What is an anesthesiologist?
An anesthesiologists is a physician who has been extensively trained, and is an expert in the safe administration of anesthetic drugs for a surgical procedure. Anesthesiologists have also been trained to safely administer medications and perform procedures to control pain. In addition, we have expertise in management of airway issues and vascular access techniques (central vein access etc.). You should talk to your surgeon, obstetrician or primary care physician about consulting an anesthesiologist.
What is a CRNA?
A CRNA is a Certified Registered Nurse Anesthetist. This individual has undergone extensive training so that they can deliver anesthetic care safely as a member of a “care team” with an anesthesiologist.
When do I speak with my anesthesiologist?
Before your surgery, you will typically be contacted by an anesthesiologist, or one of their trained staff members. During this consultation, we will obtain medical history information, with special emphasis on any cardiac or pulmonary (lung) diseases you may have. During this interview, you will have an opportunity to ask questions. If the anesthesiologist is unable to reach you, you will have an opportunity PRIOR TO ENTERING THE OPERATING ROOM the day of the surgery to speak with your anesthesiologist.
The anesthesiologist I talked to is not the anesthesiologist the day of surgery. Why?
Although the majority of the time, the anesthesiologist who conducts the pre-operative interview will also perform the anesthetic, occasional scheduling conflicts or last minute emergency cases may mean another anesthesiologist may be assigned to your case.
What are the risks of anesthesia?
In general, the safe delivery of anesthesia by an anesthesiologist or a CRNA and anesthesiologist “care team” is routine. The specific risks of anesthesia are dependent on the type of procedure to be done, the general health of the patient and the type of anesthetic technique being used. In our practice, we perform general anesthesia, regional anesthesia, sedation (MAC) anesthesia, and local anesthesia (which are described in detail in a later section). You should discuss with your anesthesiologist any questions you have about specific risks.
Is anesthesia safe?
In short, yes, anesthesia is extremely safe. Advances in the field of anesthesiology, monitoring equipment and medications make are ongoing with the goal of making anesthesia as safe as possible. As a result, the practice of anesthesiology is far safer today than in the past. Anesthesiologists have led the way in developing safe techniques for patient care, and these techniques have been adopted in many areas of the hospital. Anesthesia, as a specialty, is often cited in the medical profession for the successful implementation of safety efforts hospital wide.
What is general anesthesia?
General anesthesia is commonly referred as “gong to sleep” for a surgical procedure. It is the most common anesthetic technique in practice today. Anesthetic medications are given to a patient through an IV which interfere with the brain’s ability to “sense” or “feel” stimulation from surgery or a procedure. Common side effects of general anesthesia include post-operative drowsiness, brief disorientation, nausea, sore mouth/throat and eye irritation.
What is regional anesthesia?
Regional anesthesia refers to a group of techniques where local anesthetic agents are injected so that a part of your body becomes less able to feel pain or stimulation. It is , similar to what a dentist does when he “numbs up” your mouth for a dental procedure. There are a variety of regional techniques including epidural anesthesia, spinal anesthesia and peripheral nerve blockade.
What are risks and benefits of regional anesthesia?
As with any type of procedure, the potential for side effects and complications exists with regional anesthesia. Most common side effects include incomplete or failed anesthesia at the surgical site, nerve damage and rarely patient awareness during the surgical procedure. The benefits of regional anesthesia are localized anesthesia to the site of the surgery only, minimizing the need for anesthetic inhalational (gas) or intravenous (IV) drugs. Additionally the regional technique often provides prolonged post-operative pain control minimizing the immediate need for pain medications.
What is epidural anesthesia?
Epidural anesthesia (or epidurals) are small tubes (catheters), about the size of a fishing line, which are placed into the epidural space in your back. Depending the location or “level” of the epidural injection, the epidural anesthetic will “block” the nerves at that region of the body, so that that region of the body feels less pain. The catheter or “tube” is then attached to a pump so we can continuously give anesthetic into the epidural space. Epidurals are most commonly used for women in labor, but are also used for major abdominal surgeries and occasionally for orthopedic procedures.
What is spinal anesthesia?
Spinal anesthesia or “spinal” involves the placement of anesthetic into the spinal sac located within the spinal column. A “spinal” is usually performed at the level of the lower back (lumbar vertebrae). Once the anesthetic is injected into the spinal sac it affects the conduction of the spinal cord and spinal nerves at the site. Typically patients cannot feel or move areas that are treated.
What is peripheral nerve blockade?
A peripheral nerve block (or “block”) is performed by injecting a small amount of anesthetic agent near a specific nerve in the body. Depending on the type of surgery being performed, the block may be performed in the neck, in the thigh, or in the back of the leg. Your anesthesiologist will discuss the specifics of your particular block with you on the day of your surgery.
The most commonly performed peripheral nerve blocks are:
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- Femoral block – anesthetizes the top of the thigh and most of the knee (typically used for knee replacement and knee arthroscopy)
- Lumbar plexus block – anesthetized the hip, thigh and knee (typically used for hip surgery)
- Infraclavicular block – anesthetizes the elbow, forearm and hand
- Interscalene block – anesthetizes the shoulder and upper arm
- Popliteal block – anesthetizes the lower leg and foot
- Sciatic block – anesthetizes the back of the thigh, lower leg, and foot
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What is sedation (MAC) anesthesia?
MAC anesthesia is when a small amount of sedation is given to you though your IV so that you are comfortable during your procedure. It is often called “twilight” anesthesia, and in general, it is a far lighter form of anesthesia than a general. The types of procedures that may be done under MAC are minor, so that you can return to your daily activities following your procedure. We do ask, however, that if you receive any form of anesthesia, you refrain from driving a car, or signing any important papers until the following day.
Can I eat and drink the day of surgery?
We ask that you have nothing to eat or drink after 11pm the night before your surgery, except a small sip of water to swallow your medications.
Why can I not eat or drink before surgery?
Anesthesia decreases a patient’s ability to protect their lungs from food or liquids entering. If food or acid from the stomach should enter the lungs during anesthesia, severe, even life threatening lung complications may occur. Therefore, for your safety it is essential that your stomach is empty prior to your procedure.
What medications do I take before surgery?
Your anesthesiologist will provide you with a list of medications you should take the morning before your surgery. It is therefore important to inform your anesthesiologist of any and all medications you take. In general, you should take your heart and blood pressure medications on the morning of your surgery as you normally would. In addition, any prescription medications you take for acid reflux (heartburn) should also be taken (if you ordinarily take them in the morning). Finally, bring your inhalers with you, as we may ask you to take them prior to your surgery.
What if I have a problem at home after surgery?
If you have a medical emergency, you should contact your surgeon or dial 911. If you have questions regarding your anesthesia or have side effects related to your anesthesia, you may contact the Acuity office at (314) 549-5004. The office will be able to get you in touch with the appropriate person.
When can I drive?
When you can drive depends on the type of surgery you have had. In general, your surgeon will instruct you as to when it is appropriate for you to resume driving. In addition, your sureon will ahave detailed instructions about when you can resume work, heavy lifting etc. Please refer to your surgeon’s discharge instructions for further details.
What are my options for pain control after surgery?
Patients who are scheduled to go home after their procedure (out-patients) will typically be discharged with pain pills and prescriptions from their surgeon. Surgical patients being admitted to the hospital (in-patients) will have intravenous pain medications and even regional techniques such as epidural anesthesia available to them. Please discuss your pain control regimen with your surgeon and anesthesiologist.