FREQUENTLY ASKED QUESTIONS
Basics of Anesthesia
Preparing for Anesthesia
BASICS OF ANESTHESIA
What is an anesthesiologist?
An anesthesiologist is a physician who specializes in providing anesthesia care during surgery. An anesthesiologist has completed medical school and received an MD, followed by four years of residency training in anesthesiology.
All of our anesthesiologists are active members of the American Society of Anesthesiologists and are either board certified or board eligible through the American Board of Anesthesiology.
In addition, several of our anesthesiologists have trained additional years and completed subspecialty fellowships in pain management, cardiac, regional, obstetrical, and neurosurgical anesthesia.
Anesthesia care has three components:
PREOPERATIVE: medical evaluation before surgery and consultation with your surgeon
INTRAOPERATIVE: administration of anesthesia and maintenance of your safety in the operating room
RECOVERY: management of your recovery room care after surgery
What are the different types of anesthesia?
“Anesthesia” means “reversible lack of awareness” which can be complete (a GENERAL anesthetic) or PART of the body as in a SPINAL or EPIDURAL anesthetic.
Each type of anesthesia serves a different purpose.
In LOCAL anesthesia, the surgeon injects an anesthetic drug into the tissue, which numbs a specific area. This type is suitable for minor surgery such as excision of a mole or dental surgery. The patient may be awake or sedated.
In REGIONAL anesthesia, a part of the body is numbed, such as an arm or the lower part of the body. There are several kinds of REGIONAL anesthesia. Two of the more common types are SPINAL and EPIDURAL anesthesia. They can be used for surgery of the lower abdomen and lower extremities such as a hysterectomy or a hip replacement. In addition, regional anesthesia is frequently used for labor and delivery as well as cesarean section. As with local anesthesia, the patient may be awake or sedated. The numbness wears off after the surgery.
In GENERAL anesthesia, the whole body “goes to sleep”, becomes unconscious, and has no awareness. During surgery the anesthesiologist carefully monitors, manages and maintains your body functions using state of the art equipment. A breathing tube may be inserted during surgery. The length and depth level of anesthesia is calculated and adjusted precisely.
At the end of all surgeries the anesthesiologist coordinates the emergence from anesthesia and accompanies the patient to the recovery unit.
What are the risks?
All medical procedures have a small risk of adverse reactions; however, advances in anesthesia technology have made adverse events rare.
What can you, as a patient, do to reduce the risks?
Give an accurate and thorough medical history about your health conditions
Review all medications with your doctors and follow the instructions regarding when to stop certain medications prior to surgery, especially herbal and homeopathic supplements
Follow fasting guidelines
Ask questions so all your concerns have been addressed by both the surgeon and anesthesiologist
When surfing the internet, use reputable and reliable sources OR click on the links included on this page.
PREPARING FOR SURGERY & ANESTHESIA
What are the diet restrictions before my anesthesia?
Fasting before surgery is a very important safety action to reduce the risks of vomiting and aspirating stomach content into your lungs during surgery.
The current recommendation is to stop eating and drinking after 11 p.m. the night before surgery. This includes no water, coffee or juice. If you know the time of your surgery, you may eat and drink up until eight hours prior to surgery. Small sips of water may be taken to swallow medications. You may brush your teeth but not drink the water. Gum and candies are considered food and should be avoided.
Under certain circumstances (surgery in the afternoon), your anesthesiologist may allow you to drink CLEAR liquids up to four hours before surgery. Elective surgery may be cancelled if fasting instructions are not followed.
Suggestion: If you are unclear about when to fast, call your surgeon or Click on this link for answers to common questions.
Can I take my usual medications?
It is extremely important that your surgeon and your anesthesiologist have a current and complete list of all your medications including over the counter medications, herbals and dietary supplements.
Together and in consultation with your primary doctor, they will determine which ones you can safely take at the time of surgery. Do not interrupt medications unless you are instructed otherwise.
Suggestion: Keep, update and review a list of your prescriptions and itemize important medical information well ahead of your surgery time.
Do dietary supplements and herbal medicines affect my anesthesia during surgery?
Vitamins, dietary supplements, and herbal medicines can interact with certain anesthetics. For instance, some supplements and herbs prolong the effects of anesthesia, increase risk of bleeding or raise blood pressure.
To help prevent and avoid these problems during surgery, provide your surgeon and anesthesiologist a complete list before surgery. Some common examples are echinacea, garlic, ginger, ginseng, ginkgo biloba, and St. John’s wort. The more we know, the better we can individualize and optimize your care.
THE DAY OF SURGERY
THE PRE-OPERATIVE PERIOD
Part One: Trip to the Hospital or Surgery Center
Try to be calm and relaxed. Breathe deeply and think positively. If possible, bring a supportive relative or friend. We also support meditation and healing tapes.
Part Two: Checking in
In the admitting area you will complete your paperwork. Then you will be guided to the preoperative area. The preoperative nurse will have you change into a hospital gown, record your vital signs, briefly review your medical records, and go over postoperative instructions. The nurse will also start your intravenous catheter (IV), using an anesthetic to decrease the discomfort associated with an IV start.
Part Three: Preoperative Anesthesia Interview
Your anesthesiologist will:
Review your medical and surgical history (including previous anesthesia)
Perform a focused physical examination
Discuss any medical conditions which may require attention during surgery
Order additional lab tests if indicated
Explain the anesthetic plan, alternatives and risks
Address your anesthetic questions and concerns
Start your IV if not done yet
Give you an oral or IV sedative to help you relax
THE INTRA-OPERATIVE PERIOD
The anesthesiologist will administer the anesthetic.
The anesthesiologist will:
Assist in keeping you comfortable (use a warming blanket) and safe (check and pad all your pressure points)
Manage and maintain vital signs and functions
Coordinate and optimize your anesthetic for your type of surgery
Waking Up or Emerging from Anesthesia
As you awaken from general anesthesia or sedation, you will gradually become more aware of your surroundings. Initially you will feel drowsy, but with time you will become fully aware. Initial recovery takes place in the post anesthesia care unit that is supervised by the anesthesia department. Specially trained nurses will closely monitor your vital signs, report your condition to the doctors and manage your care under the doctors’ supervision. The anesthesiologist will visit to evaluate the progress of your recovery.
Will I have pain or nausea when I wake up?
We utilize all modalities and medications to prevent and minimize pain and nausea even before you wake up. In the event you have any discomfort or nausea, the nurse will give medications already ordered for you.
Will I have a sore throat?
A sore throat after general anesthesia is not uncommon if a breathing tube was used. It should resolve within a day or two. If the sore throat persists or worsens, please contact our office or your surgeon for advice.
How can you soothe your child?
Helping a child through surgery and anesthesia can be stressful for parents. The more you know, the better and less stressed you will feel. We encouraged you to ask questions and have all your concerns addressed.
Suggestion: Children usually absorb and follow their parents’ emotional state and level of anxiety. By projecting calmness and optimism, your child will feel the same.
Suggestion: Bring along a comforting soft toy or favorite item such as a blanket.
How will my child go to the operating room?
In the preoperative waiting area, your child may get an oral sedative. Depending on the child’s age and tolerance, an intravenous catheter may be inserted. When your child is drowsy and relaxed, the team will gently take him or her to the warmed operating room. Without an IV (usually ages less than five), the child goes to sleep by breathing a mixture of oxygen and anesthesia through a mask. If an IV is present, the child goes to sleep by injection of medications through the IV.
What are the options for pain management during labor and delivery?
Labor is a personal and individual experience for expecting mothers. Even in the same woman, each pregnancy has a unique and different labor pattern. Many factors such as genetics and culture can influence how a person tolerates and copes with labor pain.
At Saint John’s Health Center, we encourage and support all options of pain management for labor including hypnotherapy and the Bradley method. In addition, the anesthesiologist will consult with you, your obstetrician, and your nurse as to whether labor epidural anesthesia is appropriate for you.
What is epidural anesthesia?
In epidural anesthesia, a small flexible catheter is inserted at the level of your lower back into an area called the epidural space. The epidural catheter works much like an intravenous catheter. The anesthesiologist will either inject medications and/or start a drip depending on your needs. An initial injection typically takes 10-20 minutes for the full effect to take place (numbness from the level of the belly button down to the legs and feet). This is followed by a drip (combination of local anesthetic and dilute narcotic) to maintain the level of pain relief and numbness. Common side effects are itching, drowsiness and temporary weakness of the legs.
What if I need a cesarean section?
Usually an epidural or spinal anesthetic is used for a cesarean section. The anesthesiologist will assist you in preparing mentally and physically for a cesarean delivery. Occasionally general anesthesia is required.
What is a spinal headache?
Spinal headaches happen rarely after placement of a spinal or epidural anesthetic. If a spinal headache occurs, the headache is readily treated with several effective treatment options and frequently resolves without treatment. If a headache occurs, the patient should notify the nurse who will call the anesthesiologist. The anesthesiologist will evaluate the patient and initiate a treatment plan.