I had a hernia repair surgery in Dec '05. I am about to have another one in Oct '06. Like always I am so nervous about going under general anesthesia. I am a 40 year old female and I am a smoker and weigh 221lbs. I am not going to smoke anymore after tonight, 2 days before my surgery. Do you feel that I am considered high risk for general anesthesia and also what are the chances of death or other risks associated with anesthesia? 

Risk is a difficult issue because everyone has a different idea of what is high risk. Many people are terrified of air travel because of highly publicized catastrophic air crashes but when you calculate deaths per mile travelled it may be safer than driving a car. 

People also have difficulty appreciating the meaning of numbers. Is 1 in 100 a high, medium or low risk? Is a high risk of a very minor problem, equivalent to the low risk of a more severe one? There are ways that researchers have devised to discuss risk in a way comprehensible to patients such as comparing the risk of various medical procedures to activities outside of health care, such as driving, flying, lightning strikes, etc. 

With that as a general introduction I would say, and of course you know this already, that you are at higher risk than a person who is completely healthy. Your smoking and your obesity increase your risk of complications. (I am making the assumption that you are not 6 ft 6 ins tall and therefore your weight is not proportional to your height!). 

Smoking, if you don't have any associated "end-organ" disease, like heart or lung disease, is not likely to increase your risk of death, but does increase the risk of lung complications and of wound infection. 

Moderate obesity, without commonly associated problems like heart disease, diabetes, or sleep apnea creates technical problems for the anesthesiologist (starting your IV, doing a nerve block, placing monitors, positioning you) which can themselves lead to increased complication rates. If you have heart disease, lung disease or diabetes then your risk does go up significantly. 

The unrepaired hernia is presumably causing you pain or discomfort, or poses the risk of obstructing some part of your bowel. So its always about balancing the risk of the surgical procedure (and the anesthetic) with the benefit of fixing the surgical problem. Having scared you with all of that, I will say that we take care of 40 year-old overweight smokers every day and the vast majority of them do very well. They don't die from the anesthetic but they may experience an increased rate of wound infections and other complications that are generally not life-threatening. You should be commended for quitting smoking before your surgery and I hope you are able to stay off the cigarettes! 

I am scheduled for arthroscopic surgery on my elbow. Currently, I take several medications - paxil, lipitor, tricor, medicines for irritable bowel. I am also taking amoxicillin at the suggestion of the surgeon because of an abcessed tooth. In general, however, I am in pretty good health except for being overweight - my most recent physical included a stress test which was normal. Do all of these medications make me a higher risk for complications from the general anesthesia? I was told that I should take them pre-surgery at the regular dosing time with a minimal amount of water. I had knee surgery 5 years ago so I am pretty sure I am not allergic or anything like that. Thank you. 

Higher risk than what? Or who? If you're in good general health and don't have any functional limitations or systemic illness, then you are rated a "1" on the American Society of Anesthesiologist's Physical Status scoring scale. At the far end of the scale (a "5") is a patient not expected to survive, with or without an operation! Your risk of major complications, or even death, from anesthetic-related causes, is very low (possibly as low as 1 in 200,000 risk of dying). The medications themselves don't add any increased risk. They do suggest that you have hyperlipidemia (increase cholesterol) and maybe depression. Hyperlipidemia increases your risk for heart disease which increases your risk for anesthetic-related problems. But if your stress test was okay, and you are capable of moderate exercise - e.g. walking 4-5 miles per hour on the flat, then you need not worry about that. The advice for you to continue your regular medications on a regular schedule is appropriate. Your medications can be taken on the morning of surgery with sips of water. Medications like Lipitor are shown to be cardioprotective around the time of surgery - that is they protect against heart attacks or angina - and should definitely be continued. Paxil is less important. If you skip a dose or two of Paxil you are unlikely to come to any harm. You should definitely continue your antibiotics until the full course is completed. 

The risk of anesthesia, whenﾠI want to haveﾠa hernia operation.ﾠThe prothrombin time range is 24.5 seconds.ﾠAlso, isﾠthere aﾠrisk of bleeding in the operation because Iﾠhave liver cirrhosis. 

The prothrombin time is one way of measuring how well your blood clots. It is most often used to adjust the amount of blood-thinning medication (e.g. warfarin) that some people take to prevent thrombosis (heart attacks or strokes). Cirrhosis is a liver condition in which the liver may not produce the normal amount of blood clotting factors. So a patient with cirrhosis may also have an abnormal - prolonged - prothrombin time. The actual time varies a bit when the same blood sample is tested in different labs. So today the prothrombin time is usually reported as the "INR" (international Normalized Ratio) - a method of comparing the prothrombin time to a standard. If your lab considers your prothrombin time to be abnormally prolonged then you may be at risk of bleeding during a surgical procedure. The risk depends, obviously, on how big the operation is. An inguinal hernia operation does not usually result in much bleeding. Most surgeons are unlikely to operate on a patient in whom the INR is greater than about 1.5 but opinions will vary on the exact number at which it is safe to operate. If you must have the operation, there are ways of improving the ability of your blood to clot in preparation for the surgery. This includes giving Vitamin K, and plasma. Anesthesia on its own does not pose a risk of bleeding. However, if your INR is increased it suggests that your liver is not working well at all, and you are likely to have a lot of other problems related to the decrease in liver function. If this is the case you should be carefully evaluated by your anesthesiologist before surgery, and should be taken care of in a setting where the staff are accustomed to dealing with such patients who can beﾠvery sick indeed. 

I am 20 yrs old and having a laparoscopy done next month for a mass on my uterus. What kind of anesthesia do they usually put you under for this procedure, and what are the risks for `anesthesia awareness`. I`ve never had any kind of surgery and have never had to be put alseep for anything and to tell you the truth I am TERRIFIED. It`s not even the surgery I`m worried about its the thought of `being put to sleep`. Are there any risks I should be worried about? 

A certain amount of anxiety preceding an anesthetic and surgery is perfectly normal but I wonder what you've read about or heard about that has made you feel so terrified! Almost all patients who have laparoscopic surgery of any kind will have a general anesthetic. The good news is that, statistically, anesthesia is safer than ever. The risk of serious harm to you as a result of the anesthetic is rather low. Completely accurate figures are a bit hard to come by, but the risk of death related to anesthesia in an otherwise healthy young person having a laparoscopic procedure of the kind you describe is probably less than 1 in 200,000. Is that low enough? The risks for anesthesia awareness, based on recent studies, are a bit higher - around 0.15%, or 15 cases in every 10,000 patients undergoing anesthesia. What are your risks of awareness? Probably much lower than this, because the number I've quoted includes patients at higher risk of awareness, such as those who are pregnant, having heart surgery, or trauma surgery. In those patients, the amount of anesthesia given is often less than in other patients. That number also lumps together those patients who have a few moments of awareness, without pain, with those who have a really bad experience. At the extreme end, these unfortunate people are in pain from the surgery while unable to move or communicate their distress. Most people who have awareness do not have this kind of terrifying experience. Is there are guarantee that you won't be aware during your surgery? I am afraid not. It's in the nature of anesthesia, and of medical care in general. People are not machines, and we can't yet precisely measure what is going on in the brain. But, assuming you are having your procedure in a good hospital with competent medical staff I think you can be pretty confident that you will have a safe anesthetic without awareness during the operation. Be sure to mention your concerns to the doctors taking care of you, including of course your anesthesiologist. I am sure they will make a special effort to calm your fears. 

My son is 3 yrs old and is having to get put to sleep for a dental procedure at columbus childrens hospital. As expected I am extremely scared that something may happen or he may have an allergic reaction and not wake up. My questions about that would be..In the instances where they do show signs of having an allergic reaction do they have medicines that would be able to get the drug out of his system to prevent a fatal outcome. Also I like to know the chances of something going wrong during a simple dental procedure on a completely healthy child? I`d like to say Thank you for taking the time to answer my question and I'm sorry cause I do realize there was a similar question asked previously. So Thank You! And I'm sorry! Thanks Again!!!!! 

As you know, I have answered a few questions about the risk of anesthesia, as this is one of the most common worries that patients have. Anesthesia is very safe for healthy people having minor surgery. The risk of dying from anesthesia in this group of people is probably around 1 in 200,000. I think you'll agree that is pretty rare. 

It is patients with serious illnesses, such as heart, lung, liver or kidney disease who have a much higher risk of serious problems with anesthesia (and with surgery). The risk is also increased with major surgery. 

At the extremes of life, the risk is increased also. One of the higher risk groups is patients under the age of one. Children that young probably do better in centers where there are specially trained and experienced pediatric anesthesiologists. Above the age of one, the risk is much less, especially for minor procedures like dental surgery. 

Allergic reactions to anesthesia drugs are rare also. The risk of a serious allergic reaction is probably somewhere around 1 in 10,000. However, a patient who has such a reaction (also called anaphylaxis) that is recognised and treated early should do just fine. Anesthesiologists are trained to recognise and treat this kind of reaction. 

The best thing for you to do is to call and ask to speak to your anesthesiologist, or even to visit the facility ahead of time, with your child. This should both allay your fears and give the doctor a chance to talk to and examine your son. I hope everything goes well. 

My daughter who is 8 months old will soon be having an MRI done, which she will have general anesthesia. She has KT syndrome (klippel trenauny syndrome) a rare vascular disorder affecting her entire left leg. The MRI is needed to see the extent of the vascular malformation, so as to provide proper treatment for her. I am very nervous and concerned about her receiving anesthesia. How safe is it for her? Thank you so much for your time. 

Patients with Klippel Trenaunay syndrome have port-wine stains, varicose veins, and bony and soft tissue hypertrophy (enlargement) involving an extremity. 

As far as I know, there are no special issues that increase the risk of a patient with this syndrome undergoing general anesthesia. 

Children under a year of age (infants) do statistically have a higher risk than older children or adults. This has lead some authorities to recommend that infants receive anesthesia care only from specialist pediatric anesthesiologists. Having said this, children of all ages down to newborns have anesthesia on a routine basis, with generally good outcomes, around the world. 

General anesthesia in an MRI scanner requires the use of special MRI-safe equipment. This is another reason why it's likely that your daughter's procedure is best done in a hospital, where all the resources needed to take care of small children are available, rather than in a free-standing imaging center. 

I will be having breast surgery and reconstruction soon. My HMO has plastic surgeons who can do a bilateral mastectomy with DIEP reconstruction in 12-18 hours. An outside physician can do the same surgery in 6-8 hours. Can you tell me what greater risks would be involved in being under anesthesia for 12-18 hours versus 6-8 hours? I am 52 years old. Thank you. 

Thanks for your question. If you are a healthy individual without other medical problems, your risk of an anesthesia complication from a mastectomy and reconstructive surgery is rather low. I cannot comment on the risk of the surgical procedure itself, which is probably the most important issue in your case. I would advise you first of all to get some clarification from your surgeons as to why there is such a big time difference between the two procedures you describe. It is possible that the shorter procedure (6-8 hrs) is actually a different operation in some way. For that kind of information you should speak directly with your surgeons. The best person with whom to discuss the risks of anesthesia is an anesthesiologist who has had the opportunity to review your medical records, take a full medical history and examine you, and who is aware of the nature and extent of the planned operation. Having said all that, I am not aware of any evidence that the duration of general anesthesia by itself increases the risks of anesthesia complications. Studies of anesthesia-related risk have shown correlation with other factors, like: 1. Your general medical condition especially problems like diabetes, heart or lung disease, malnutrition or obesity, 2. Your functional status, that is your ability to tolerate at least moderate levels of physical activity. Obviously, anesthetic outcomes are also related to the skill and experience of the anesthesiologist or anesthesiology team that is taking care of you. The anesthetic needs to be tailored to your medical condition, to the surgery itself, and wherever possible, to your individual preferences. As with other medical outcomes, having your surgery in a center that performs larger numbers of the procedure is more likely to result in a good outcome than having it in a hospital does only a small number each year.ﾠ 

Is going under anesthesia safe when you are about to get your wisdom teeth taking out? 

General anesthesia for wisdom teeth extraction has the same risks as general anesthesia for other types of minor surgery. Assuming you are in good health, and have a competent team taking care of you in a well-run hospital or surgery center, the risks are very low. 

Does a really low thyroid level have any dangers when put under? I discovered my thyroid was really low after I was put under. And I remembered the guy in the recovery room told me that it took a long time to wake me up and I remember them slapping my face. I was 4 hours in recovery for just a D&C. I am just curious I came across this subject and was just wondering. Thanks. 

Hypothyroidism can in fact cause delayed recovery from anesthesia. The metabolism (breakdown and excretion) of anesthetic drugs is slowed, and there is also increased sensitivity to the effects of these drugs. Severe hypothyroidism by itself can result in lethargy or even coma, as well as depression of heart function, blood clotting, kidney function, and temperature control. Severe hypothyroidism therefore is a medical emergency and would be a major complicating factor if such a person had to undergo surgery. Fortunately most cases of hypothyroidism are mild and do not lead to significant problems with anesthesia, especially if the patient is taking thyroid hormone replacement treatment. 

My wife is having a D & C, endoscopy, and laparoscopy. She is 41 years old and in excellent health. She was told these surgical procedures are standard procedures that are considered low risk. My question is how safe is the general anesthesia that is usually given to patients during these procedures and what are the general side effects? Her family has a history of asthma, but she does not have it. She was told this would be an out patient surgery. She is five feet tall and weighs one hundred and five pounds. In addition, my wife was told that an Anesthesiologist would begin her anesthesia and that a nurse anesthetist would then take over. Is this standard practice? Thank You. 

ﾠ Your question about the risks of general anesthesia has been answered previously. 

The risk of serious complications or side effects directly attributable to anesthesia is, reassuringly, very low, especially in those with good general health. The type of surgical procedure you mention usually requires general anesthesia. 

The most common "minor" side-effect of general anesthesia is nausea or vomiting, which can occur in anywhere from 10 - 30 % of cases. A period of grogginess and decreased mental alertness is of course to be expected - this usually lasts no longer than 12 - 24 hours. Dental injury can occur in around 1 in every 1000 cases. 

Anesthesia staffing varies. In some hospitals, anesthesia is provided by physicians only. In other settings, a nurse anesthetist is part of the team led by a physician anesthesiologist. In this circumstance, the anesthesiologist has responsibility for your care, but may not be in the operating room at all times. During the surgical procedure, either the anesthetist, the anesthesiologist, or both, will be in the operating room, monitoring your life functions and maintaining the anesthesia. There is some evidence that this team approach results in a higher level of safety than when care is provided by a solo practitioner. Feel free to write back if you still have questions or need further explanation. 

I am 19 years old 5`1 and 93lbs, and am going to be getting all four of my wisdom teeth out soon. I am really nervous about the whole thing and am wondering what risks I have of having a serious complication with the anesthetic, like dying, paralyzed, brain dead,etc. I am a smoker and I used to have thyroid disease. Diabetes, stroke, heart disease runs in my family. Please help! Thank you for taking the time to answer my questions. 

ﾠThanks for your questions. Anesthesia is much safer today than in the past, thanks to well-trained anesthesiologists, better anesthetic drugs, and improvements in technology. The risk of dying as a direct result of an anesthetic is extremely low. A recent study from Australia estimated the risk to be 1 in 40,000. However this includes patients who are extremely ill and therefore at much higher risk than ordinary people having elective (non-emergency) surgery. The risk of other serious complications such as paralysis or brain injury is also very low. A family history of diabetes, stroke or heart disease is unlikely to have any impact on your anesthesia unless you suffer from these conditions yourself. Smoking does increase your risk. Smokers are more likely to have respiratory problems after surgery, such as wheezing, lung collapse or lung infection. You would be well-advised to quit smoking ahead of your surgery ﾖ a good excuse to do so if you didnﾒt have one before! Treated thyroid disease should also not be a concern, assuming that your thyroid gland function is now normal, with or without medication. I do hope that you will have a chance to discuss your concerns before surgery with the anesthesiologists who will be taking care of you. Ask your dental surgeon or the facility where you will have the surgery whether this is possible. 

My mother needs to have a mastectomy A year and a half ago she developed painful peripheral neuropathy which she noticed right after surgery for a broken hip. She does not have diabetes & her doctors do not know what exactly caused it. We are concerned as to whether there are any cautions concerning her going under anesthesia (whether or not this might effect her conditon) & whether she should have a consultation with the anesthesiologist before the mastectomy. Thank you. 

ﾠYour mother would be well-advised to consult with the anesthesiologist before surgery to discuss this and any other concerns. Unfortunately not all hospitals provide this sort of preoperative consultation routinely. Ask your surgeon if this can be arranged. 

A peripheral neuropathy limited to the feet or hands is unlikely to cause any problems with anesthesia. Conversely, the anesthesia for a mastectomy (which is normally done under general anesthesia) is most unlikely to affect her existing condition. However, some neuropathies are associated wtih other problems in the nervous system. Diseases such as diabetes may cause neuropathy affecting other parts of the body, such as the heart and stomach. This type of condition, known as autonomic neuropathy might have an impact on the anesthetic and your anesthesiologist will want to know a little more about the course of your mother`s illness, the tests she has undergone, as well as any treatment she is now taking. This will allow the anesthesiologist to design a safe anesthetic minimising the risk of complications or side-effects. 

I have a large umbilical hernia. [I am 63,male,6`3",230lb.,moderately active]. In addition to the hernia,I have cirrhosis but alcohol-free since 1992. What are the chances that anesthesia will shock my liver? If not, what type of anesthetic should, in your opinion, be used and what after-effects are expected? 

ﾠMany patients with cirrhosis have normal, or just minimally impaired function of the liver. If your liver functions normally, the chances that you will experience any problems with a general anesthetic using standard anesthetic drugs, is rather low. Your liver function can be assessed by means of certain blood tests, (such as bilirubin, transaminases, and prothrombin time), as well as by a careful history and physical exam undertaken by your physician. 

If your liver function is significantly impaired, then the effects of some drugs may be increased or prolonged, and the dose of certain anesthetic agents may need to be modified. There might also be an increased risk of bleeding during and after surgery. 

If your liver function is normal then the after-effects expected from a general anesthetic would not differ from those a normal person might have. You might wish to ask your surgeon how to go about getting a consultation with your anesthesiologist preoperatively to discuss your concerns. The anesthesiologist can ensure that your liver problem, and any other pertinent health problems, are evaluated and taken into account when planning your anesthetic. 

how safe is general anesthesia as it is used today? 

ﾠAnesthesia is much safer today than in the past, thanks to better trained anesthesiologists, better anesthetic drugs, and improvements in technology. The risk of dying as a direct result of an anesthetic is extremely low. A recent study from Australia estimated the risk to be 1 in 40,000. However this includes patients who are extremely ill and therefore at much higher risk than ordinary people having elective (non-emergency) surgery. Sometimes it is hard to know whether a patient died as a result of the anesthesia, the surgery, or simply from severe illness at the time of the operation. The chance of having problems from anesthesia depends a lot on the type of surgery, and the condition of the patient, as well as the expertise of those providing anesthesia. High risk groups include the very old, who may have heart disease, diabetes, cancer, or other serious illnesses, and the very young, especially infants under the age of 1, whose organ systems may be immature, and for whom anesthesia and surgery may be technically more difficult. Emergency surgery is also associated with much higher anesthetic risk as these persons tend to be most seriously ill. In general, it is your overall state of health, plus the type of surgery that has the most influence. Even at the extremes of age, most patients can be safely anesthetized, including 100 year-olds and premature babies. Dying from an anesthetic is very unlikely, but there are a few surprisingly common complications or side-effects of anesthesia. These include nausea, vomiting, sore throat, and dental injury. Nausea after general anesthesia (going to sleep) occurs 20 - 30% or more of the time, and in some types of surgery, such as tonsillectomy (removal of the tonsils), may happen in 60 - 70% of patients. Fortunately, far fewer people will actually throw up, but this continues to be an annoying common side effect. Sore throat can occur in 20 - 50% of cases or more. Injuries to teeth occur, on average, in every 1 - 2000 cases. Both these problems commonly have to do with the insertion of an airway (breathing tube) which is usually necessary during a general anesthetic. It is wise therefore to let your anesthesiologist know about any fragile or loose teeth and possibly to have these taken care of before undergoing anesthesia. 

For a routine colonoscopy, my doctor is letting me decide between twilight and total anesthesia. But she says that total anesthesia is safer (anesthesiologist present) and has fewer after effects. I forgot to ask her why, in that case, any one doctor offers twilight sleep or any patient chooses it. What are the tradeoffs? 

Twilight anesthesia and total anesthesia are not standard terms, so I can't really tell you exactly what your doctor means. The official classification of "levels of sedation" goes as follows: 1. Minimal sedation (anxiolysis) is a drug-induced state during which patients respond normally to verbal commands. 2. Moderate sedation/analgesia (conscious sedation) is a drug-induced depression of consciousness during which patients respond purposefully to verbal commands, either alone or accompanied by light tactile stimulation. 3. Deep sedation/analgesia is a drug-induced depression of consciousness during which patients cannot be easily aroused but respond purposefully following repeated or painful stimulation. 4. Anesthesia consists of general anesthesia and spinal or major regional anesthesia. It does not include local anesthesia. General anesthesia is a drug-induced loss of consciousness during which patients are not arousable, even by painful stimulation.ﾠMy guess is that your doctor is offering you either a Level 1-2 experience in which you are given small amounts of intravenous sedation, administered by a nurse, or a Level 3-4 experience involving an anesthesiologist. With the latter you have the benefit of greater comfort for you during the procedure, and possibly better conditions for the doctor doing the colonoscopy. This usually comes at a higher cost, (although you may not be the one paying) but with perhaps a slightly longer recovery time. An intravenous infusion of a drug called propofol is very often used for deeper sedation, however propofol is not the only drug that can be used for this. The key issue is safety. There is probably no significant difference between the two approaches as far as safety (the risk of harm) is concerned, assuming you've got competent professionals doing the work. Anyone permitted to administer lower levels of sedation must have the ability to "rescue" the patient from deeper levels that may occur unintentionally. In the United States anyone providing general anesthesia or deep sedation is likely to be an anesthesiologist or nurse anesthetist, although some gastroenterologists are seeking special permission, through legislation, to allow them to administer propofol for colonoscopies without an anesthesia provider. 

Does a spinal numb you only from the waist down just like the epidural? 

The effect of a spinal anesthetic is quite similar to the effect of an epidural. The "height" of an epidural or spinal anesthetic (in other words, how much of your body is numbed) depends on how much anesthetic medication is injected through the epidural catheter. Similarly, the height of a spinal depends on how much anesthetic is injected through the spinal needle. 

Your anesthesiologist will decide, based on the operation that is to be performed, how much medication to use. With a cesarean section, the aim is to have the level of numbness around the "nipple line" - that is an imaginary line across the chest at the level of the nipples. 

One of the main differences is that an epidural anesthetic can be made to last a long time by injecting more medication into the epidural catheter. The effect of a spinal anesthetic cannot be lengthened - the medication is injected through the needle, and the needle is then withdrawn. Epidural and spinals are equally safe for cesarean sections and are considered to be safer than general anesthesia for this operation. 

I need a total hip replacement and the surgeon I`ve seen says he uses spinals for surgery. I`ve heard bad things about this and wonder how safe that kind of anesthesia is. 

Thanks for your question. You can rest assured that spinal anesthesia is a safe choice for hip surgery. Many patients when offered this type of anesthesia are concerned about serious side effects, such as paralysis, and also about troubling but less dangerous side effects, such as headache. There seems to be a common, although false, perception that these complications occur often. In fact, spinal anesthesia has a long track record of safety, with a rate of serious complications (low!) about equal to the rate of major problems with general anesthesia (also low!). 

Studies that have looked at the overall outcome of spinal and general anesthesia for hip surgery have not found a completely convincing advantage of one over the other, and therefore both types of anesthesia are commonly used. In our hospital, at least half of the hip replacement surgery is done with spinal anesthesia. Among the reasons it is favored, include: (1) more rapid recovery of mental function, (2) the lack of need for insertion of breathing tubes, (3) the lower incidence of nausea or vomiting, and (4) the prolongation of anesthesia after completion of surgery, which means a longer pain free period. 

Paralysis after spinal anesthesia is very rare. The number of patients who develop a headache is also quite low in expert hands and using appropriately sized (small) needles, fewer than 1% or so of patients should have a headache. Although a "spinal headache" is troublesome, it is not life-threatening. 

Not all patients are candidates for spinal anesthesia. We do not offer this technique to patients who are at risk for internal bleeding problems or to patients with infection in the area where the needle is inserted. In our hospital, we try to offer a realistic explanation of the different anesthetic techniques, their risks and benefits. Assuming there is not an absolutely compelling reason to choose a particular technique, we usually allow the patient to make a choice. It is best for you to have this discussion with your anesthesiologist, the physician who will be responsible for this aspect of your care.ﾠ 

I had a total knee replacement that the doctor wants to repair with an "EPIDURAL". How dangerous is this? I am 70 years old and in good health otherwise. Thank you. 

Briefly, an epidural is a very thin catheter (tube) that is inserted into the epidural space, which is an area just inside the spinal canal. The procedure normally takes less than 20 minutes or so to perform, and usually causes minimal or no discomfort. Anesthetic medication is then injected into the catheter, causing numbing of the legs and abdomen, and allowing surgery to be done in those areas. 

Epidural anesthesia is quite similar to spinal anesthesia. Epidural anesthesia is a standard method of anesthesia for knee replacement surgery. It has at least 4 advantages over general anesthesia. First, because less sedative medication is required, mental recovery tends to be quicker. Secondly, the insertion of a breathing tube, with its attendant risk of sore throat or tooth injury, is not required. Thirdly, nausea and vomiting during the recovery period is less likely. And finally, in many cases the epidural is left in place after surgery to provide excellent treatment of pain. 

All anesthetic techniques have some risk, and epidurals can (extremely rarely) cause such problems as infection, bleeding in the spinal canal, or (more commonly) headache or lowering of blood pressure. The overall risk of serious complications, in most patients, is not different from general anesthesia. 

I`m doing a research paper on the effects of anesthesia on a baby when it is administered to the mother during childbirth. What are the risks, how serious are they, and what are the chances of a negative effect on the baby. 

ﾠIn the United States, epidural analgesia is the most effective form of pain relief offered to mothers during labor and childbirth. It is considered to be very safe, both for mother and baby. In many hospital-based birthing centers, 70% or more of the women giving birth receive epidural analgesia or anesthesia. I will clarify the words used here. "Analgesia" is another word for pain relief. "Anesthesia" is the term for drugs or techniques used to block the pain of a surgical procedure such as a cesarean section. For a cesarean section, epidural or spinal anesthesia is safer than general anesthesia. If you need a more detailed account of the risks, and effects of these techniques, please be a little more specific about the kind of anesthesia you are researching in your paper.