The following information applies to most patients having surgery under general anesthesia. However, some patients may have specific medical problems which may require special treatment. Your anesthesiologist will be able to answer any questions you may have during the preoperative interview or if you wish, you may e-mail your questions to kvega@totalanesthesia.com
What is General Anesthesia?
General Anesthesia means that you are unconscious so that you do not remember, move during surgery, perceive pain or discomfort, or have dangerous changes in your heart rate or blood pressure. Gases or intravenous drugs can be used to produce General Anesthesia. Combinations of medications will be used to provide general anesthesia for your safety and comfort.
What happens after I lose consciousness?
Following the start of anesthesia, medication is administered to keep you asleep for the remainder of the procedure. Some of these medications are gases, like nitrous oxide (laughing gas), while others are administered through your IV. Powerful pain relievers, muscle relaxants and sedatives are used to maintain anesthesia. Your responses to these drugs and to the surgery will be carefully monitored and the anesthetic will be carefully adjusted for you. Other medications may be administered to regulate blood pressure, heart rate or rhythm, and brain or kidney function.
Throughout the operation, your breathing, heart rate, blood pressure and temperature will be constantly monitored. The effects of surgery, the anesthetic drugs and any preexisting medical problems on your body will be used to constantly adjust the anesthetic. The anesthesiologist is responsible for diagnosing and treating any medical problems which may arise during surgery. By use of the sophisticated monitoring equipment and modern anesthetic drugs, it is possible to effectively minimize the risks of surgery.
When surgery is completed, the anesthetic drugs are discontinued, and the patient’s bodily functions are allowed to return to normal. Pain medications are routinely given at this stage to keep patients comfortable in the recovery room. Most patients wake up 5 or 10 minutes after entering the recovery room.
Will I have an IV before the surgery?
We know that getting an IV can be the hardest part of your anesthetic and surgery, but it is well worth the trouble. It allows us to give you fluids to make up for skipping breakfast. It allows quick access for medications if any emergency should arise during surgery. Finally, an IV allows you to receive the pain medications, antibiotics, and fluids your body will require following surgery.
With the exception of some small children having a minor surgery like ear tube placement, almost all patients need an IV before surgery. For very young children who need an IV, we can often let them drift off to sleep by having them breathe oxygen and anesthesia gases and then start the IV after they are asleep. For older children and adult patients, our nursing staff and Anesthesia team take great care to make the IV insertion as pleasant and painless as possible. Numbing medication to the skin before starting will often ease the process.
Will I need a breathing tube?
Not necessarily. Many patients having minor surgery performed under general anesthesia can breathe oxygen and anesthesia gases through a mask during the procedure. However, for major surgeries, it is often necessary to control the patient’s breathing using a breathing tube. The breathing tube also serves to protect the patient’s lungs from food or acid spilling from the stomach. The breathing tube (called an endotracheal or ET tube) is made of soft plastic and is placed through the mouth into the patient’s windpipe. Usually, this goes in after the patient loses consciousness and is removed before the patient wakes up.
If I have a chronic medical problem, how will it be handled during surgery?
Many patients presenting for surgery have a variety of underlying conditions such as heart problems, high blood pressure, diabetes or asthma. Your anesthesiologist will gather information on these conditions during the preoperative evaluation and will be well prepared to treat these conditions. As a medical doctor, your anesthesiologist is uniquely suited to treat any sudden medical emergency during surgery as well as chronic conditions which may affect the course of the anesthetic.
Who will stay with me during the entire surgery?
There will be an anesthesiologist (Anesthesia Doctor) or a nurse anesthetist (C.R.N.A.) with you during the entire surgery. The nurse anesthetist will be supervised by the anesthesiologist throughout the procedure. The anesthesiologist will be present or immediately available for the duration of the procedure, and will help manage critical parts of the anesthetic. Also, your anesthesiologist will act as your medical specialist during your surgery to protect and regulate your critical life functions as they are affected by surgery. He or she will also diagnose and treat any medical problems during surgery or in the recovery period.
Can I drive home after my surgery?
No. You MUST make arrangements to have a responsible adult to take you home. If there is no one to take you home, your surgery may be postponed or cancelled. It is not advised to operate vehicles or machinery for 24 hours after surgery. Even if you go home, it is strongly suggested that you have someone stay with you during the first 24 hours.
What are the risks and side effects of General Anesthesia?
All surgeries and anesthetics carry some risks. The risks depend on many factors, including the patient’s general medical condition, the type of surgery, and the type of anesthetic. The specific risks may vary, so your anesthesiologist will discuss both the most common, as well as the most serious risks associated with your anesthesia.
Minor side effects from general anesthesia and surgery are common. These include nausea, sore throat, headache, or muscle aches. Fortunately, these are most often not serious and resolve on their own soon after surgery.
Rare but serious reactions to anesthesia medicines are possible, and may include heart attacks, strokes, death, dental damage, or remembering some or all of the surgery. Fortunately, these serious reactions are very rare. If you have experienced problems following anesthesia or have particular concerns, please discuss these with your anesthesiologist before your surgery.
For over a century, anesthesiologists have been leading efforts to improve the safety of patients having surgery. They have developed national standards to enhance the safety of anesthesia and other areas of medicine as well. Together with sophisticated monitors, anesthesia equipment, and better drugs, today’s highly trained anesthesiologists and nurse anesthetists are able to deliver safer anesthesia care than ever before.
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