General Anesthesia Services, Inc
PO Box 4005
Charleston, WV 25364
QUESTIONS FREQUENTLY ASKED BY OUR PATIENTS
When you here the word "anesthesia" crop up in casual conversation, you probably have a general idea of its meaning. When you are a patient preparing for surgery, a general idea may not be enough. As a patient, you should understand as much as possible about your anesthesia care. And since anesthesia plays a vital role in your surgery, the more you know about it, the better.
The following information is designed to answer some of the basic questions you may have about anesthesia.
- Q: Who will provide my anesthesia care?
A: Your anesthesia will be administered by an anesthesiologist or an anesthesia care team consisting of an anesthesiologist medically directing a Certified Registered Nurse Anesthetist (CRNA).
The Anesthesiology Team
An anesthesiologist is a physician who, after graduation from medical school, has completed three to four years of extensive training in the specialized field of anesthesiology.
Anesthesiologists administer or perform special procedures that keep you pain-free during surgery. In addition, they have a thorough understanding of any medical problems you may have. This comprehensive knowledge of your physical condition enables the anesthesiologist to work side-by-side with your primary physician and surgeon to give you appropriate medical care.
A CRNA is a registered nurse with two additional years of specialized study and clinical training in anesthetic management techniques. CRNAs are vital members of the anesthesiology team and work under the direction of the attending anesthesiologist.
- Q: What does the anesthesiology team do?
A: The answer to this question may seem obvious, but administering anesthesia is just one of many responsibilities your anesthesiology team has in taking care of you.
The Role of the Anesthesiology Team
Before your surgery, the anesthesiologist studies your medical history and current problem in detail to select the type of anesthesia and monitoring techniques best suited for your specific needs. In the operating room, the anesthesiologist both administers your anesthetic and monitors your physical condition while the surgeon is operating. Team members actually may help you breathe, using special equipment. They also give you intravenous fluids and blood transfusions, should you require these. In a very real sense, the anesthesiology team is watching over you second-by-second for the entire time you are in the operating room.
The anesthesiology team uses a number of sophisticated medical instruments to measure how your body responds to the surgery and the anesthetic. Blood pressure, breathing and body fluids are all monitored. Your heart tracing and the amount of oxygen in your blood are monitored. In some instances, the team will make direct measurements of your arterial blood pressure with a small plastic tube in your forearm. The pressure of the venous blood returning to your heart is monitored when necessary. When appropriate, the anesthesiologist informs the surgeon about these measurements and about your overall physical condition, so that every step is taken to see you through the surgery safely.
- Q: What type of anesthesia will I receive?
A: The anesthesiology team has numerous drugs and techniques to keep you free of pain during your operation. Some anesthetic agents have specific properties that make them more beneficial for particular operations and for patients with certain types of medical conditions. The final selection of an anesthetic is based on your operation, your specific needs and your medical history. General anesthesia, regional anesthesia, local anesthesia, or a combination of these techniques may be chosen.
General anesthesia puts the entire body "to sleep" for surgery. This is usually accomplished in two stages. First, you will be given a short-acting drug intravenously which will make you drift off in a pleasant, relaxed manner. Pentothal is often used for this purpose, but the team may choose to administer other drugs after considering your medical history. Regardless of the type, the effects are similar: you will fall asleep and lose awareness of what is going on around you.
Once you are asleep, the second stage of your anesthetic keeps you asleep for the duration of your surgery, however short or long. This is done in a variety of ways. You may breathe anesthetic gases (called "inhalation agents") or a combination of anesthetic drugs may be injected intravenously as often as necessary. Individual anesthetic needs vary from one patient to the next and your team has the knowledge and expertise to decide which agents will work best for you.
Regional anesthesia involves numbing a particular region of the body so that you do not feel pain during the operation. Common types of regional anesthesia are spinal anesthesia, axillary block and epidural anesthesia. When you receive regional anesthesia, you may be awake and aware, or you may receive medication that will make you drowsy or even keep you in a light sleep and unaware of the activity around you. In any case, you will not be able to feel any pain in the affected area, even though sensations of pressure may be felt. And even though you may not be fully asleep, the anesthesiology team will still monitor your condition with the same degree of attention given to general anesthesia.
Local anesthesia involves the injection of local anesthetic drugs. The surgeons themselves usually administer these drugs. If you are receiving a local anesthetic, you may remain awake and alert throughout the entire surgical procedure. If the surgeon considers that your safety requires it, an anesthesiologist will monitor your vital signs, exactly as if you were receiving regional or general anesthesia. You may also receive tranquillizers and pain relievers intravenously to help you through the procedure.
Childbirth and Anesthesia
Anesthesia is a natural concern for women giving birth. It is important to remember that the all-important goals in anesthesia for childbirth are the well being of the child and the safety and comfort of the mother. All anesthetics are administered so as to avoid depressant effects on the newborn child.
Many women having babies choose to receive pain relief for their labor and delivery. If you wish, and if your obstetrician and the anesthesiologist approve, you can remain fully awake during labor and delivery. It's best to discuss the question of anesthesia with your obstetrician and with your anesthesiologist well in advance of your delivery date.
- Q: How do I prepare for anesthesia?
A: The evening before your operation, if you are in the hospital, an anesthesiologist will visit you. The purpose of this visit is to obtain details of your medical history, so that the anesthesiologist can select the safest approach to your care. The visit also allows you to ask any questions you may have.
Your Medical History
The anesthesiologist will need to know your medical history, including any past and current medical problems. The anesthesiologist will also want to know about allergies you may have and all medications you may be taking, since these can affect your responses to the anesthetic agent. These questions are directed toward determining any medical condition that may influence your anesthetic management.
What You Can Do
There are a few things you can do to help. For your safety, you will be asked to have nothing to eat or drink in the 8 hours preceding your operation. Your cooperation is extremely important to reduce the risk of vomiting and of having food or fluid enter your lungs during anesthesia. If you are a smoker, stop smoking as soon as you are told surgery is scheduled. By doing so, you will improve your blood's ability to carry oxygen during anesthesia and surgery.
- Q: What happens on the day of surgery?
A: One or two hours before your surgery, you may receive premedication drugs. These will help you relax before the operation and will also make for smooth induction of your anesthesia.
In Your Room
Before you go to the operating room, you may be asked to remove your glasses, contact lenses, jewelry, facial makeup, and nail polish. If you use a hearing aid, check with your anesthesiologist to see if you should leave it behind or wear it to the operating suite. Your personal belongings should be in the care of a relative, a nurse, or a hospital security staff member.
You will be required to leave any dentures in your room. While this may be a bit embarrassing, it is in your best interest. While you are anesthetized, an "airway" device made of plastic, metal or rubber may be placed in your mouth to assist your breathing. Occasionally, when a patient is under anesthesia or just waking up, he or she will bite hard on the airway and damage teeth.
In the Operating Room
After you arrive in the waiting area of the operating suite a member of the anesthesiology team will meet you. An intravenous (IV) infusion will be started in an arm or hand vein and you will be taken to the operating room. Your blood pressure will be checked and electrocardiogram leads placed on your chest so that your heart activity can be monitored while you are under anesthesia. If you are to receive a general anesthetic, you will receive medication through the IV, which will induce your anesthesia.
Once you are asleep, further medications may be given to keep you free of pain for the duration of your surgery. The anesthesiologist will also monitor your bodily functions closely throughout the operation and administer fluids and blood as required.
When the operation is over, you will be transferred to the postoperative recovery room. While there you will emerge from the effects of your anesthetic under continuous observation by nurses and other personnel specifically trained to care for anesthetized patients. Pain medication may be ordered, as you require it by the surgeon or anesthesiologist. Although the length of time you spend in the recovery room is dependent on your individual needs, the anesthesiologist often will be able to provide you an estimate of this in advance.
In certain case, you may awake to find yourself not in the recovery room but in the Intensive Care Unit (ICU). You may have been informed about this by your surgeon in advance, or it may be unexpected. In either case, there is no need for alarm.
- Q: What will I feel like afterward?
A: First of all, you probably will not remember too much about your operation. The anesthetic and other drugs occasionally blunt the memory, and it may be several hours before you realize that the operation is over. If you are worried about disclosing "family secrets" or saying something embarrassing as you emerge from anesthesia, be assured that it is very rare for an awakening patient to be unaware of speaking. Even if you do, your confidentiality is completely protected.
You will be visited after your operation by an anesthesiologist. The postoperative visit lets you discuss any concerns you might have about the anesthesia you received. If you feel that you are experiencing any problems, feel free to discuss them with us during this visit, or tell your nurse that you wish to be visited by your anesthesiologist.
Possible After Effects of Anesthesia
Patients sometimes experience nausea after surgery. Typically, this is caused by the medication you receive for pain relief. With the use of new anesthetics and drugs, nausea is now the exception rather than the rule. If you are easily nauseated let your anesthesiologist know ahead of time. The anesthesiologist can give you medication to reduce its severity.
You might have a mild sore throat after surgery. This can result from several things: not having fluids the night before surgery or the airway placed in your mouth during anesthesia. Sometimes, a sore throat may also be due to a tube that was inserted into your windpipe to assist your breathing during the operation. Whatever the cause, the condition should not last long.
If an intravenous needle was inserted in your arm to give you fluids during surgery, your arm or hand will be a bit sore. The discomfort is likely to disappear as your body recovers from the operation. Any black-and-blue marks from IV needles or other needle punctures should disappear in a few days.