Everything was going so well today. Your hair was doing that thing you like, there was no line at the coffee place, and you got to work on a little early. You even found out you're getting that promotion over Karen. Not bad! Now you're driving home, and you suddenly feel a sharp pain in your lower abdomen. Was it something you ate? Before you can think about it too much, the sharp pain hits again. By the time you get home, you're sweating. You check your temperature. A fever is setting in.
Finally, you think, "better safe than sorry." Time to put that health insurance to use.
And that's how you got here. Lying back in a hospital bed, a heart monitor beep-beep-beeping by your side, and a doctor explaining your imminent surgery. They're going to take your appendix out. You might be scared about what happens if you wake up during surgery, but lucky you, there's a drug to keep that from happening. You're going to go under general anesthesia, and by the time you wake up, you'll be right as rain. But exactly what happens when you go under? And, aside from that appendix getting taken out - or whatever your particular surgery may be - what happens to your body in anesthesia?
Not only will your brain not be able to talk to the nerves sending signals from your extremities, organs, and muscles, it also won't be able to talk to itself. In a normal brain, electrical signals move rapidly in a chaotic way, as different portions of the brain communicate with one another. This connectivity is what keeps you aware and alert, and it's what anesthesia moves to shut down.
First, the signals stop behaving so chaotically as they become orderly and calm. In response, your body settles down as well. Your breathing and heart rate stabilize, and research shows that your brain simply doesn't communicate with itself anymore. This may happen because some anesthetics bind to the GABAA receptor in your brain, and they hold the gateways between parts of your mind open, letting negatively charged particles flow into the cell. Either way, it's the change from chaos to order which keeps you under.
There's one other vital part of the body that feels the impact of general anesthesia, and that's your spine. General anesthesia gets into your blood stream when you breathe it in, or when it's injected, and once there it finds its way to your spinal cord. The spine is also what controls your sense of feeling and movement in your limbs, So as the anesthesia impairs flow of neurological and electrical activity through your spine, your body stops being able to move, even if you're conscious. In other words, you're completely paralyzed.
You won't realize this while you're in stage three of anesthesia, and you won't remember it later because you'll have complete amnesia. That being said, it does sometimes give way too a distressing side effect. Upon waking, some people experience residual paralysis, where they cannot feel or move their limbs. This is nearly always temporary, and very rare, so it's not something to worry much about.
Okay, ready for something terrifying? We're not entirely sure how general anesthesia even works. Even with all our modern medical knowledge, we still don't fully understand how it is that anesthesia keeps us under, or keeps us from remembering or feeling pain. We know what parts of our body are suppressed or start working, but not why.
There are few well-respected theories, but no certainty. One theory states that anesthesia dissolves some of the fat present in brain cells, and this is what changes the brains activity. Another similar idea states that anesthesia makes it difficult for certain neurons in the brain to fire, because they bind to and incapacitate some of the proteins on the surface of neurons. These proteins are needed to regulate sleep, attention, learning, and memory, so when they're interfered with, we get the comatose-like state of being associated with the anesthetized.
Shockingly enough, when you're under general anesthesia, you usually do not have to be attached to a machine that controls your breathing and heart rate. Instead, you'll probably be given a breathing mask that feeds you oxygen (LMA), though it's true that you may have a tube put down your throat in order to make your breathing easier. It's only sometimes that you're hooked up to that tube and a ventilator though.
You see, general anesthesia may slow your breathing and make it harder for your brain to tell you to keep breathing enough to make sure your body can function. The oxygen mask allows your lungs to get what they need, and having a endotracheal, or breathing tube, means that your airway will stay clear throughout the procedure.
Don't worry about waking up with a tube down your throat, though, because the surgeons and anesthesiologists will remove the tube once they're sure you can breathe on your own, without risk. For some surgeries and anesthesia, the tube is not even needed.