What type of anesthesia is right for me?

During surgery, you will be administered some form of anesthesia. The anesthetic technique used for your surgery depends on both the procedure being performed and your medical history. Your anesthesiologist will help you decide which technique is best for you.

Below are three major types of anesthesia:

General Anesthesia – This causes you to be unconscious for the entire procedure. You will be completely unaware and will feel no pain during the surgery. The medication is given into a vein (intravenously) or inhaled. A breathing tube may be inserted into the windpipe to maintain proper breathing during surgery.Regional Anesthesia – This involves injecting a local anesthetic (numbing medication) around major nerves or the spinal cord to block pain signals. You are usually also given sedative medication into a vein for relaxation.

There are two types of Regional Anesthesia: Spinal or epidural anesthesia – The numbing medication is injected around the spinal cord and blocks pain signals from the entire region of the body. This is often used for leg, lower abdominal, gynecological and rectal procedures.Peripheral nerve blocks – The numbing medication is injected near major nerve groups to specific areas, i.e., the arm, hand or leg. This blocks the pain signals from that area.Local Anesthesia – The numbing medication is injected directly into the surgical site to temporarily block pain sensations from a particular area. A sedative medication may be administered for relaxation.

What should I tell my child about anesthesia?

If your child needs elective surgery, it’s important to educate yourself as much as possible. Any hospital visit can be an anxious time for a parent and child. The more information that you, as a parent, gather, the calmer you will be and the better you will be able to comfort your child.

Here are some tips: Educate yourself about both the procedure and the anesthesia required. Ask questions of both the surgeon and the anesthesiologist. Provide age-appropriate information to your child. Children tolerate surgery better when they are well prepared. Explain to your child what to expect throughout the entire process. Reassure your child that everything will be explained beforehand. Stay calm. Your composure is essential. Nothing calms a child as much as a calm confident parent.

Will I remember anything during anesthesia?

Recall or awareness under general anesthesia, also known as intra-operative awareness, occurs when a patient regains consciousness and becomes aware of certain events that occur during surgery. While new brain wave monitors may prove helpful in reducing the risk of awareness, none of these technologies are currently perfected.

Approximately 0.1 to 0.2 percent of adult patients undergoing general anesthesia report awareness. There are a number of causes for this. The most common cause is the use of light anesthesia, as is common for emergency trauma surgery or high-risk surgery where a deep level of anesthesia would not be tolerated by the patient.

Because awareness under general anesthesia is extremely rare, it should not be viewed as a reason to avoid surgery. In the unlikely event of intra-operative awareness, discuss this with your anesthesiologist as soon as possible after the procedure.

How can I reduce my risk of adverse events from anesthesia?

Here are some ways you can reduce your risk:

Eating and Drinking Before Anesthesia
As a general rule, you should not eat or drink anything after midnight before surgery. Discuss this subject with your anesthesiologist because you may be allowed to consume clear liquids on a more liberal time schedule.

Medications (Prescription & Over the Counter)
It is important to tell your anesthesiologist about all prescription and over-the-counter medications that you are taking. Some medications should be taken and others should not.

Anesthesiologists are finding that certain herbal medications may prolong the effects of anesthesia. Others medications increase the risk of bleeding or raise blood pressure. That is why you should discuss medications with your anesthesiologist.
Anti-Coagulants or Blood Thinners

Before your procedure, it is also vital to mention any blood thinners you are taking with your surgeon and anesthesiologist. These trained physicians will decide whether you should continue taking blood thinners or stop using them based on the risk/benefit.

Obstructive Sleep Apnea
Obstructive Sleep Apnea (OSA) is the condition where a person stops breathing during sleep because their airways become obstructed. The usual cause is soft tissue in the back of the throat that blocks the breathing passage.

The condition affects 18 million Americans and is most common in overweight males over age 40. However, it can affect anyone in any age group.

You May Have Sleep Apnea If:
You are frequently tired by waking in the morning and throughout the day You have been told that you snore or stop breathing during sleep You have been told that you make snorting noise during sleep You wake frequently during the night If you feel that you may have sleep apnea, talk to your primary care physician. Sleep apnea can be treated in a variety of ways. If left untreated, it can cause high blood pressure, cardiac disease, thinking problems and even sudden death.

It is recommended that you stop smoking before surgery and for at least one week after surgery.
Smokers have an increased risk of complications during and after surgery, including delayed wound healing and pneumonia. In addition, smokers are at an increased risk for cardiac complications. By stopping before surgery, you can decrease those risks. It is especially important not to smoke on the day of surgery.

There are benefits to using your surgical procedure as the starting point to quit smoking. There is evidence that smokers who quit before surgery experience fewer symptoms of nicotine withdraw and are more likely to be successful in their attempt to stop completely.

What about pain after surgery?

Here is some useful things to think about before and after surgery:

Before Surgery

Ask Your Doctor What to Expect
Will there be much pain after surgeryWhere will it occurHow long is it likely to lastBeing prepared helps put you in controlDiscuss Pain Control Options with Your Doctor

Talk with your doctor about pain control methods that are availableDiscuss any concerns you may have about pain medicineAsk about side effects that may occur with treatmentTalk About the Schedule for Pain Medicines in the Hospital
Pain medications may be given only when you ask for them or they may be given on a set time schedule. Sometimes there are delays, and the pain gets worse while waiting for the medication.

Your doctor may also order the pain medication to be delivered by a Patient Controlled Analgesia pump (PCA). With PCA, you control when you get the medication. When you begin to feel pain, you press a button to inject the medicine through the intravenous (IV) tube in your vein.

After Surgery

Take (Or Ask For) Pain Medication When Pain First Begins
Take action as soon as the pain startsIf you know your pain will worsen when you start walking or doing breathing exercises, take pain medicine first. It’s harder to ease pain once it has taken hold. This is a key step in proper pain control.Tell the Doctor or Nurse About Any Pain That Won’t Go Away

Don’t worry about being a “bother.” Pain can be a sign of problems with your operation; the nurses and doctors want and need to know about it.

Stick with your pain control plan if it’s working. Your doctors and nurses can change the plan if your pain is not under control. You need to tell the nurses and doctors about your pain and how the pain control plan is working.

How are anesthesiologists paid?

You will usually receive a bill for the anesthesia services from the anesthesiologist. You may also receive a bill from the hospital for the technology and supplies that they provide. Most anesthesiologists will file your insurance claim as a courtesy to you. As with other physician services, you are responsible for any deductibles or co-pays.