What is Anesthesia?

Anesthesia consists of the administration of a drug or drugs to render the body or part of the body incapable of sensing a painful stimulus. This can be achieved by a variety of methods, and the method chosen is often dictated by the surgical procedure as well as the patient's medical history and wishes.

How risky is Anesthesia?

Due to advances in patient safety, the risks of anesthesia are very low. Over the past 25 years anesthesia-related deaths have decreased to one death per 200,000 to 300,000 anesthetics administered. Certain types of illnesses, such as heart disease, high blood pressure and obesity, can increase your anesthesia risks. Even so, anesthesiologists routinely bring even very sick patients through major operations safely.

Why can’t I eat and drink before anesthesia?

While under anesthesia, you lose your protective reflexes and it is possible to vomit under anesthesia and aspirate gastric contents into your lungs. You may be asked to take some or all of your usual medications with a few sips of water before surgery – these are usually dissolved and out of your stomach by the time anesthesia starts.

What kind of anesthesia will I have?

The kind of anesthetics possible for surgery are:

1. General Anesthesia (completely unconscious)
2. Regional Anesthesia (a region of your body is numbed by the use of a spinal, epidural or other type of injection)
3. Local Anesthesia (a numbing medicine is injected around the area of surgery.)

The type of anesthesia you receive will depend on the type of surgery, your medical condition, your surgeon’s preferences, and your wishes. Your anesthesiologist will discuss available options with you and make a suggestion for the type(s) of anesthetic. If you have any questions or concerns, please feel free to discuss the anesthetic with your anesthesiologist.

What is General Anesthesia?

General anesthesia typically starts with the IV injection of a medication that causes rapid loss of consciousness. Anesthesia is maintained through a combination of IV medications and anesthetic gases to keep you unconscious during surgery. Typically, after losing consciousness, a breathing tube will be inserted through your mouth into the back of your throat or into your trachea. Some of the more common side effects from general anesthesia are drowsiness, nausea, sore throat, and headache.

What is Regional Anesthesia?

Regional anesthesia is a technique to render a portion (or region) of a patient’s body insensate to pain for a surgical procedure, as well as provide pain relief after surgery. Regional anesthesia is divided into two main categories: Neuraxial anesthesia (spinal and epidural anesthesia) and peripheral nerve blocks.

What is Spinal Anesthesia?

Spinal anesthesia involves injecting a small amount of local anesthetic in the low back. This produces complete numbness of the body below a certain level (typically from the navel down). This technique can be used for many types of surgeries such as urological, vascular, and orthopedic procedures, but is typically not preferred for outpatient surgery.

What is a Peripheral Nerve Block?

Peripheral nerve blocks allow an entire extremity to be partially or completely numb for several hours. These techniques are often used in the setting of arm, shoulder, or knee surgery. Sometimes peripheral nerve blocks are used in the operating room as the primary anesthetic (in conjunction with intravenous sedation), but they are more commonly performed to provide many hours of post-operative pain relief.

What is Monitored Anesthesia Care ("MAC")?

Monitored Anesthesia Care or "MAC" is performed for minor surgical procedures such as removal of a skin lesion or minor orthopedics such as hand or finger surgery. In these instances a local anesthetic is injected into the surgical site to produce numbness. Patients will typically receive intravenous sedatives to produce a calm and sedate mental state. The combination of sedative agents not only provides the patient with a feeling of calm and well-being, but also provides a certain degree of amnesia for the intra-operative events. One advantage of MAC is that recovery from anesthesia is often fairly quick with minimal side effects.

How do I prepare for anesthesia?

Patients will be screened pre-operatively by a nurse from TOPS. If there are any concerns regarding your medical history, further information may be obtained from your primary care physician or other specailty physicians. If further information is requred, a visit with an anesthesiologist may be scheduled prior to the day of surgery. It is critical to collect as much data as possible about your medical history and to ensure that you are as medically fit as possible prior to your anesthetic.

Also, you will be given instructions as to when to cease eating and drinking prior to surgery and which medications you should take both the night before and the morning of your surgery. Typically, heart and blood pressure medications are allowed, and diabetes medications (including both insulin and oral anti-hyperglycemics) are to be held.