Answered by SecondMedic Expert
General Physician · General Physician
No, tracheal intubation is not always necessary during general anesthesia. In some cases, the anesthesiologist might opt to use a face mask and drugs to keep the patient asleep rather than using an endotracheal tube. For example, when performing minor procedures such as dentistry or cataract surgery involving short-term (less than 2 hours) general anesthesia, it is often more appropriate to use a face mask instead of intubation since this eliminates many potential risks associated with having a patient intubated.
In certain cases where patients are at higher risk for complications related to airway obstruction due to obesity or difficulty breathing on their own, tracheal intubation may be used as a preventive measure against these dangers. Additionally, if the procedure that needs to be done will take more than two hours under general anesthesia then it’s usually recommended that the patient receives tracheal intubation in order for them to remain asleep throughout the entire surgery and avoid any potential distress caused by waking during it. Furthermore depending on what kind of drug regimen is being used (inhaled vs intravenous), endotracheal intubation might also need to be used for mechanical ventilation purposes in order for adequate levels of oxygen and carbon dioxide exchange occur in those patients who are too sedated from given medications or have decreased respiratory reserve due to other medical conditions like COPD or asthma requiring extra support breathing during surgeries which can only be adequately provided with an artificial airway via endotracheal tube placement.
