Questions & Answers about Sem a anestesia, a injeção teria sido muito pior.
Sem means without.
So Sem a anestesia means Without the anaesthetic or Without the anesthesia.
Portuguese often begins a sentence with this kind of phrase to set the condition first. In English, we can do the same:
- Without the anesthesia, the injection would have been much worse.
The comma helps separate that introductory phrase from the rest of the sentence.
In Portuguese, definite articles like o / a / os / as are used more often than in English.
So a anestesia literally means the anesthesia / the anaesthetic, but in natural English we might simply say without anesthesia.
Portuguese often prefers the article here because it is referring to the specific anesthesia involved in that situation.
Compare:
- Sem anestesia = without anesthesia, in a more general sense
- Sem a anestesia = without the anesthesia, referring to the one that was actually used
Both can be possible, but Sem a anestesia sounds more specific.