THE

Anesthesia

EXPERIENCE

THE

Anesthesia

EXPERIENCE

Anesthesia is medication that is given to you for the relief of pain and sensation during your surgical procedure.

The dosage and form of anesthesia is administered by our board-certified anesthesiologists and nurse anesthetists during surgery. Prior to surgery, your anesthesiologist will meet with you to review your medical history, do an examination, and discuss the appropriate type of anesthesia for your surgery and your medical condition. The types of anesthesia used most often for surgery and surgical procedures include general anesthesia, regional anesthesia, and monitored anesthesia care (MAC).

pta-anesthesia-halfcolumn-bp-cuff-1080x810
Types of Anesthesia
In general anesthesia

an anesthetic is used to put the patient into an unconscious state. Medication is administered intravenously or inhaled through a breathing mask or tube, and the patient is unconscious and pain free from the start of the anesthetic to the end of the surgery. During your surgery, additional anesthetic gases and intravenous medications may be given so that you remain unconscious and pain free.

Regional anesthesia

is used to block out pain only in the area of the body where the surgical procedure is being performed. A local anesthetic is injected in the spinal cord or the area of nerves that provide feeling to that part of the body. Spinal and epidural anesthesia are two forms of regional anesthesia that are used quite often. Intravenous sedation is also given with regional anesthesia so that you will rest throughout the surgery with less awareness and anxiety.

A spinal or epidural anesthetic

is used for lower abdominal, pelvic, rectal, or lower extremity surgery. A spinal is a single dose injection made into the lower back, below the end of the spinal cord, and the lower body becomes numb. An epidural anesthetic medication is continually infused through a thin catheter into the space that surrounds the spinal cord in the lower back, causing the lower body to become numb.

Monitored anesthesia care (MAC)

is intravenous sedation medication administered by the anesthesiologist or nurse anesthetist. The anesthesia care team continuously monitors your vital signs to ensure that you are comfortable and relaxed while a local anesthetic is administered to the surgical site.

General Questions about Anesthesia

Q: DO PEOPLE TALK UNDER GENERAL ANESTHESIA? WHAT ABOUT AWARENESS?
A: General anesthesia renders you unconscious, so speech as well as memory is not possible. Keep in mind that our anesthesia staff remains with you for the duration of the procedure to adjust the anesthetic on an ongoing basis, which makes any degree of awareness highly unlikely.

Q: A REGIONAL ANESTHETIC (SPINAL, EPIDURAL, ETC.) HAS BEEN RECOMMENDED FOR ME. WILL I SEE ANYTHING DURING SURGERY?
A: Not unless you want to. Sedatives are almost always administered along with the regional anesthetic, and while we make no guarantees of complete amnesia, these sedative medications result in a very relaxed patient. In fact, experience shows that the majority of patients who previously have had a regional anesthetic request another if they return for subsequent surgery.

Q: WHAT IS THE LIKELIHOOD OF NAUSEA?
A: Statistically, the risk of nausea is about 20 percent. The highest incidence of nausea occurs following abdominal operations. We frequently administer additional anti-nausea medications to those at risk. Scientifically, the cause of nausea with anesthesia and surgery has never been clearly identified. Unscientifically, we are also concerned about people with a history of nausea after procedures or who have sensitivity to narcotics (such as codeine), and we will additionally treat these patients. As with most drugs, including anti-nausea medications, side effects are possible. Therefore, each patient is considered on an individual basis.

Q: WHY DID I HAVE A SORE THROAT AFTER MY LAST PROCEDURE?
A: Many procedures need more airway protection than that provided by a mask. So for those cases, after the general anesthetic has been administered, a breathing tube is placed into the windpipe to secure the airway. This tube is routinely removed before the patient has fully regained consciousness. The breathing tube may cause a sore throat that usually passes in a day or two.

Q: I HAVE AN UNUSUAL ALLERGY. ARE THERE SPECIAL CONCERNS RELATED TO THIS ISSUE?
A: Swelling, difficulty breathing, and/or low blood pressure are serious allergic reactions. Some reactions are labeled allergies, but may be predictable side effects of medications. For example, an “allergy” to a local anesthetic manifesting itself as rapid heart rate may have been from epinephrine (adrenaline) contained in some solutions. Additionally, some itching with narcotics is not unusual. Please discuss your specific medical conditions and any known allergies with your anesthesiologist prior to surgery.

Q: I HAD A PROBLEM WITH A PREVIOUS ANESTHETIC, BUT I DON’T KNOW THE DETAILS. WHAT SHOULD I DO?
A: Prior to your surgical procedure, we can request your old medical records or you can personally request medical records from other non-Novant facilities where we do not practice. Our anesthesia staff makes every effort to talk to you or to your family about any issues or medical conditions that may impact your anesthesia.

Q: WHAT IS THE DIFFERENCE BETWEEN MONITORED ANESTHESIA CARE (MAC) AND GENERAL ANESTHESIA?
A: Not all surgeries require general (unconscious) anesthesia. Sometimes, sedation (usually used to supplement local numbing injections) is enough to keep you comfortable. It is possible to give you light sedation, moderate sedation, or deep sedation, depending on the type of procedure or your medical condition. You may hear various phrases with different terminology used to describe sedation protocols. For example, monitored anesthesia care (MAC) combines intravenous sedation with local anesthetic infiltration or nerve blocks, and enables patients to undergo lengthy and complex procedures as outpatients.

Some anesthesia terms mean the same thing or have overlapping connotations. Sometimes, the phrases are used interchangeably, but are technically a little different. And, some of these descriptors for sedation techniques are actually quite specific. The continuum of consciousness, as it relates to anesthesia, goes from awake, to lightly sedated, to moderately sedated, to deeply sedated, and finally unconscious under general anesthesia.

What to Expect the Day of Surgery

Q: WHAT DO I NEED TO DO BEFORE SURGERY?
A: Do not eat or drink ANYTHING (not even mints or gum) after midnight the night before your procedure (except medicines with sips of water), unless otherwise instructed by your surgeon. An empty stomach is very important during surgery.

Q: WHAT ABOUT MY MEDICATIONS?
A: It may be extremely important for you to continue some of your medicines, such as those for heart, blood pressure, and breathing problems. These drugs should be taken with sips of water. Other medicines, such as insulin, blood thinners, or aspirin-like drugs may need to be stopped or the dose adjusted to prevent unwanted reactions. Make sure you ask your surgeon about these medicines, and please bring a list of your current or recently taken drugs (and their doses) with you for your anesthesiologist to review.

Q: WHEN WILL I MEET MY PTA CARE TEAM?
A: You will have a chance to meet and talk with your anesthesiologist and nurse anesthetist the day of your surgery. A pre-anesthesia assessment will occur the day prior to your surgery if you are an inpatient, or the day of your admission if you are scheduled for outpatient surgery.

Q: I HAVE SIGNIFICANT MEDICAL PROBLEMS OR ANESTHESIA CONCERNS. WHAT SHOULD I DO?
A: Bring these medical problems to the attention of your surgeon well before the day of your surgery. Their office will contact our anesthesiologists in advance of your procedure if necessary. Your primary care physician may also contact us directly if there are
special concerns.

Q: HOW DO I KNOW WHERE AND WHEN TO ARRIVE?
A: Your surgeon will give you those instructions, and the hospital will contact you as well. Usually your arrival time will be at least one hour prior to your surgery to allow for preparation.

Q: WHO SHOULD ACCOMPANY ME?
A: A responsible adult must be available to drive you home if you are to be discharged after your procedure. That person should also be available in case you have to stay overnight.

Q: WHAT HAPPENS BEFORE GOING INTO THE OPERATING ROOM?
A: In the pre-op area, you will have an intravenous line (IV) inserted (A local anesthetic is almost always administered before the IV needle is placed). In most cases, immediately before going into the operating room, we give a rapidly acting sedative through the IV. This sedative does not put you to sleep, but helps you to relax.

Q: WHAT OTHER PREPARATION OCCURS IN THE PRE-OP AREA?
A: If you are having a regional anesthetic, we often administer the anesthetic block in the pre-op area, following sedation. For major operations requiring invasive monitoring, we typically begin some of the preparatory work before you enter the operating room.

Q: WHAT HAPPENS AT THE END OF SURGERY?
A: We discontinue the anesthetic, which returns you to consciousness. You will then be transported to the Post Anesthesia Care Unit (PACU), where you will recover from the anesthetic. In most cases, you will have been given pain medicines before you arrive in
the PACU.

Q: WHAT IF I’M PARTICULARLY SENSITIVE – OR INSENSITIVE?
A: Each person is different, therefore every anesthetic is unique. This is the science and art of the practice of anesthesia. Our anesthesia team continually monitors and carefully makes any necessary adjustments throughout your procedure.

Q: WHAT HAPPENS WHEN SURGERY IS OVER?
A: Our anesthetists will continue to care for you in the PACU. If an admission to a hospital has been planned after your procedure, you will remain in the PACU until you are ready to go to your room. If you are having outpatient surgery, you will be released once your condition meets discharge guidelines.

Q: WHAT DO I NEED TO DO AFTER OUTPATIENT SURGERY?
A: The medications given during anesthesia will affect your judgment and coordination. Therefore, you will be required to have a responsible adult escort you out of the surgical facility, drive you home, and stay with you the night after your surgery. You must also avoid activities such as driving, drinking alcoholic beverages, and making big decisions, for at least 24 hours after the operation.

Anesthesia is medication that is given to you for the relief of pain and sensation during your surgical procedure.

The dosage and form of anesthesia is administered by our board-certified anesthesiologists and nurse anesthetists during surgery. Prior to surgery, your anesthesiologist will meet with you to review your medical history, do an examination, and discuss the appropriate type of anesthesia for your surgery and your medical condition. The types of anesthesia used most often for surgery and surgical procedures include general anesthesia, regional anesthesia, and monitored anesthesia care (MAC).

pta-anesthesia-halfcolumn-bp-cuff-1080x810
Types of Anesthesia
In general anesthesia

an anesthetic is used to put the patient into an unconscious state. Medication is administered intravenously or inhaled through a breathing mask or tube, and the patient is unconscious and pain free from the start of the anesthetic to the end of the surgery. During your surgery, additional anesthetic gases and intravenous medications may be given so that you remain unconscious and pain free.

Regional anesthesia

is used to block out pain only in the area of the body where the surgical procedure is being performed. A local anesthetic is injected in the spinal cord or the area of nerves that provide feeling to that part of the body. Spinal and epidural anesthesia are two forms of regional anesthesia that are used quite often. Intravenous sedation is also given with regional anesthesia so that you will rest throughout the surgery with less awareness and anxiety.

A spinal or epidural anesthetic

is used for lower abdominal, pelvic, rectal, or lower extremity surgery. A spinal is a single dose injection made into the lower back, below the end of the spinal cord, and the lower body becomes numb. An epidural anesthetic medication is continually infused through a thin catheter into the space that surrounds the spinal cord in the lower back, causing the lower body to become numb.

Monitored anesthesia care (MAC)

is intravenous sedation medication administered by the anesthesiologist or nurse anesthetist. The anesthesia care team continuously monitors your vital signs to ensure that you are comfortable and relaxed while a local anesthetic is administered to the surgical site.

General Questions about Anesthesia

Q: DO PEOPLE TALK UNDER GENERAL ANESTHESIA? WHAT ABOUT AWARENESS?
A: General anesthesia renders you unconscious, so speech as well as memory is not possible. Keep in mind that our anesthesia staff remains with you for the duration of the procedure to adjust the anesthetic on an ongoing basis, which makes any degree of awareness highly unlikely.

Q: A REGIONAL ANESTHETIC (SPINAL, EPIDURAL, ETC.) HAS BEEN RECOMMENDED FOR ME. WILL I SEE ANYTHING DURING SURGERY?
A: Not unless you want to. Sedatives are almost always administered along with the regional anesthetic, and while we make no guarantees of complete amnesia, these sedative medications result in a very relaxed patient. In fact, experience shows that the majority of patients who previously have had a regional anesthetic request another if they return for subsequent surgery.

Q: WHAT IS THE LIKELIHOOD OF NAUSEA?
A: Statistically, the risk of nausea is about 20 percent. The highest incidence of nausea occurs following abdominal operations. We frequently administer additional anti-nausea medications to those at risk. Scientifically, the cause of nausea with anesthesia and surgery has never been clearly identified. Unscientifically, we are also concerned about people with a history of nausea after procedures or who have sensitivity to narcotics (such as codeine), and we will additionally treat these patients. As with most drugs, including anti-nausea medications, side effects are possible. Therefore, each patient is considered on an individual basis.

Q: WHY DID I HAVE A SORE THROAT AFTER MY LAST PROCEDURE?
A: Many procedures need more airway protection than that provided by a mask. So for those cases, after the general anesthetic has been administered, a breathing tube is placed into the windpipe to secure the airway. This tube is routinely removed before the patient has fully regained consciousness. The breathing tube may cause a sore throat that usually passes in a day or two.

Q: I HAVE AN UNUSUAL ALLERGY. ARE THERE SPECIAL CONCERNS RELATED TO THIS ISSUE?
A: Swelling, difficulty breathing, and/or low blood pressure are serious allergic reactions. Some reactions are labeled allergies, but may be predictable side effects of medications. For example, an “allergy” to a local anesthetic manifesting itself as rapid heart rate may have been from epinephrine (adrenaline) contained in some solutions. Additionally, some itching with narcotics is not unusual. Please discuss your specific medical conditions and any known allergies with your anesthesiologist prior to surgery.

Q: I HAD A PROBLEM WITH A PREVIOUS ANESTHETIC, BUT I DON’T KNOW THE DETAILS. WHAT SHOULD I DO?
A: Prior to your surgical procedure, we can request your old medical records or you can personally request medical records from other non-Novant facilities where we do not practice. Our anesthesia staff makes every effort to talk to you or to your family about any issues or medical conditions that may impact your anesthesia.

Q: WHAT IS THE DIFFERENCE BETWEEN MONITORED ANESTHESIA CARE (MAC) AND GENERAL ANESTHESIA?
A: Not all surgeries require general (unconscious) anesthesia. Sometimes, sedation (usually used to supplement local numbing injections) is enough to keep you comfortable. It is possible to give you light sedation, moderate sedation, or deep sedation, depending on the type of procedure or your medical condition. You may hear various phrases with different terminology used to describe sedation protocols. For example, monitored anesthesia care (MAC) combines intravenous sedation with local anesthetic infiltration or nerve blocks, and enables patients to undergo lengthy and complex procedures as outpatients.

Some anesthesia terms mean the same thing or have overlapping connotations. Sometimes, the phrases are used interchangeably, but are technically a little different. And, some of these descriptors for sedation techniques are actually quite specific. The continuum of consciousness, as it relates to anesthesia, goes from awake, to lightly sedated, to moderately sedated, to deeply sedated, and finally unconscious under general anesthesia.

What to Expect the Day of Surgery

Q: WHAT DO I NEED TO DO BEFORE SURGERY?
A: Do not eat or drink ANYTHING (not even mints or gum) after midnight the night before your procedure (except medicines with sips of water), unless otherwise instructed by your surgeon. An empty stomach is very important during surgery.

Q: WHAT ABOUT MY MEDICATIONS?
A: It may be extremely important for you to continue some of your medicines, such as those for heart, blood pressure, and breathing problems. These drugs should be taken with sips of water. Other medicines, such as insulin, blood thinners, or aspirin-like drugs may need to be stopped or the dose adjusted to prevent unwanted reactions. Make sure you ask your surgeon about these medicines, and please bring a list of your current or recently taken drugs (and their doses) with you for your anesthesiologist to review.

Q: WHEN WILL I MEET MY PTA CARE TEAM?
A: You will have a chance to meet and talk with your anesthesiologist and nurse anesthetist the day of your surgery. A pre-anesthesia assessment will occur the day prior to your surgery if you are an inpatient, or the day of your admission if you are scheduled for outpatient surgery.

Q: I HAVE SIGNIFICANT MEDICAL PROBLEMS OR ANESTHESIA CONCERNS. WHAT SHOULD I DO?
A: Bring these medical problems to the attention of your surgeon well before the day of your surgery. Their office will contact our anesthesiologists in advance of your procedure if necessary. Your primary care physician may also contact us directly if there are
special concerns.

Q: HOW DO I KNOW WHERE AND WHEN TO ARRIVE?
A: Your surgeon will give you those instructions, and the hospital will contact you as well. Usually your arrival time will be at least one hour prior to your surgery to allow for preparation.

Q: WHO SHOULD ACCOMPANY ME?
A: A responsible adult must be available to drive you home if you are to be discharged after your procedure. That person should also be available in case you have to stay overnight.

Q: WHAT HAPPENS BEFORE GOING INTO THE OPERATING ROOM?
A: In the pre-op area, you will have an intravenous line (IV) inserted (A local anesthetic is almost always administered before the IV needle is placed). In most cases, immediately before going into the operating room, we give a rapidly acting sedative through the IV. This sedative does not put you to sleep, but helps you to relax.

Q: WHAT OTHER PREPARATION OCCURS IN THE PRE-OP AREA?
A: If you are having a regional anesthetic, we often administer the anesthetic block in the pre-op area, following sedation. For major operations requiring invasive monitoring, we typically begin some of the preparatory work before you enter the operating room.

Q: WHAT HAPPENS AT THE END OF SURGERY?
A: We discontinue the anesthetic, which returns you to consciousness. You will then be transported to the Post Anesthesia Care Unit (PACU), where you will recover from the anesthetic. In most cases, you will have been given pain medicines before you arrive in
the PACU.

Q: WHAT IF I’M PARTICULARLY SENSITIVE – OR INSENSITIVE?
A: Each person is different, therefore every anesthetic is unique. This is the science and art of the practice of anesthesia. Our anesthesia team continually monitors and carefully makes any necessary adjustments throughout your procedure.

Q: WHAT HAPPENS WHEN SURGERY IS OVER?
A: Our anesthetists will continue to care for you in the PACU. If an admission to a hospital has been planned after your procedure, you will remain in the PACU until you are ready to go to your room. If you are having outpatient surgery, you will be released once your condition meets discharge guidelines.

Q: WHAT DO I NEED TO DO AFTER OUTPATIENT SURGERY?
A: The medications given during anesthesia will affect your judgment and coordination. Therefore, you will be required to have a responsible adult escort you out of the surgical facility, drive you home, and stay with you the night after your surgery. You must also avoid activities such as driving, drinking alcoholic beverages, and making big decisions, for at least 24 hours after the operation.

 

 

pta-care-team-400x400-b

 

 

THE PHYSICIAN CARE TEAM

Your anesthesiologist and nurse anesthetist are responsible for your comfort and well-being during the operative procedure.

Their primary responsibility is to provide safe and optimal conditions for your surgery. The anesthesiologist or nurse anesthetist will monitor and manage your vital body functions including breathing, heart function, and blood pressure during your surgery. They are also responsible for managing any medical problems that may arise related to the surgery, as well as any chronic medical condition you may have, such as asthma, diabetes, and high blood pressure or heart problems.

Your anesthesia care team will help to ensure your safety during surgery and make the operative procedure as comfortable as possible. The anesthesia care team will be with you throughout your procedure. They will work with the surgeon and other specialists to provide quality and caring service for an optimal and outstanding hospital experience.

pta-care-team-400x400-b

THE PHYSICIAN CARE TEAM

Your anesthesiologist and nurse anesthetist are responsible for your comfort and well-being during the operative procedure.

Their primary responsibility is to provide safe and optimal conditions for your surgery. The anesthesiologist or nurse anesthetist will monitor and manage your vital body functions including breathing, heart function, and blood pressure during your surgery. They are also responsible for managing any medical problems that may arise related to the surgery, as well as any chronic medical condition you may have, such as asthma, diabetes, and high blood pressure or heart problems.

Your anesthesia care team will help to ensure your safety during surgery and make the operative procedure as comfortable as possible. The anesthesia care team will be with you throughout your procedure. They will work with the surgeon and other specialists to provide quality and caring service for an optimal and outstanding hospital experience.