Frequently Asked Questions
Anesthesia is a way to control pain during a surgery or procedure by using medicine called anesthetics. It can help control your breathing, blood pressure, blood flow, heart rate and rhythm. Some of these medications are delivered through a breathing mask or breathing tube in your windpipe, and some are delivered through a small catheter in your vein.
Anesthesia may be used to:
- Relax you
- Block pain
- Make you sleepy or forgetful
- Make you unconscious for your surgery
General anesthesia is an unconscious state where you have no awareness and no sensation to pain or any stimuli. These medications may be administered either through a vein or it may be a vapor medication that you breathe into your lungs through a breathing tube while unconscious. This is the deepest form of anesthesia available and generally requires a breathing tube placed through your mouth and into your trachea or “windpipe.”
Monitored anesthesia care is a term used when sedation is administered under the care of an anesthesia provider. The sedation can be light, moderate,or deep depending upon the specific operation and the patient’s medical history. These medications may lessen your anxiety, reduce any pain and keep you comfortable during the operation or procedure. Many of these medications will cause you to have little or no memory of the procedure or operation itself. Often, sedation will be administered along with regional anesthesia or may be the primary anesthetic for procedures such as a colonoscopy.
Local anesthesia is a medication that numbs your nerves so you don’t feel pain (like Novocain for dental procedures). It is often given for minor procedures like when you get stitches for a deep skin cut. The technique involves giving you a small shot of local anesthetic directly into the surgical area to block pain or to block larger nerve bundles such as a peripheral nerve block.
- Peripheral Nerve Block – This is a shot of local anesthetic medicine to block pain around a specific nerve or group of nerves. These blocks are often used for larger procedures such as on the hands, arms, feet, legs or face.
- Epidural Analgesia – Often called an “epidural,” epidural analgesia is the most common anesthetic offered to manage labor pain during child birth but can also be used to manage pain for lower extremity, large abdominal or lung operations. This procedure involves placement of a catheter generally at the lower portion of the back in a location called the epidural space (i.e. lumbar epidural). The advantage of using a catheter is that it avoids repeat needle injections and allows for continuous infusion and re-dosing of medications to reduce your pain. If a patient is undergoing a large abdominal operation or a lung operation, the epidural will be placed higher in the spine, also known as a “thoracic epidural.”
- Spinal Analgesia – Often called a “spinal,” spinal analgesia is the more common anesthetic given for a caesarean section (commonly called a C-Section) but can also be used for other surgical operations as well. It is similar to an epidural except that this technique generally avoids placement of a catheter. Instead, your provider will administer a single injection of medication in the lower back at a location called the intrathecal space. The intrathecal space is closer to the spinal cord than the epidural space and therefore requires significantly smaller dosing of medications and avoids placement of a catheter.
The most significant factors used to determine which type of anesthesia that will be administered include the specific kind of surgery you are scheduled for combined with your current overall medical status and your surgical and medical history.
This history includes prior surgical operations that you may have had in the past such as heart surgery or other current medical problems (treated or untreated) such as high blood pressure or diabetes. When considering the type of surgery, your provider will help you determine which type of anesthesia will keep you the most comfortable, have the least side effects and benefit your overall recovery. Sometimes, such as in an emergency, it may not be possible to discuss the available options with you.
Children react differently to anesthesia and often require specialized care during the perioperative period. Throughout the surgery or procedure, an anesthesia provider will vigilantly monitor your child’s “vitals” such as blood pressure, heartbeat and oxygen levels. A pediatric anesthesiologist will lead your child’s anesthesia care team, assisted by a certified registered nurse anesthetist (CRNA). You will meet your anesthesiology team prior to surgery and will have an opportunity to ask any questions. Please inform the team of everything you can remember about any previous surgical operations and medical problems or if any family members experienced problems with anesthesia.
We are proud to offer 24 hours a day, seven days a week, 365 days a year coverage by a fellowship-trained pediatric anesthesiologist. Further, several of our CRNAs have years of experience in caring specifically for children during surgery and the perioperative period.
Medications – Medications may be permitted to be taken immediately prior to surgery and can be taken with small sips of water. Please speak with your provider to determine which medications should be taken before surgery and if certain medications need to be adjusted or stopped.
Smoking – Smoking increases your chances of having complications both during and after surgery including wound infections, pneumonia and heart attacks. The longer you go without smoking, the lower your chances are in having one of these complications. If you are currently smoking, you should quit.
Transportation – If you are scheduled for outpatient surgery, meaning you are planning to go home after the operation, it is required that you make safe travel arrangements to return home with another adult. In general, you are not allowed to leave alone or drive during the day after receiving anesthesia. However, certain situations do exist where you may be allowed to leave the hospital alone if the operation was done under local anesthesia with no sedation. Please speak with your provider to learn more.
It is vital that your stomach remains empty before receiving sedation or anesthesia. Your stomach contains acid and enzymes, which are proteins that digest and break down food particles. Normally when you are awake and conscious, your body can maintain reflexes to keep food, acid and digestive enzymes from coming up the esophagus (also known as the food pipe) and down into your lungs.
However, general anesthesia or sedation can block these natural reflexes. If your stomach is not empty, you are at a very high risk of aspirating food, acid and digestive enzymes into your lungs. If you aspirate these contents into your lungs, you are at a very high risk in developing a severe, life-threatening lung infection (aspiration pneumonia) or a severe lung inflammation condition (aspiration pneumonitis).
Immediately after your surgical operation, you will be taken to the Post Anesthesia Care Unit (PACU). While in the PACU, you will be cared for by a registered nurse under the direction of a provider from the Anesthesiology and Perioperative Medicine department. The nurse will monitor your vital signs (blood pressure, heart rate and breathing) and your pain level. Do not be afraid to tell the nurse or any member of the care team if you are in pain. Our common goal is to help manage and minimize your pain.
Some of the side effects of anesthesia may last for hours. If you received a regional or local anesthetic, you may experience numbness or loss of feeling in some areas of your body. This is normal and will wear off over time.
A common side effect, especially from general anesthesia, is a small drop in body temperature that may cause you to feel cold and shiver after surgery. The nurse can provide you with warming blankets to help you feel more comfortable. In addition, you may experience nausea or vomiting as a side effect from either the operation itself or from the anesthesia medications. There are ways to treat these symptoms and shorten the length of time you may experience these side effects. Don’t be afraid to tell the nurse or any member of the care team if you are experiencing any of these symptoms.