Patients

Types of Anesthesia

 

General Anesthesia

Regional Anesthesia

Monitored Anesthesia Care (Sedation)

General Anesthesia

General anesthesia is usually given through an IV to get a patient to sleep. Once a patient is asleep, anesthesia is usually given through a mask or breathing tube. During general anesthesia, a patient is completely unconscious so that they will not feel, see, or hear anything. 

Regional Anesthesia

Regional anesthesia involves an injection of local anesthesia (like Lidocaine or its cousins) in specific regions of nerves to make a certain part of the body numb for surgery. 

There are three types of regional anesthesia:

Epidurals involve placing local anesthesia in a patient’s back through a small tube or catheter. This stays in place to continuously numb their chest and/or abdomen and legs depending on where it is placed.

Spinals involve placing local anesthesia into the spinal sac where a person’s spinal fluid lives. There is only a single shot with no needles or tubes left behind. Spinals set up quickly and last for several hours. They are commonly used for C-sections and total joint replacements.

Nerve blocks are used to provide post-operative pain relief by selectively injecting local anesthesia to certain nerves. These blocks can last from 12-24 hours depending on the medication used, type of nerve block, and a person’s physical condition.

Each nerve block has its own particular risks. The most common risk is the block not working as well as can be hoped, usually because the medication did not spread as desired, either due to needle placement or a patient’s particular anatomy. Serious problems like numbness or paralysis lasting up to several months is very rare but can happen. The most rare complications includes infection, seizures, or heart collapse.

Monitored Anesthesia Care (Sedation)

With this method, a patient receives pain and sedative medications through the IV. The surgeon also often injects local anesthesia which helps reduce pain during and after the procedure. This type of anesthesia is commonly used for endoscopies, colonoscopies, cataracts, and podiatry, among others.

Pre- and Post-Surgery Procedures

Before Surgery

Someone from our pre-testing clinic will call you and ask you some questions. If there are specific concerns regarding your medical history or you are scheduled to stay in the hospital, you will likely also be seen for a pre-op appointment. This is done to help identify and assess any medical conditions in order to minimize the risk of your surgery and reduce any potential delays on the day of surgery.

Follow pre-operative fasting and medication instructions.

Stop smoking. Even taking a break for a week before the procedure can make a difference.

Have a recovery plan in place, including a responsible adult to take you home.

Resources:

Rest assured, fasting is not meant to be cruel. Although it is likely uncomfortable, it is a medically important precaution.

Normally people sense food, liquid, or acid coming up from the stomach and then cough or swallow it back down. Anesthesia may dull these natural protective reflexes which could allow those contents to get into your lungs. This is called aspiration, and it can lead to lung inflammation, infection, and a prolonged hospital stay. 

While most medications are compatible with anesthesia, there are some important exceptions. 

It is important to discuss these at your pre-operative appointment or with your surgeon or specialty doctors (i.e. cardiologist). Your anesthesiologist will also be able to help you with those questions.

You will meet your anesthesiologist and possibly a nurse anesthetist working with them. You will also see your surgeon and anyone else who may be involved in your care, such as the operating room nurse, physician assistant, resident, or medical student.

The anesthesiologist will verify who you are, the procedure being done, and make sure any medical issues have been identified and assessed in order to minimize the risk of undergoing a procedure. This includes asking about your medical history, current medical conditions and medications, recent changes in your health, and family medical history. Then, we will talk you through a personalized anesthesia care plan and provide an opportunity for you to ask questions.

After Surgery

Your anesthesiologist or CRNA will take you to the Post-Anesthesia Care Unit (recovery room). They will provide a detailed report to the recovery room nurse and you will be monitored and cared for while you wake up. The nurse taking care of you will notify your family members when/if they may join you in the recovery area.

Drowsiness should be expected the day of your surgery, and it is advised that a responsible adult drive you home and then stay with you overnight. Detailed instructions specific to your procedure will be printed out and reviewed with you and the person taking you home before being discharged. If you are staying in the hospital overnight, your surgical team will be available to answer specific questions about your continuing care when you are more awake.

Some of the more general instructions include avoiding the following: driving a car, operating machinery, drinking alcoholic beverages, or taking non-prescription medication without your doctor’s permission for at least 24 hours after surgery because normal coordination and various reflexes may be impaired.

Your anesthesiologist will write orders for the nurse in the recovery room. Once you are more awake and ready to go home or to your room, the surgical team will take care of all your medications. If you have specific concerns about pain medication going home, be sure to discuss this with your surgeon.

Nausea is one of the most common side effects from anesthesia and from any pain medicine you receive after surgery. We evaluate the risk of post-operative nausea and vomiting in every patient and routinely give two or more medications to help prevent this. Some procedures, medical conditions, and types of anesthesia make nausea more or less common depending on those factors.

FAQs

Yes. Your anesthesiologist and/or nurse anesthetist will be there the entire time. We act as your medical advocate while you are having your procedure. In addition to delivering anesthesia, we will closely monitor, evaluate, and regulate your vital signs during the procedure.

It is hard to know the exact circumstances surrounding that event but awareness under general anesthesia is typically very rare. Since the phenomenon happens so infrequently, the causes are difficult for researchers to study. But we are happy to discuss any concerns you have with you. If you had a procedure with sedation (cataract, colonoscopy) or local anesthesia only, this could be actually be expected. 

There are a variety of potential risks that depend on your medical conditions and the type of procedure and type of anesthesia you will have. The most common side effects include nausea, sore throat, fatigue, and lip injury. Much more rare events might include injury to teeth/vocal cords, allergic reactions, abrasion or the eye or loss of sight, heart attack, stroke or death.

An anesthesiologist is a physician who has chosen anesthesiology as their specialty, in a similar way as your internist, pediatrician, or surgeon chose their specialty. Your anesthesiologist is Board Certified or Board Eligible in anesthesia. This means that we are doctors who have completed four years of college, four years of medical school, and up to six years of residency and fellowship training after medical school.

Anesthesiologists practice one of the most complex medical specialties. This means that our physicians have a wide breadth of medical knowledge of surgical procedures, drugs and how they act with the body, and the physiological changes that might take place during a procedure.

CRNAs are advanced practice registered nurses with specialized graduate-level education. Also called a nurse anesthetist, a CRNA works under the direction of an anesthesiologist. Together they make up a patient’s anesthesia care team.