Understanding Anesthesia
Anesthesiologists are dedicated to relieving pain and caring for patients before, during, and after surgery. There are three main types of anesthesia used during surgery.
General Anesthesia
Under general anesthesia, you are unconscious and have no awareness or sensation. Usually, intravenous (IV) medications are given to initiate this state. A breathing tube may be placed to protect your lungs and help breathe for you while you are asleep. There are a number of anesthetic medications that are given through an IV or through a breathing tube that keep you asleep, comfortable and provide for pain control when you awaken. Sometimes a general anesthetic is combined with regional anesthesia to provide optimal pain control.
Regional Anesthesia
A regional anesthetic is when your physician anesthesiologist places local anesthesia around a group of nerves. This medication causes numbness at the surgical site. Sedatives or a general anesthetic are often given through your IV to ensure your comfort while you are in the operating room. There are 3 main types of regional anesthesia:
Spinal
A spinal is a type of anesthetic where a very small, delicate needle is inserted into your back and into the fluid around your spinal nerves. A single dose of numbing medication is injected, causing numbness of your lower abdomen and lower extremities for a short duration of time. A spinal anesthetic is most often used for operations in the lower abdomen and lower extremities.
Epidural
An epidural is a type of anesthetic where, a tiny, flexible and hollow plastic tube is placed into the back where the nerves exit the spine sheath. A continuous infusion of numbing medication is then used to provide pain control. For major surgeries of the chest, abdomen, and lower extremities, the epidural catheter may be left in place for several days to provide pain relief. Our Acute Pain Service sees you everyday when you are in the hospital with a pain catheter.
Peripheral Nerve Blocks
Peripheral Nerve Blocks allow us to numb an extremity. Either a single dose of numbing medication, or a continuous catheter is used to provide pain relief. Peripheral nerve blocks are often combined with general anesthesia or IV sedation to provide for your comfort in the operating room.
Monitored Anesthesia Care (MAC)
In this type of anesthesia, sedation is given in your IV while your surgeon injects numbing medication into the surgical area. Since various degrees of IV sedation can be provided, you and your anesthesiologist can plan for the level of sedation you desire. Infrequently, a MAC does not provide optimal conditions for the surgical procedure. At these times a general anesthetic is usually the back-up plan.
Frequently Asked Questions
It's completely normal to have questions before a procedure, especially about anesthesia. We've answered some of the most common questions our patients ask, so you can feel informed and at ease going into your appointment.
What are the risks of having anesthesia?
Improved monitoring and better medications have greatly improved the safety of anesthesia. Every medical procedure has some risk. The risk of anesthesia depends on many factors, including what type of surgery and your health. Fortunately, adverse events are rare. Since the risk varies depending on your type of surgery and your medical condition, your anesthesiologist can best answer this question.
Who is in charge of my anesthesia?
Your NAP anesthesiologist is a physician who is board certified (or board eligible) by the American Board of Anesthesiology. Our physicians have completed four years of medical school, then an additional year of internship, followed by three more years of intense training in anesthesia. Many of our NAP anesthesiologist have completed an additional year of specialty training. Your anesthesia maybe supervised by an anesthesiologist and performed by a Certified Registered Nurse Anesthetists (CRNA).
Is there a possibility I could “wake up” during anesthesia?
The possibility of being awake and aware during surgery is exceedingly uncommon. It may happen under special circumstances such as emergency surgery if a patient is in shock, meaning their body is not able to tolerate the anesthetic. With different types of anesthesia, for example Monitored Anesthesia Care, you may be awake or sleepy during all or parts of the procedure.
What are the side effects of anesthesia?
Anesthetics affect everyone differently. The more common side effects include:
- Nausea-it affects about one third of people undergoing general anesthesia. If nausea has been a problem with past anesthetic experiences, let your anesthesiologist know. There are ways to tailor the anesthetic to help improve your nausea.
- Drowsiness-you may feel drowsy and tired for hours after your surgery. Anesthetics wear off differently for different people. After your surgery, you will be closely monitored by a nurse until you feel more awake and are able to answer questions.
- Sore throat-when you asleep for your surgery you will have a soft plastic tube in your throat to make sure your airway is open. This allows air to move in and out easily. Even when this tube is placed gently and carefully, you may still experience a sore throat. This soreness usually improves after one day. Damage to your throat or your vocal cords is rare.
- Damage to teeth-can happen during the placement of the breathing tube or if when waking up you bite down on the plastic. Having poor oral hygiene increases the risk of damage to teeth.