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Anesthesia

Anesthesia is the loss of feeling or sensation with or without loss of consciousness. Our objective is to keep you pain-free, comfortable and safe, either awake or asleep while your surgeon performs the necessary procedures.

Kinds of Anesthesia

  • General Anesthesia may be given intravenously, inhaled as a gas, or frequently, a combination of the two. The drugs work primarily on the brain and nervous system to render you pain-free and unconscious. The inhaled gases are administered through a mask or an artificial airway. In most cases the artificial airway is inserted after you are asleep and removed before you are fully awake.
  • Regional Anesthesia includes spinal, epidural, IV blocks and various regional nerve blocks. A regional anesthetic blocks the nerves that lead to the surgical site. You will remain conscious, but the area of your body affected by the surgery will be insensitive to pain. You typically will be given IV sedatives or tranquilizers to make you feel comfortable and less aware.
  • Local Anesthesia is injected directly into the surgical site, making the area insensitive to pain. This is also known as monitored anesthesia care (MAC). You typically will be given IV sedatives or tranquilizers to make you feel comfortable and less aware.

Combinations of the above may be most appropriate for some surgeries.

What if I don't want to stay awake during regional or local anesthesia?

In most instances, sedation can be administered to keep you comfortable and less aware of your surroundings. You are encouraged to discuss your preference with the anesthesiologist and CRNA caring for you on the day of surgery.

Risks and Side Effects

  • Side effects of anesthesia, surgery and post-op pain medication include nausea and vomiting.
  • Less serious risks include bruising at the IV site, sore throat, muscle ache, dental injury, corneal abrasion or headache.
  • Rare, but more serious risks include nerve damage, changes in heart rhythm, heart attack, pneumonia, kidney or liver damage, stroke, allergic drug reactions, high temperature, blood reactions, awareness under general anesthesia or death.

What to Expect

Before Surgery

A nurse from the pre-anesthesia clinic will contact you to interview you about your health, family and medical history, personal habits and allergies. Please answer as fully and honestly as possible. Your answers influence the kind and amount of anesthesia chosen for you.

Patients with a complicated medical history will be scheduled for an appointment with an anesthesiologist. If your medical history is uncomplicated but you would like to see an anesthesiologist, please let the pre-anesthesia clinic nurse know.

The best anesthetic for you is based upon your age, size, medical history and type of procedure for which you have been scheduled. Sometimes the options are limited by physical or medical circumstances. The anesthesia team will discuss your options and help you choose the one that is safest for you.

The Day of Surgery

You will be admitted the morning of your surgery as either an inpatient or an ambulatory patient. In either case, it is important that you do not eat or drink anything after midnight (including candy, breath mints and chewing gum) the night before surgery. If the surgeon or anesthesiologist tells you to take specific medication after midnight, use only as much water as needed to swallow pills.

It is very important to your health that you follow these instructions without fail. If you do not, your surgery may be delayed or canceled or you may have an adverse reaction leading to complications such as aspiration (getting stomach contents in your lungs), which could lead to pneumonia or death.

On the morning of your surgery, you may be given a sedative to help you relax. You may also get medications such as antibiotics and drying agents as needed. Shortly before the time of your surgery, you will be moved to the preoperative holding area.

The Pre-Operative Holding Area

There may be other patients in the pre-operative holding area when you arrive. Final identification and chart checks will be made here. You may be asked the same questions by several different people. Please be patient with us. It is very important that you and your health care providers identify the correct surgical site and procedure being done.

An IV will be started and more medication may be administered here. The operating room and anesthesia personnel who will be taking care of you during your surgery will introduce themselves. If you need intra-arterial or central venous pressure monitoring during your surgery, these lines will be placed by the anesthesia team. If nerve block or epidural pain relief is appropriate for your surgery, these procedures may be done in this area as well. These procedures will all be explained and discussed with you fully.

The Operating Room

You will be moved to the operating room and placed on the operating room bed. The bed is very narrow so that your surgeon can get close to you to do your surgery. The operating room temperature is kept very low but you will be given heated blankets to keep you warm. Every effort will be made to keep you comfortable throughout your procedure.

Activity will be going on in the room as the staff prepares equipment for your surgery. The anesthesia team will attach you to the monitoring equipment: blood pressure cuff, electrocardiogram (EKG) leads and an oxygen sensor. They will then start your anesthesia.

A CRNA or an anesthesiologist will remain with you constantly until your surgery is complete and you are transferred to the post anesthesia recovery unit. They will continuously monitor you and adjust the anesthetic to meet your needs and surgical conditions.

When Surgery Is Over

Depending on your health history, the surgical procedure and the type of anesthesia you received, you will be taken from the OR to the most appropriate recovery area -- Post Anesthesia Care Unit (PACU), Ambulatory Surgery, or Intensive Care Unit(ICU).

While you are being prepared for this transition, you may become more awake and aware of activity in the operating room. At this time, dressings will be applied and you will be transferred to a transporting bed.

In the designated recovery area, your vital signs will again be monitored and oxygen may be administered. The nurse taking care of you will make every effort to keep you comfortable.

Recovery

We want to make sure that your recovery goes as smoothly as possible. If you had day surgery, an ambulatory surgery nurse will contact you by phone the following business day to see how you are doing. If you are an inpatient, a CRNA or anesthesiologist will come to see you in the hospital.