Anesthesia for investigation purposes

Who needs anesthesia ?

• Claustrophobic patients – The claustrophobia or the fear of enclosed spaces is an anxiety disorder that often gives rise to panic attacks. Globally speaking, about 5-7% of the population is affected by the severe claustrophobia.
  The claustrophobic patients cannot stand still during the investigations that last between 5 minutes (in case of the computed tomography) and 2 hours (in case of the magnetic resonance) and need to be sedated in order to maintain their position during the examination.
• Pediatric patients – who cannot understand the necessity of the investigations due to their age or children with the hyperkinetic syndrome, those with attention deficit that cannot stand still even if they want to, as well as those retarded, are sedated because the investigations are needed and cannot be performed otherwise.
• Patients requiring analgesia for chronic diseases or malignancies also benefit from the presence of the anesthetist who can administer various medicines, such as anti-inflammatory substances and opioid analgesics in order to remove pain.
• Comatose patients, patients with prostheses and with respiratory deficiencies, are monitored, ventilated and sedated in order for the hemodynamic and respiratory parameters to be maintained throughout the examination.

Pre-anesthetic training

• In order to perform the anesthesia, it is necessary to observe the food break, the same in all cases that require anesthesia in the whole medical world, ie 6 hours for solid foods and 2 hours for liquids. In conclusion, 4 hours after no longer consuming solid food, the patient can still drink water or tea (clear liquids), then 2 hours before the investigation he no longer consumes anything.
• Patients with respiratory virus are not anesthetized due to the risk of bronchospasm, acidosis, respiratory arrest. After the episode is remitted (without fever, cough, runny nose) wait 5 days then the procedure can be performed safely.

If the investigations are an emergency and the patient’s life depends on this examination, the risks of the procedure are explained, maximum precautions are taken and investigations with anesthesia are performed as soon as possible.

Patients should know that after anesthesia they are drowsy for about 3 hours and cannot drive on that day.

Parameters monitored during anesthesia

Anesthesia is performed with a mask or oxygen goggles to increase the inspired oxygen fraction, blood pressure, peripheral oxygen saturation and heart rate are monitored, and in coronary patients and children with heart malformations the investigation is performed with continuous EKG.

The anesthetist, the emergency physician and the operator performing the investigation can see the patient through the MRI window or computed tomography, on the monitor that records the patient’s face for any grimaces, involuntary facial movements and also constantly monitors the parameters mentioned above.

The clinic is equipped with each device (a computer tomograph and two MRIs) complete intubation kits, defibrillators, aspirators for oropharyngeal secretions, oxygen sources in the rooms for preparation and examination of patients.

Anesthesia risks

Like any medical act, the anesthesia involves several risks, such as apnea, heart rate and rhythm disorders, blood pressure changes,

allergic reactions to anesthetics substances or contrast agent, pain or hematoma located to the place of the intravenous puncture and rarely cardio-respiratory arrest.

The potential complications are influenced by a series of elements such as: age, related pathology, interaction of some anesthetic substances with the chronic treatments administered to patients, the use of toxic substances (alcohol, cigarettes, drugs), as well as by the particular anatomical features: malformations or deformities of the face, chest or spine, obesity or other changes in the body that prevent normal breathing.

Special recommendation for the patients with chronic diseases

• The hypertensive patients who take antihypertensive medication shall not stop taking these medication, especially the beta-blockers (Atenolol, Carvedilol, Nebilet, Concor and Metaprolol), which can be taken 2 hours before the anesthesia, when they are still allowed to drink clear liquids.
• The patients with antiepileptic treatment shall not interrupt the medication. However, if they forget to administer the medication before the investigation, they need to know that during the sedation or anesthesia investigation are protected against the seizures by the anticonvulsant action of the benzodiazepines used during the anesthesia.
• The patients with type I hyperglycemia are not allowed to eat or to administer the insulin and those with type II hyperglycemia who take oral anti-diabetic medication are not allowed to eat, to take their pills, provided that in what concerns the hypoglycemia, we can find out the value of the blood sugar in less than 1 minute and we can take the appropriate measure, if the case may be.
• The patients with acknowledged hyperthyroidism who are about to undergo a contrast agent computed tomography should have a thyroid hormone dosage or at least of the TSH value in order to avoid a thyrotoxic crisis.