Your Anesthesia Care

Anesthesia is a Major Part of Your Surgery

Before, during and immediately after your operation, you will receive comprehensive anesthetic care to assure your utmost safety and comfort throughout the surgical experience. The Department of Anesthesiology utilizes an anesthesia care team approach which includes anesthesiologists (MDs) and certified registered nurse anesthetists (CRNAs) working together in a collaborative fashion under the guidance of the anesthesiologist. We consider ourselves your “guardian angels” during surgery.

Your anesthesia care is designed to minimize pain and anxiety and to maintain all your vital functions in a smooth and stable fashion. The specific anesthetic technique selected is individualized to your needs and is based upon many factors which include your medical history, your physical condition, the nature and extent of your surgery and, whenever possible, your personal preferences.

Different Types of Anesthetics

There are three major classes of anesthetics and each (or a combination) may be appropriate for different situations:

General Anesthesia

Drugs are administered intravenously or by inhalation to render you unconscious and cause your entire body to be insensible to pain during surgery. Common after-effects may include grogginess, nausea, and slight soreness in the throat.

Regional Anesthesia

This approach numbs a major portion of your body using local anesthetic agents. Examples include spinal anesthesia and epidural anesthesia, which cause numbness in the lower portions of the body. Other examples include axillary block or intravenous regional techniques which produce numbness of the arm and hand.

Local Anesthesia

Injection of local anesthetic drugs directly into the surgical area may suffice for minor procedures. While the surgeon will usually inject the surgical area with local anesthetic, the anesthesiologist or nurse anesthetist will provide any necessary sedation or other additional medications to assure that you are comfortable and as stable as possible. Please note that intravenous sedative drugs are commonly used in conjunction with regional anesthesia and local anesthesia in order to help you relax or promote a light sleep during surgery.

The Preoperative Consultation

The preoperative consultation is a key part of the anesthetic and surgical process.

Depending on your age, medical status, and type of surgery, you will have either an office visit or a telephone appointment with a physician or a physician’s assistant from our department’s Perioperative Medicine (POM) Clinic .  These clinicians are our “eyes and ears” and will gather key information, consult us if any potential issues related to anesthesia are discovered, and help us to make sure that all your medical problems are as well-treated as possible.

On or before your day of surgery, we will review all of the information that has been gathered, examine you as necessary, and discuss anesthetics options, including associated benefits and risks.  We will answer any questions and address any concerns you may have about undergoing anesthesia. We will also prescribe appropriate preoperative medication, which the nurses will administer prior to anesthesia.

Eating or Drinking Before Surgery

You will be asked not to eat or drink for a period of time before your surgery. This is designed to prevent any problem related to regurgitation or passive reflux of stomach contents during the surgical period.

You will receive specific instructions on preoperative fasting prior to your surgery, which will be based on current recommendations of the American Society of Anesthesiologists .

With few exceptions, you will normally be asked to take usual morning medication with a few sips of water.  Note: Do not take diabetes medications (including pills or insulin) on the day of surgery. Do not take non-steroidal anti-inflammatory drugs such as Motrin starting on the day before surgery. Medications with blood-thinning effects (such as aspirin or coumadin) may need to be stopped several days before surgery. Please ask your surgeon if and when to stop blood thinners. 

During Your Surgery

The primary anesthetist who will be with you throughout your entire anesthetic in the operating room may be either an anesthesiologist or a nurse anesthetist working under the direction of an anesthesiologist. During your operation, your vital functions will be closely monitored and medications and fluids will be administered as necessary. Since every individual is unique and responds differently to anesthesia and surgery, no two anesthetics are exactly alike.

After Your Surgery

In the post-anesthesia care unit, (PACU or recovery room), an anesthesiologist will direct your medical care until you are discharged. A skilled and attentive recovery room nurse will be by your side and care for you as needed.  Your recovery from anesthesia will be affected by the nature, extent, and duration of your surgery, as well as the type of anesthesia that you have had. Patients going home on the same day of surgery must meet established criteria before being discharged.

Because very small concentrations of anesthetic and sedative agents may persist in your body for up to 24 hours, it is important not to drive, operate dangerous machinery, or make major decisions for approximately 24 hours after your anesthetic.