What types of anesthesia are used in cancer surgery?

Anesthesia refers to drugs or other substances that keep you from feeling pain during surgery. They work by causing loss of feeling or awareness. There are three types:

• Local anesthesia causes loss of feeling in one small area of the body. You stay awake.
• Regional anesthesia causes loss of feeling in a part of the body, such as an arm or leg. Some blocks numb everything below the waist.
• General anesthesia causes loss of feeling and a complete loss of awareness that seems like a very deep sleep.

A fourth option sits alongside these. Monitored sedation makes you relaxed or sleepy. You may still be able to talk, but you probably will not remember much. Sedation can be used on its own or with local or regional anesthesia.

How the choice gets made

The main driver is the operation, not the cancer. A small growth taken off the skin needs only a numb patch. Surgery inside the chest, belly, or skull needs you fully asleep, with a machine helping you breathe.

The surgical approach matters too. Open surgery uses one large cut, and it usually calls for general anesthesia. Minimally invasive surgery uses a few small cuts and a laparoscope, a lighted tube that lets the surgeon see inside. It often calls for general anesthesia as well. Some treatments replace the scalpel and may need less. Two examples are cryosurgery, which uses the extreme cold of liquid nitrogen or argon gas, and laser surgery.

Your own health is the third factor. Heart disease, lung disease, sleep apnea, and past trouble with anesthesia all shape the plan.

Who gives it, and what can go wrong

Anesthesia may be given by an anesthesiologist, a doctor who specializes in it. It may also be given by a nurse trained in anesthesia. Someone watches your breathing, heart rhythm, and blood pressure the whole time.

The National Cancer Institute counts reactions to anesthesia among the risks of cancer surgery. The other risks it lists are pain, infection, bleeding, and damage to nearby tissue. For general anesthesia, the main concerns are heart rhythm problems, trouble breathing, allergic reactions, and confusion afterward. Waking during surgery happens, but it is rare.

That confusion is worth knowing about ahead of time. It usually clears fast. But it can last several days in some people over the age of 60. If you are bringing an older relative in for cancer surgery, plan for that. Arrange for someone to be with them in the days after.

What to do before your operation

Ask which type of anesthesia you will have, and who will be giving it. Ask what to expect on waking. A sore throat, grogginess, and nausea are common after general anesthesia.

Tell the team every drug and supplement you take, including over-the-counter ones. Mention any past trouble with anesthesia, in you or in your blood relatives. Follow the fasting rules exactly. If nobody gave you a stop time for food and drink, call and ask for one.

Recovery time depends on the type of anesthesia, how big the surgery was, and what your job asks of you. Ask for a realistic estimate before the day arrives.