In some cases, surgical interventions are divided into large and small, but many surgical procedures combine the characteristics of each of these types.
Extensive Surgical Interventions
Extensive surgery often involves opening one of the largest cavities in the body (abdomen, chest and skull). An abdominal dissection is called a laparotomy, a thoracotomy, and a craniotomy of the skull. Extensive surgery can create stress on vital organs. Such surgeries are usually performed with general anaesthesia in hospital operating theatres and involve a team of doctors. Generally, after a major surgery, the person should stay in hospital for at least one more night.
Small Surgical Intervention
During small surgical interventions, large body cavities are not opened. Small surgeries can be performed using local, regional or general anesthesia and can be performed in the emergency department, outpatient surgery center or doctor’s office. There is usually no undesirable effect on vital organs; the surgery may be performed by a single doctor who is or is not a surgeon. As a rule, a person may return home already on the day of the minor surgery.
Local and Conductive Anaesthesia
These types of anesthesia involve injections of drugs (such as lidocaine or bupivacaine) that cause numbness only in certain parts of the body.
When local anesthesia is performed, the drug is injected under the skin at the site where the incision is to be performed and causes numbness only in that area.
When performing a conductive anesthesia, which covers a larger area of the body, the drug is injected into the area around one or more nerves and causes numbness of the body part for which these nerves are responsible. Thus, the drug is injected into the area around certain nerves causes numbness in fingers or feet, certain areas or the whole limb. One type of regional anesthesia involves injecting the drug into a vein (intravenous blockade anesthesia). A special device, such as a woven elastic bandage or a pneumatic cuff for measuring venous pressure, squeezes the place of connection of the limb with the torso, detaining the drug inside the veins of this limb. Intravenous blockade anesthesia can cause numbness in the entire limb.
When performing local or conductive anesthesia, the person remains awake. But in some cases, doctors administer intravenous mild sedative anxiolytic drugs to help the person to relax. In rare cases, numbness, tingling or pain may be felt in the areas where the anesthetic was injected, within days or even weeks after the surgical procedure.
Spinal anaesthesia and epidural anesthesia are special types of conductive anaesthesia that involve the injection of the drug in the area around the spinal cord in the lower back. The size of the area where the numbness can cause such anesthesia can be quite large (for example, from the waist to the toes) and depend on the place of injection and the position of the body. Spinal anesthesia and epidural anesthesia are used for operations in the lower body, such as hernioplasty or operations on the prostate, rectum, bladder or lower extremities, as well as some gynecological operations. These types of anesthesia can also be used during childbirth. In some cases, after spinal anesthesia, headaches may be observed for several days, but usually they can be successfully eliminated.
During general anesthesia, a drug circulating through the bloodstream is injected, resulting in unconsciousness. The drug can be injected intravenously or by inhalation. General anesthesia slows down breathing, so the anesthesiologist injects a special tube into the patient’s throat. In short operations, the use of such a tube may not be required. Instead, the anesthesiologist may use a portable breathing mask to support breathing. If the operation takes a long time, the patient breathes with the help of artificial ventilation apparatus (artificial ventilation of the lungs). General anesthesia affects vital organs, so the anesthesiologist carefully monitors heart rate, heart rhythm, respiration, body temperature and blood pressure throughout the entire duration of the drug. Serious side effects occur very rarely.