What is Anesthesia?

What is Anesthesia?

Anesthesia is the condition or state of blocking awareness and sensation. It allows patients to undergo surgery and other medical procedures without the distress and pain they would otherwise encounter.

What are the different types of anesthesia?

Anesthesia can be given in a number of ways, directed at different parts of the body. Not all anesthetics cause unconsciousness.

Local anesthesia restricts the numbness to a small part of your body. This is usually used for minor procedures, like stitching a cut. The local anesthetic can be given via sprays, ointments, or injections. The patient remains awake, but does not feel any pain.

Regional anesthesia is used for operations involving larger, or deeper parts of the body. The local anesthetic is injected around a cluster of nerves that carries signals to the brain, making that part of the body (for example, your arm or leg) numb. The patient may remain awake or may be given a sedative. Either way the patient does not see or feel the actual surgery take place.

Examples of regional anesthesia are the use of an epidural during childbirth, spinal anesthesia for prostate surgery or an appendectomy, or an eye block for cataract surgery.

General anesthesia is the state of controlled unconsciousness. The patient will feel nothing and be completely unaware of anything during the entire procedure. There are different general anesthetic drugs. Some are gases delivered through a breathing mask or tube, while others are injected through the vein. Blood delivers these drugs to the brain, thus putting the patient to sleep. The length and level of anesthesia is calculated and constantly adjusted by the anesthesiologist.

What are the risks of anesthesia?

All medical procedures carry risks. The specific risks of anesthesia vary with the kind of procedure and the medical condition of the patient. Receiving anesthesia is potentially dangerous, but is now made safer by the anesthesiologists’ training and equipment. Serious complications (for example, paralysis) are fortunately very rare. Your anesthesiologist stays with you the entire time until you recover from the anesthetic.

How do I prepare for anesthesia?

Before the operation your anesthesiologist will examine you, and will want to know your medical history in order to best take care of you. Be honest when your anesthesiologist asks about your allergies, illicit drug or alcohol abuse, pills you are currently taking, past anesthetic experiences, and past or present medical problems. Your laboratory results can be of help, and should be made known to your anesthesiologist.

If you are a smoker, consider giving it up weeks before scheduled surgery. If you are overweight, many of the risks of having an anesthetic are increased, and reducing your weight will help. A visit to the dentist to repair loose or broken teeth/crowns may help reduce dental damage associated with breathing tube placement during general anesthesia.

Why do we fast before anesthesia?

The rule is clear about fasting, and should be strictly followed. Nothing by mouth means absolutely nothing, including water. Generally, fasting is imposed 8 hours before the scheduled procedure. If food or liquid is present in your stomach during the delivery of the anesthetic, it could come up into the back of the throat and into your lungs, affect your breathing and cause serious lung damage.

I am taking maintenance medications. Do I need to stop taking them before my surgery?

You should continue to take your usual medicines up to the day of surgery, unless your anesthesiologist or surgeon has specifically asked you not to. Some medications need to be discontinued before the operation, like blood thinners, oral drugs for diabetes, and herbal or dietary supplements. If you are not sure, your anesthesiologist can advise you.

Could herbal medicines and dietary supplements really affect my anesthesia?

Some herbal drugs may increase the risk of bleeding and raise blood pressure. Others may prolong the effects of anesthesia. A written list of everything you are taking, whether they have been prescribed or purchased over the counter, would be helpful for your anesthesiologist.

Why talk about smoking? Am I more at risk?

Cigarettes and tobacco have unhealthy effects on the body, especially the heart and lungs. Your anesthesiologist would therefore want to know whether or not you smoke. Although it may take 3 to 6 weeks for the lungs to recover from some of the effects of smoking, giving up smoking even a day before surgery helps a little. There are instant physiologic benefits from smoking cessation, such as increased oxygen carrying capacity in the blood, and improvement in wound healing.

Can I be put to sleep in my room before transfer to OR?

Sometimes, drugs may be administered to patient’s hours before the actual operation. These drugs may be given as tablets or injections and are called pre-medications. They relax you and may send you to sleep. Requesting to be asleep in the room before transfer to the OR is not a safe goal of premedication. Delivery of anesthesia should only be initiated once proper monitors are in place to ensure the patient’s wellbeing.

What determines the type of anesthesia to be used?

The choice of anesthesia depends on several factors: the type of surgery, the patient’s physical condition, the equipment, staff and resources available at the hospital, the patient’s preferences, and the anesthesiologist’s recommendations. Be free to discuss any concern you might have with your anesthesiologist, in order for the most appropriate anesthetic plan to be made.

What general instructions will I receive after receiving anesthesia?

Both written and verbal instructions will be given. Although specific instructions may be given by both your surgeon and anesthesiologist, general instructions for 24 hours after your anesthesia are the following:

• Do not drink alcoholic beverages or use nonprescription medications.
• Do not drive a car or operate dangerous machinery.
• Do not make important decisions.

You will also be instructed to call the nurse if you have any concerns or if you need emergency help, especially if you will be sent home.

What can I expect after the operation until I go home?

Patients often experience drowsiness and minor after-effects following anesthesia, including muscle aches, sore throat and occasional dizziness or headaches. Nausea also may be present, but vomiting is less common. These side effects usually decline rapidly in the hours following surgery, but it may take several days before they are gone completely. The majority of patients feel tired up to the next day, usually due to general fatigue or surgical discomfort. Recovery is common and is expected in the next few days.

Source: Patient Education Web Site for the American Society of Anesthesiologists (ASA).www.asahq.org/patientEducation.htm TMC Department of Anesthesia Patient Education Team

Note: This information is not intended to be used as a substitute for professional medical advise, diagnosis or treatment. If you or someone you know have any of the symptoms mentioned above, it is advisable to seek professional help.

The Medical City offers a roster of competent anesthesiologists who may assist patients for surgery.

For any inquiries please call:

ANESTHESIA PREOPERATIVE EVALUATION CLINIC (APEC)

Tel. No.: (632) 988-1000 / (632) 988-7000 Ext. 6617

Department of Anesthesiology
Tel. No.: (632) 988-1000 / (632) 988-7000 Ext. 6258

CENTER FOR PATIENT PARTNERSHIP
Tel. No.: (632) 988-1000 / (632) 988-7000 Ext. 6444

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Anesthesia – Common Pain

What is The Medical City Pain Management Clinic approach to your pain?

• The Pain Management Clinic first understand your pain, and then works towards the relief of your pain so you can have a fuller and better quality of life.
• It considers your pain as the disease itself and offers treatment modalities even when the cause may not be obvious.
• It offers an algorithmic approach to pain management and tailor-fits this to individual responses. At The Medical City we have a competent of pain experts who can address different types of pain.

References:

Loeser JD, Butler SH, Chapman CR, editors. Bonica’s Mangement of Pain, 3rd edition, United States of America (USA): Lippincott Williams and Wilkins, 2001. TMC - Pain Management TMC - Department of Anesthesiology

Note: This information is not intended to be used as a substitute for professional medical advise, diagnosis or treatment. If you or someone you know have any of the symptoms mentioned above, it is advisable to seek professional help.

The Medical City offers a roster of competent pain experts who may assess and treat people with different types of pain.

For any inquiries please call:

PAIN MANAGEMENT CLINIC
Tel. No.: (632) 988-1000 / (632) 988-7000 ext. 6453

DEPARTMENT OF ANESTHESIOLOGY
Tel. No.: (632) 988-1000 / (632) 988-7000 ext. 6258

CENTER FOR PATIENT PARTNERSHIP

Tel. No. (632) 988-1000 / (632) 988-7000 Ext. 6444