For many patients, having any type of surgery can cause concern. The following questions have been answered to help you become more informed about anesthesia and preparing for your procedure.
Are there different kinds of anesthesia?
There are three main types of anesthesia: local, regional, and general.
Local anesthesia: The anesthetic drug is usually injected into the tissue to numb just the specific location of your body requiring minor surgery, for example, on the hand or foot.
Regional anesthesia: Your anesthesiologist makes an injection near a cluster of nerves to numb the area of your body that requires surgery. You might be awake, or you may be given something to help you relax, sometimes called a sedative.
There are several kinds of regional anesthesia. Two of the most frequently used are spinal and epidural anesthesia, which are produced by injections made with great exactness in the appropriate areas of the back. They are frequently preferred for childbirth and prostate surgery.
General anesthesia: You are unconscious and have no awareness or other sensations. There are a number of general anesthetic drugs. Some are gases or vapors inhaled through a breathing mask or tube and others are medications introduced through a vein. During anesthesia, you are carefully monitored, controlled and treated by your anesthesiologist. A breathing tube may be inserted through your mouth and frequently into the windpipe to maintain proper breathing during this period. The length and level of anesthesia is calculated and constantly adjusted with great precision. At the conclusion of surgery, your anesthesiologist will reverse the process and you will regain awareness in the recovery room.
What are the risks of anesthesia?
All operations and all anesthesia have some risks, and they are dependent upon many factors including the type of surgery and the medical condition of the patient. Fortunately, adverse events are very rare. Your anesthesiologist takes precautions to prevent an accident from occurring.
The specific risks of anesthesia vary with the particular procedure and the condition of the patient. You should ask your anesthesiologist about any risks that may be associated with your anesthesia.
What about eating or drinking before my anesthesia?
As a general rule, you should not eat or drink anything after midnight before your surgery. Under some circumstances, you may be given permission by your anesthesiologist to drink clear liquids up to a few hours before your anesthesia.
Should I take my usual medicines?
Some medications should be taken and others should not. It is important to discuss this with your anesthesiologists. Do not interrupt medications unless your anesthesiologist or surgeon recommends it.
Could herbal medicines, vitamins and other dietary supplements affect my anesthesia if I need surgery?
Anesthesiologists are conducting research to determine exactly how certain herbs and dietary supplements interact with certain anesthetics. They are finding that certain herbal medicines may prolong the effects of anesthesia. Others may increase the risks of bleeding or raise blood pressure. Some effects may be subtle and less critical, but for anesthesiologists anticipating a possible reaction is better than reacting to an unexpected condition. So it is very important to tell your doctor about everything you take before surgery.
I want an epidural when I have my baby, how does that work?
An epidural block is given in the lower back and is designed to relieve labor pain. You will either be sitting up or lying on your side when you receive your epidural. The block is administered below the level of the spinal cord. The anesthesiologist will use a local anesthesia to numb an area of your lower back. A special needle is placed in the epidural space just outside the spinal sac.
Should I stop smoking before my surgery?
Yes – it is important to quit smoking now. Your surgery represents a golden opportunity to do so. There is evidence that smokers who quit at or before surgery experience fewer symptoms of nicotine withdrawal and are more likely to succeed in their attempt to stop smoking long term. Even if it’s only a week or two before surgery, there is still a benefit to quitting.
You can find the materials that the ASA has developed to help you stop smoking at
http://www.asahq.org/For-Members/Clinical-Information/ASA-Stop-Smoking-Initiative.aspx.
Are long surgeries more dangerous?
There is no evidence that the duration of general anesthesia by itself increases the risks of anesthesia complications. Studies of anesthesia-related risk have shown correlation with other factors, such as:
- Your general medical condition especially problems like diabetes, heart or lung disease, malnutrition or obesity,
- Your functional status, that is your ability to tolerate at least moderate levels of physical activity.
Obviously, anesthetic outcomes are also related to the skill and experience of the anesthesiologist that is taking care of you. The anesthetic needs to be tailored to your medical condition, to the surgery itself, and wherever possible, to your individual preferences.
Is pain relief in my spine safe?
You can rest assured that spinal anesthesia is a safe choice for many surgeries. When offered this type of anesthesia, many patients are concerned about serious side effects, such as paralysis, and also about troubling but less dangerous side effects, such as headache. There is a common, although false, perception that these complications occur often. In fact, spinal anesthesia has a long track record of safety, with a very low rate of serious complications.
Should my throat be sore after surgery?
A sore throat after general anesthesia is not uncommon, occurring about 20-30% of the time. In most cases it is mild, and gets better without treatment over a couple of days. It is unusual for the soreness to last longer than a few weeks. If this does occur, please contact your physician.
Should my IV site continue to be sore and swollen weeks after surgery?
Phlebitis is a term that means inflammation of a blood vessel. Phlebitis occurs quite commonly after the insertion of an IV. There is a wide variation because it depends on how phlebitis is defined, such as the place the IV is inserted, the duration that the IV has been in place, the type of material that the IV is made of, the length of the IV catheter, and on the existence of other disorders such as diabetes. If you continue to feel pain and have swelling for more than three weeks you should connect with your physician.