Anesthesia can arouse great concerns, even if its risks are extremely rare. The point with Bruno Vibert, psychotherapist.
According to the French Society of Anesthesia and Resuscitation (SFAR), more than 13 million anesthesia Are practiced each year in France, there are two types of anesthesia: general anesthesia which temporarily removes consciousness and sensitivity to pain and locoregional anesthesia which only makes part of the body. In the first, the patient is completely asleep and is therefore unconscious, while in the second, the patient is awake and aware. Note that among loco-regional anesthesia, spinal and epidural are found, used to put the lower half of the body, as well as anesthesia by nervous block. How does it go? Is it legitimate to be afraid of it? How to manage stress as the intervention approaches? Advice from Bruno Vibert, psychotherapist specializing in the management of emotions related to phobia or anxiety.
An anesthesia is always carried out by doctors specializing in anesthesia-resuscitation in a very regulated environment.
- Before any programmed surgical intervention requiring anesthesia (general or locoregional), the patient has an appointment with an anesthesiologist between 48 hours and a week before the day of the operation. During this meeting, the doctor chooses the most suitable type of anesthesia. The course of anesthesia, the risks involved and the side effects (headache, fatigue, nausea, dental lesions, disorders of attention, muscular disorders …) are then mentioned. Finally, a blood test is carried out.
- On the day of the operation, the patient is prepared (shower with antimicrobial soap, shaving the area to be operated …), installed in a bed and taken to the operating room where it is taken care of by an anesthesia team. The anesthesiologist, supported by a nurse, poses a venous path to inject drugs that remove consciousness and analgesics to remove pain, or a facial mask that diffuses an anesthetic gas to breathe. It installs the different devices to measure tension, breathing and heart activity.
Mortality linked to anesthesia has been divided by 10
- During the operation, one or more members of the anesthesia team are there to monitor the patient’s condition, continuously administer drugs to maintain this artificial sleep, adapt the anesthetic product dose and prepare their alarm clock by ceasing the administration of products.
- After the operation, the patient is then brought to the alarm clock where he is taken care of by other doctors and nurses anesthetists. The patient gradually regains knowledge until he is renewed in his room. The patient must then eat slightly to regain strength after these few hours of youngness.
What are the risks? Death, awakening …
“”There is extremely little risk of not waking up or waking up during the intervention. Anesthesia is extremely well mastered, prepared and secure“, reassures psychotherapist Bruno Vibert. Mortality linked to anesthesia was divided by 10 between 1980 and 1999, according to figures updated by Public Health France in 2019, the death rate Completely or partially linked to anesthesia are 6.9 and 47 per million respectively. Today, the products used have almost no more side effects and anesthetic techniques are very safe: the administration of the anesthes is controlled by computer and surveillance throughout the intervention is meticulously carried out by an electroencephalogram (EEG), an extremely reliable brain exploration method to measure the activity of the brain and adjust the doses in the event of need.
What does the fear of anesthesia reflect?
General anesthesia is not a natural and harmless act, it is a programmed sleep, which can therefore be anxiety -provoking. “”You have to accept this fear at all costs and not feel guilty, because being afraid is a very natural mechanism. It is a protective phenomenon that is automatically set up when you feel a danger. And general anesthesia can be perceived as a danger“, Besides Bruno Vibert. The fear of general anesthesia generally reflects three much deeper fears: the fear of never waking up, the fear of losing control or even, the fear of waking up during the intervention. However,”We must dissociate fear of phobia: fear is a natural phenomenon where there is a certain logic and conscience, while phobia corresponds to an irrational and uncontrollable fear“, Specifies the expert.
Behind the fear of not waking up, hides the fear of dying
Unlike death, anesthesia is a reversible action: the patient is not inert, but simply disconnect from the environment. Thus, once you stop administering hypnotic products, the patient gradually becomes aware. “”The fear of waking up during the intervention, on the other hand, brings us back to suffering. This fear actually reflects the fear of suffering, to see all the actions that can be done on us and to feel the pain during the operation“explains Bruno Vibert. Finally,”The fear of losing control hides a fear of revealing a part of us or being manipulated by others. This can also reflect a lack of confidence in the medical team. Especially since for an operation requiring general anesthesia, we are undressed, which further strengthens discomfort, loss of modesty and exposure. However, you have to reassure yourself. During an anesthesia, we are not entirely in loss of control because, even if we are unconscious, our body, it continues to function and regulate itself as if it were awake“, Specifies the psychotherapist.
A few days before the intervention, It is possible to do a sophrology session during which you will work your breathing and learn to better manage your emotions. To relax, it is also possible to practice self-massage of temples, regions where there is an accumulation of nerves. You can also work visualization or mental imagery, ideal for creating a protection bubble. “”For example, the day before anesthesia: close your eyes, breathe slowly and imagine a place in which you feel good. This exercise can very well be carried out a few minutes before the start of the intervention. It is also important to put into perspective and project yourself into “after anesthesia”, even if it requires a big mental effort. To help you, ask yourself these questions: how will I feel after the operation? What sensations will I find as soon as I wake up? “, advises Bruno Vibert.
During the pre-anesthesia meeting with the doctor, you must ask all your questions without hesitation. “”The caregiver is there to reassure you if you feel anxiety: his role is to make you confidence and as comfortable as possible. And the more information you will have, the less your fear of the unknown will be great“, says the expert. In addition, before your arrival in the operating room, a drug against anxiety can be offered to you. This tablet makes it possible to calm the anxiety and facilitate the falling asleep of the future operated. As far as possible, be accompanied in the hospital by a close person who will appease you and help you take a step back on your fear. This person will not be able to access the room of operations, but will be in the Hall bedroom.
