Anesthesia

Anesthesia refers to a loss of sensation with or without loss of consciousness that is typically used to allow patients to comfortably undergo surgery. There are four main types of anesthesia:

General anesthesia. This type of anesthesia is accomplished by a combination of medications that a person breathes through a mask or receives through a catheter in a vein to cause the person to fall asleep and remain asleep throughout the duration of surgery.

Regional anesthesia. This type of anesthesia occurs when your anesthesiologist places medication around the nerves that supply the area to be operated on. This may be accompanied by giving you medication to help you relax during the surgery. Spinal/epidural anesthesia, peripheral nerve blocks and perineural catheters are examples of regional anesthesia.

Local anesthesia. This type of anesthesia is accomplished by injecting medication under the skin in the area where the surgery will occur. This may be accompanied by giving you medication that will help you relax during the surgery.

Monitored Anesthesia Care (MAC) anesthesia. This type of anesthesia is accomplished by giving you medications which help you relax during a procedure while you remain breathing on your own and responsive.

All four types of anesthesia allow you to comfortably undergo surgery without seeing or feeling what is happening.

Your anesthetic care will be provided by a team of doctors and nurses who specialize in the care of patients undergoing surgery. All patients are under the direct care of a physician while they are undergoing their surgery and during the time they are in the recovery room. Additional members of your anesthetic team may include any number of the following:

Anesthesia resident. A physician who is currently in the process of completing their four years of supervised training in anesthesia.

Medical student. A medical student in their third or fourth year of medical school may be assigned to your case. Medical students are there to observe and learn about the practice of anesthesia.

CRNA. A certified nurse who has undergone specialized training in the practice of anesthesia.

SRNA. A certified nurse who is currently in the process of completing their specialized training in anesthesia.

At least one member of the anesthesia team will be with you at all times while you are in the operating room under anesthesia. They will be monitoring your blood pressure, heart rhythm and rate, and the oxygen levels in your blood.

You should tell your anesthesia team about all medical problems that you currently have or have had in the past. Other important information to tell your anesthesia team includes: allergies to any medications or foods, previous surgeries, previous anesthesia experience, family history of problems with anesthesia, a list of all medications that you are currently taking, physical disabilities that may make it difficult for you to lie in a certain position.

In general, you should not eat or drink anything after midnight prior to your surgery. If your doctor has told you to take medications by mouth the morning of your surgery, you may take them with a sip of water. In certain cases you may be given permission to drink clear fluids up to two hours prior to your surgery.

Your doctor will let you know which medications you need to continue as regularly scheduled before your surgery. Commonly prescribed medications, such as blood pressure, cholesterol, and pain medications should be continued unless told otherwise. If you take any blood thinners, such as aspirin, Coumadin, Lovenox, or heparin, please ask your physician for specific instructions. Please discuss with your doctor how to take your diabetes medications. Your morning dose of medications may be taken the day of surgery with a sip of water.

Your anesthesiologist will discuss with you the risks of anesthesia during your preoperative visit. In general, anesthesia is very safe. Each patient's medical history and type of surgery will influence the risk of undergoing the procedure. Your anesthesiologist will discuss these risks with you and will implement an anesthetic plan that they believe is safest for you.

It is normal for patients to remember parts of the procedure when under local, MAC and regional anesthesia. It is very rare for patients to wake up or remember anything while under general anesthesia. If you have any questions, please discuss with your anesthesiologist prior to surgery.

It is normal for patients to feel sleepy right after waking up from anesthesia. It is common to have a sore throat after general anesthesia due to the breathing tube. You will be given medication to treat and help prevent nausea and pain during and after surgery. If you experience pain after surgery, we will provide you with the needed medication to help you feel better.

Your anesthesiologist will discuss with you what your options are for controlling pain after surgery. Some patients may benefit from regional anesthesia techniques that can provide pain relief after the surgery. Other pain controlling options include the use of intravenous medications as well as pills that you take by mouth. If you experience pain after surgery, a nurse will be present and will provide you with additional pain medicine.

Written by:
Daniel Tolpin, M.D.
Jaime Ortiz, M.D.
August 2010