What are the indications and contraindications for general anesthesia?

Indications for general anesthesia include major surgical procedures, delicate operations, prolonged surgeries, patients unable to cooperate with anesthesia, and severe trauma surgeries; contraindications include severe cardiac or pulmonary insufficiency, increased intracranial pressure, severe hepatic or renal failure, acute shock, and allergies to anesthetic agents. Specific decisions require comprehensive evaluation by a physician. If surgery is needed or if you have questions about anesthesia, it is recommended to seek medical advice promptly.

I. Indications

1. Major surgical procedures: Suitable for highly invasive surgeries such as thoracotomy or laparotomy. General anesthesia renders the patient completely unconscious and free of pain, preventing stress responses caused by intraoperative pain and ensuring safe surgical performance.

2. Delicate operations: For high-precision procedures such as neurosurgery or ophthalmic surgery, general anesthesia helps maintain stable body positioning, prevents minor movements from interfering with surgical accuracy, and improves the success rate of the operation.

3. Prolonged surgeries: When surgery exceeds three hours, regional or spinal anesthesia may not sustain adequate effect. General anesthesia allows continuous drug administration to maintain a stable anesthetic state, meeting the time requirements of lengthy procedures.

4. Patients unable to cooperate with anesthesia: For infants, young children, or patients with psychiatric disorders or severe anxiety who cannot cooperate with local anesthesia, general anesthesia ensures the patient remains still and calm during surgery, facilitating surgical procedures.

5. Severe trauma surgeries: In cases such as multiple fractures or extensive burns, where injuries are severe and pain is intense, general anesthesia provides rapid pain relief and facilitates intraoperative monitoring and life support.

II. Contraindications

1. Severe cardiac or pulmonary insufficiency: In patients with conditions such as acute myocardial infarction or severe pneumonia with respiratory failure, general anesthesia may further suppress heart and lung function, increasing the risk of respiratory or cardiac arrest.

2. Increased intracranial pressure: In cases such as brain herniation or unevacuated intracranial hematoma, general anesthesia may exacerbate elevated intracranial pressure, leading to brain damage. Intracranial pressure must first be reduced before anesthesia feasibility can be assessed.

3. Severe hepatic or renal failure: Most anesthetic drugs are metabolized through the liver and kidneys. In cases of severe organ dysfunction, drug metabolism and excretion are impaired, leading to drug accumulation and potentially serious adverse reactions.

4. Acute shock state: In patients with septic or hemorrhagic shock, circulatory instability makes general anesthesia risky, as it may further depress circulation and worsen shock. Shock must be corrected before anesthesia is considered.

5. Allergy to anesthetic agents: If a patient has previously experienced allergic reactions to specific anesthetics (e.g., procaine, propofol), re-exposure may trigger rashes, laryngeal edema, or even anaphylactic shock. Such drugs must be strictly avoided.

Prior to surgery, patients should fully inform their doctors of their medical history and current medications, maintain regular sleep patterns, avoid staying up late or excessive anxiety, and follow preoperative fasting and fluid restrictions to properly prepare for anesthesia and surgery.