General anesthesia means that you lose consciousness while under anesthesia, as if you are asleep, and you are unaware that the surgery is done. What happens before, during and after this? Before anesthesia, you have to fast from water so that there will be less stuff left in your stomach. If something comes back up in your stomach during anesthesia and chokes on your trachea or accidentally enters your lungs, you will be in trouble. The night before the surgery, it’s best to get a good night’s sleep – it’s hard, and if I was told I was going to be operated on tomorrow, I’d be too nervous to sleep. You can ask the doctor and nurse on duty in the ward for a sleeping pill to help get to sleep. If you can’t sleep, it’s okay to sleep during the surgery. On the day of surgery, when you enter the operating room, you will first be connected to an ECG monitor. The basic configuration: an ECG on your chest, a blood pressure monitor on your arm, and oxygen on your finger (to see if you have enough oxygen in your blood). For major surgery or critical patients, there are more complex monitoring programs. Anesthesia and surgery require rapid intravenous administration of medications and fluids, and if the IV needle in the room is not strong enough, we will give you a shot. When you’re ready, you’ll be given your medication and go to sleep. The anesthesia is given intravenously (for the fastest sleep) and a mask is fastened to your face to give you oxygen. What happens next, no matter how scary you think it is, is done without you knowing. When you are under general anesthesia, your breathing is affected while you are unconscious. Major surgeries require a tracheal intubation (which is a soft tube inserted inside the trachea), and some surgeries can be done with a laryngeal mask (which is placed in the throat and does not go inside the trachea). After insertion, an anesthesia machine is connected, which helps you breathe and allows you to breathe anesthetic gas while you continue to sleep. The surgery begins and the anesthesiologist is not idle. If there is a lot of bleeding from the surgery, we will also actively transfuse fluids and blood if necessary. During surgery, we try to meet the surgical requirements for blood pressure and muscle relaxation, maintain the homeostasis of your body’s internal environment, protect your heart, brain, kidneys and other vital organs, and deal with any combined medical conditions. If resuscitation is required, it is also led by the anesthesiologist. After the surgery, we reduce the anesthesia, you slowly wake up, your spontaneous breathing becomes better and better, and we can remove the tracheal tube when the criteria for removing the tracheal tube are met. When you are recovering better, we can take you out of the operating room, meet your family and transfer you back to the ward. And you won’t remember anything about the surgery. It’s like the movie “Men in Black”, where it’s hard to realize what’s going on. It’s like a memory break, from the time you go under anesthesia until you wake up. Some people have dreams, but they are usually beautiful dreams. However, your body will not lie to you. You may have a urinary catheter and various drainage bags, painful surgical incisions, and in a few cases, nausea and even vomiting. Post-operative analgesia is also the specialty of anesthesiologists, and we will try to keep the pain down to a level that is acceptable to you. After all, having gone through surgery, it may be uncomfortable on the day after surgery. However, please be confident that you will get better each day after surgery and that the medical staff will do their best to help you.