibly in consultation with the primary care physician). Common medications include, for example: Aspirin®, Tiatral®, Plavix®, Xarelto®, Marcoumar®.

Antirheumatics are a group of medications that belong to the category of moderate pain relievers. Additionally, they have anti-inflammatory properties and a mild fever-reducing effect. They are also successfully used to treat pain following surgeries and dental extractions. Some examples of numerous common preparations include:

• Ponstan® (Generics: Mefenamic Acid®, Mephadolor®, Spiralgin®, among others)
• Voltaren® (Generics: Diclofenac®, Ecofenac®, Inflamac®, Olfen®, among others)
• Brufen® (Generics: Algifor®, Ibuprofen®, Irfen®, Optifen®, among others)

Association of Swiss Office Based Anesthesiologists
Berufsverband der office based (in eigener Praxis) d. h. nicht in einem Spital tätigen Anästesieärztinnen und -ärzte der Schweiz.

Inhalation of stomach contents, vomit, etc. into the airways. A very rare, but in some cases serious, complication of general anesthesia. The risk of aspiration is particularly high during the induction and emergence phases of general anesthesia. To minimize this risk, patients must abstain from eating for a certain period of time before elective surgeries (fasting requirement).

Awareness during anesthesia. This unpleasant, and potentially traumatizing, complication of general anesthesia fortunately occurs very rarely thanks to modern monitoring techniques. Patients who feel that they have been awake during a general anesthesia must absolutely inform their anesthetist!

Many of the medications used for general anesthesia have the side effect of suppressing spontaneous breathing. Therefore, during most general anesthesias, what is colloquially often referred to as 'artificial' ventilation is necessary. This involves supporting or completely taking over the patient's own breathing, who feels nothing, with technical aids (assisted or controlled ventilation, intubation anesthesia).

Used by the anesthetist for ventilating the patient, especially during the induction and emergence phases of general anesthesia. Typically, the anesthesia mask is held in front of the patient's mouth and nose just before the start of the general anesthesia and oxygen is administered for one to two minutes (preoxygenation) to saturate the patient's blood with maximum oxygen. In the so-called mask anesthesia, the patient's ventilation is carried out throughout the duration of the procedure using an anesthesia mask.

After the patent protection of the original drug expires, so-called generics (follow-up preparations) come onto the market for many proven medications. These have a different name, but contain the same active substance as the original preparation. They are usually cheaper than the original preparation, as (almost) no further research is necessary for their development.

A sterile fluid that is continuously administered into the body through a vein over a certain period of time. Infusions are used by anesthetists to replace fluid losses (e.g., due to blood loss during surgery) or to administer medications.

Commonly known as a 'shot'. Injections can be administered into a vein (= intravenous), into a muscle (= intramuscular), or under the skin (= subcutaneous). The needle used for this is called an injection needle.

A simple and reliable form of regional anesthesia. In this method, the local anesthetic is not injected directly into a nerve, but into the veins of an arm or leg. To do this, the limb in question is first made bloodless by wrapping. Then, blood inflow is stopped by a special cuff attached to the upper arm or thigh. Subsequently, the venous system of the limb is filled with a local anesthetic via an intravenous catheter. Within about 10 minutes, the arm or leg becomes numb. Very suitable for short (max. approx. 45 min), minor procedures on limbs. 

A type of general anesthesia where (controlled, often mechanical) ventilation is carried out via a flexible plastic tube ('breathing tube', endotracheal tube). Intubation (insertion of the tube through the mouth or nose into the trachea) takes place as part of the anesthesia induction, but always after the patient has fallen asleep and no longer feels anything.

A thin plastic tube that can be inserted into body cavities (e.g., a blood vessel or the urinary bladder).

Synonym: laryngeal mirror

An instrument that the anesthetist inserts through the mouth in order to see the entrance of the trachea when inserting a tube during the induction of anesthesia (intubation anesthesia).

Synonym: throat mask.

A special device that can be used for ventilation. It is inserted through the mouth into the throat after the patient has been anesthetized and is asleep, feeling nothing, and is placed over the entrance to the trachea. Unlike the insertion of a tube, it does not require a laryngoscope.

Commonly known as 'spinal fluid' or 'brain fluid'. 

A clear liquid that surrounds the brain and the spinal cord." 

Synonym: local numbness

By injecting a local anesthetic directly into a (usually small) area of the body, insensitivity to pain is created around the injection site. Local anesthetics are often administered by the surgeon or dentist, not by the anesthetist. The anesthesia team can additionally administer sedatives or painkillers intravenously in addition to the local anesthesia.

Medications that are administered to produce local anesthesia or regional anesthesia.

Synonyms: Anesthesia, General Anesthesia
General anesthesia is induced by medications through injection into a vein or inhalation of a gas, leading to a deep sleep-like state (loss of consciousness). This allows for surgeries, dental procedures, or examinations to be performed without the patient feeling anything.

A plastic tube that can be inserted through the esophagus into the stomach, for example, to aspirate stomach contents before general anesthesia.

Synonym: Stand-by
For minor procedures that do not require general or regional anesthesia, it can be beneficial for the anesthesia team to monitor and care for the patient. Typically, the same preparations are made for MAC as for anesthesia (connecting to monitoring devices, establishing venous access).

A group of special gases that, when inhaled, turn off consciousness. In patients who are not able to cooperate (children, people with disabilities, patients with severe needle phobia), the induction of general anesthesia can be done using an anesthetic gas through a ventilation mask, without the need to establish a venous access beforehand. This is then placed after the patient has fallen asleep, for safety reasons.

In rare cases, regional anesthesia can lead to more or less pronounced impairments in the function of the blocked nerves. In most cases, these sensory disturbances or paralysis gradually resolve over time (days to weeks, rarely months). Permanent damage is very rare.

In anesthesiology, fasting refers not only to abstinence from alcohol but also to abstinence from food and drinks in general. To minimize the feared complication of aspiration during general anesthesia, it is important to adhere to established fasting guidelines before elective procedures. To ensure the stomach is as empty as possible before anesthesia induction, the patient should not consume solid food or milk for 6 hours and no clear liquids for 1 hour. For emergency surgeries where the patient could not follow fasting guidelines, the anesthetist will usually recommend regional anesthesia if possible. However, if general anesthesia is unavoidable, special precautions are taken to minimize the risk of aspiration despite the non-fasting state.

Strong painkillers. These are used by anesthetists during general anesthesia along with anesthetics and relaxants to ensure a safe, stable, and as comfortable as possible administration of general anesthesia. Opiates are also used for the treatment of severe pain immediately after surgical procedures. Examples of opiates include Durogesic®, Fentanyl, Methadone, Morphine, MST®, Oxycodone, Pethidine®, Remifentanil, Targin®, Tramadol, among others.

Postoperative Nausea and Vomiting (PONV): Postoperative nausea and vomiting is a mostly harmless but subjectively unpleasant side effect of general anesthesia, and less frequently, of regional anesthesia. Without prophylaxis, it occurs in about 20% of patients, and even more frequently in children. Known risk factors for PONV include:

• PONV in previous anesthesias
• Female gender
• Non-smoker
• Propensity for motion sickness (kinetosis)

Before the induction of anesthesia, prophylactic medication can be administered, which significantly reduces the likelihood of PONV occurrence, but cannot prevent it in every case.

 The term has two meanings:

1. Consultation and information discussion conducted by the anesthetist with the patient before anesthesia.
2. Medication preparation of the patient before the start of anesthesia induction through the administration of sedatives.

To ensure optimal oxygen saturation in the patient's blood at the beginning of anesthesia, oxygen is administered to the patient immediately before and during the induction of anesthesia via a ventilation mask.

Synonyms: Partial Anesthesia, Partial Narcosis. In regional anesthesia, larger areas of the body (entire arm, entire leg, entire lower half of the body) are made insensitive to pain. The anesthetist uses their knowledge of anatomy to specifically block the nerves supplying a whole area of the body by targeted injection of local anesthetics. Today, the precise application of local anesthetics is mostly performed under ultrasound guidance. Since a local anesthesia is first applied at the puncture site, the procedure is usually virtually painless. After the local anesthetic is injected, the affected area of the body first becomes warm, and there may be a slight tingling sensation for a short time. This is then followed by the desired numbness and insensitivity to pain, but also a temporary paralysis of the muscles. Depending on the local anesthetic used, the effect of the regional anesthesia lasts between one and about four hours. To make the patient's lying still stress-free and comfortable, they can listen to music through headphones, and if needed, additional sedatives and/or painkillers can be administered (analgesia and sedation).

In outpatient anesthesia, two main forms of regional anesthesia are commonly performed:

1. Axillary Plexus Blockade ("Plexus Anesthesia"): The puncture is made in the armpit, where the nerves that supply the arm are particularly accessible. This leads to regional anesthesia of the entire arm. Optimal for hand surgery.
2. Spinal Anesthesia: Belongs to the so-called "near-spinal" regional anesthetics, as the puncture is made in the area of the spine. However, the spinal cord is not touched! The puncture for spinal anesthesia is made in a lateral position or sitting in the area of the lower lumbar vertebrae. This leads to regional anesthesia of the entire lower half of the body. Optimal for, e.g., varicose vein operations (varices), knee arthroscopies, hemorrhoid surgeries, etc.

A special form of regional anesthesia is intravenous regional anesthesia (IVRA).

Medications that can induce muscle paralysis. They are used in general anesthesia to facilitate intubation and ventilation.

Medications that can be given for calming and relaxation before anesthesias and during regional and local anesthesias. Examples include Dormicum®, Lexotanil®, Temesta®. 

Vertebral canal. A bony canal formed by the vertebrae. It contains the spinal cord, which runs from the base of the skull to approximately the level of the top lumbar vertebra. The spinal cord is surrounded by a protective covering (the dural sac) and 'floats' in a fluid (cerebrospinal fluid).

Instrument for listening to body cavities. It can be used to examine the heart and lungs, but also, for example, the intestines. The anesthetist uses the stethoscope to monitor ventilation during general anesthesias.

For safety reasons, a venous access (a thin plastic cannula in a vein in an arm or leg) must be established before any anesthesia. This allows for the administration of anesthetics, as well as necessary medications and infusions according to vital functions.