Anesthesia Works Like a Telephone System
To better understand the three types of anesthesia rewire your thinking with this telephone analogy.
Have your every wondered how anesthesia works? I have. But then a certified registered nurse anesthetist (CRNA) explained it to me so clearly that I felt compelled to share her analogy with other medical coders.
To better understand how the different types of anesthesia work, it’s best to know a little about the nervous system. If you think of your brain as a central computer that controls all the functions of your body, the nervous system is like a network that relays messages back and forth from the brain to different parts of the body. The spinal cord runs down the back and contains thread-like nerves that branch out to every organ and body part. If you compare the nervous system to an old-fashioned switchboard phone system:
- The brain is the switchboard;
- The nerves are the cables; and
- The body parts — receiving information from the world via the senses — are the phones.
Let’s consider each of the three types of anesthesia (local, regional, and general) using the telephone analogy.
Local Anesthesia Is Off the Hook
Local anesthesia means the phone (e.g., the small part of the body being numbed) is “off the hook,” and cannot receive calls (pain signals) from the switchboard (the brain) or the phone cables (the nerves). This type of anesthesia is only used for minor procedures on limited parts of the body. The patient may remain awake, but will likely receive medicine to relax or feel sleepy during the procedure/surgery. The use of muscle relaxants, which block transmission of nerve impulses to the muscles, might also be used during anesthesia to temporarily relax muscle tone, as needed. For example, local anesthesia might be used for a scar revision or during a dental procedure.
Regional Anesthesia Has Unplugged Cables
Regional anesthesia means the phone cable (the nerves) are “unplugged,” causing all the phones in a specific area (the entire area of the body being numbed) to be out of service. For example, a peripheral nerve block is regional anesthesia in which an anesthetic is injected near a specific nerve or a group of nerves to block pain from the area of the body supplied by that nerve. Nerve blocks are most commonly used for procedures on the hands, arms, feet, legs, or face.
Regional anesthesia will help the patient relax or feel sleepy during the procedure or surgery. An epidural/spinal is another example where a local anesthetic is injected near the spinal cord and nerves that connect to the spinal cord to block pain from an entire region of the body, such as the abdomen, hips, or legs. Regional anesthesia is also used with general anesthesia for pain control post-operatively.
General Anesthesia Means the Operator Is Out to Lunch
General anesthesia is where the switchboard operator (the brain) is on break and cannot connect incoming calls (pain signals to any area of the body). Under general anesthesia, the patient is completely unaware and does not feel pain during the procedure or surgery. General anesthesia often causes forgetfulness (amnesia) right after surgery or during the post-operative period.
The telephone analogy makes it clear how each form of anesthesia effects the body, and why one is used over the other for certain procedures or surgery. I think you will find this knowledge is immensely helpful when coding anesthesia services.