General anaesthesia

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Applied to the whole body as opposed to local anaesthesia. Will usual involve inhalation of a gas/vapour and/or intravenous drugs, although traditionally large amounts of the hypnotic alcohol, deliberately concussing the patient or inducing syncope might have had the same effect.

LogoKeyPointsBox.pngModern general anaesthesia has a good safety record. Risk is able to be well defined by ASA score and is highest at extremes of age and comorbidity.
  • To 5 years followup no detectable neurodevelopment delay occurs in infants exposed to less than 1 hour of general anaesthesia[1]. Longer exposures may be associated with neurodevelopmental issues.
  • In elective hip joint surgery spinal anaesthesia is generally safer but whatever mortality should be less than 0.3% [2]
  • While for most operations local anaesthesia is safer if practicable, fracture neck of femur repair only has an advantage in shorter length of stay not mortality or delirium if done under spinal rather than general anaesthetic[3]

References