Facts About Anesthesia and You

The word anesthesia means no sensation or feeling. Too obtain this freedom from feeling pain, drugs are used. Your Anesthesiologist's selection of an anesthetic agent for you is based on the type of surgery you are having, your particular medical condition, and your personal preferences.

Anesthesiologists

Doctors of Medicine who specialize in Anesthesiology (devoting their entire time practicing the science and art of anesthesia) provide your anesthesia. These physicians have taken several years of special training in anesthesiology after graduation from medical school. Anesthesiologists may also practice medicine in areas other than in the operating room. They may specialize in treating acute or chronic pain problems, or work as specialists in intensive care.

Anesthesia Care Team

Anesthesia care is administered and directed by the Anesthesiologists of the Anesthesia Care Team. The Anesthesia Care Team consists of an Anesthesiologist and a Certified Registered Nurse Anesthesiologist and a Certified Registered Nurse Anesthetist (CRNA). A CRNA is an advanced Nurse Practitioner who in addition to having a nursing degree, has received specialized training in anesthesia. The Anesthesiologist personally directs the CRNA in the administration of your anesthetic and the monitoring of your vital functions. The CRNA is present for the duration of your anesthetic.

Pre-Operative Visit

Prior to your surgery, an Anesthesiologist will obtain a brief medical history and if indicated a brief physical exam to evaluate your overall health condition. It is very important to bring a list of all medications that you are taking. You should also volunteer information regarding your personal habits including drinking, smoking, or the use of any drugs, including all non-prescribed drugs, because these affect your response to anesthesia.

At the end of your pre-operative visit your Anesthesiologist will suggest the best anesthetic for you depending on your surgery, medical condition, and personal preference. You will be advised of special medical requirements during surgery (i.e. treatment of hypertension, diabetes, etc.) and of special post-operative care plans such as respiratory care and acute pain management.

NOTE: While under general anesthesia there are special tubes and plastic airways which are used to help you breathe. When awakening from anesthesia, you may bite down on these airways. If your teeth are weak, diseased, or loose, there is a definite possibility they may be damaged. Please discuss any such problems with your Anesthesiologist during the pre-operative visit. Capped teeth, bridges, and other dental devices can also be damaged in this way. Such a problem may be unavoidable. We cannot accept responsibility for this.

Types of Anesthesia

There are essentially three types of anesthesia: general, regional, and local anesthesia with monitoring.

1) GENERAL ANESTHESIA: During general anesthesia you are completely asleep. This is achieved by using various intravenous and inhaled drugs.
2) REGIONAL ANESTHESIA: During this type of anesthesia, you remain awake and comfortably sedated while only a portion of your body is made numb. Techniques such as epidurals, spinals, or specific peripheral nerve blocks are examples of regional anesthesia.
3) LOCAL ANESTHESIA WITH MONITORING: While your surgeon injects a specific part of the body (such as an eyelid or finger, etc.) with local anesthesia, your Anesthesiologist monitors your vital signs (heart, lungs, etc.) and maintains you comfortably sedated with intravenous drugs. This is also called Monitored Anesthesia Care (MAC). If the need arises, the Anesthesiologist is prepared to administer other types of anesthesia.

Prior to any anesthetic, an intravenous tube is placed in a vein in your arm to give fluids and drugs during the surgery. While under any type of anesthesia, the function of your heart, lungs, and nervous system will be continuously monitored with the help of various instruments. These will provide a minute to minute assessment of your physiological status and thus help provide for a very safe anesthetic.

Instructions Prior To Surgery

1) Do not eat or during anything after midnight the evening before surgery. You should not swallow any fluid (including water) on the morning of the surgery unless otherwise instructed by you Anesthesiologist. Eating and drinking just before anesthesia increases the danger of regurgitation and aspiration of stomach contents into your lungs. However, you may be instructed to take some of your routine medicines (heart pills, blood pressure pills, etc.) with a sip of water the morning of surgery. You may brush your teeth or gargle the morning of surgery.
2) Give removable dentures to the nurse unless your Anesthesiologist permits you to retain them.
3) Leave all jewelry and other valuables at home.
4) Minimal facial cosmetics may be worn.

In-Patient Surgery

For in-patient surgery you may also expect to be in the recovery room for at least one hour and possibly longer. After this recovery period, you will be discharged to your room. Expect to be sedated for several hours afterwards.

Out-Patient Surgery

If you are having out-patient surgery expect to be in the recovery room area for at least one to two hours after your surgery is completed. This allows sufficient time for the anesthetic agents to wear off so that you may be safely discharged from the hospital. You should not be involved in activities requiring a high level of coordination or thinking, such as driving, using dangerous machinery, signing legal documents, or making important decisions, for a minimum of 24 hours after you are discharged from the hospital.

Acute Pain Service

One of the services which may be provided by your Anesthesiologist is post-operative analgesia. Analgesia means pain relief. Several methods can be used by your Anesthesiologist to control acute post-operative pain. Two common methods available for pain relief after surgery are the use of epidural narcotics, and a patient controlled analgesia device (PCA). Ask your Anesthesiologist what is appropriate for you.

Critical Care

Your Anesthesiologist may also be involved in critical care medicine. This is an area of medicine that involves the treatment and care of critically ill patients. The Anesthesiologist's training in monitoring and in managing breathing and heart problems is important in the care of patients who are very ill.

Whatever your medical and surgical problems may be, your Anesthesiologist and his colleagues will make your day in surgery as safe and pleasant as possible. Please feel free to ask questions about your care.

Anesthesiology Fees

Anesthesiology care is a professional medical service which is separate from hospital services. You will receive a bill from your Anesthesiologist for providing your medical care during your surgical experience. The hospital may bill you as well for anesthesia equipment and supplies.