+What is anesthesia?

Anesthesiology is the practice of medicine specializing in:

• The medical management of patients during the peri-operative period (pre-operative, intra-operative, and post-operative).
• Maintenance and protection of vital functions during surgical and other medical procedures.
• Management and control of both acute and chronic pain.
• Management of critically ill patients.

+What kind of anesthesia will I have?

There are three main types of anesthesia, General, Regional, and Monitored Anesthetic Care. Your anesthesiologist will form a plan for your anesthetic which is tailored to your procedure and your health. Will discuss options as well as risks associated with anesthesia.

General - Patients receiving general anesthesia are rendered unconscious. Usually patients have a breathing tube placed after they are unconscious to allow for assisted breathing.

Regional - This includes epidural, spinal and peripheral nerve blocks. The regional block is frequently combined with intravenous sedation throughout the procedure.

MAC - Sedation is the goal of this type of anesthesia often combined with local anesthesia provided by the surgeon. During this anesthetic the patients are not unconscious although they may not remember and they breath without assistance.

+What are the risks associated with anesthesia?

Your specific risks are based on your health history and your type of anesthesia. Recent estimates place the risk of death from anesthesia (not related to the surgery) at 1 in 200,000 to 1 in 400,000 patients or less. Improvements and advancements in equipment and monitoring have made anesthesia one of the safest medical specialties. However, any procedure requiring an anesthetic assumes some amount of risk. The most frequent serious complications with anesthesia include breathing problems, high or low blood pressure, medication reactions. Minor common complications include sore throat, chipped teeth, sore muscles, or nerve injury. There may be others specific to your procedure.

+Will I "wake up" during surgery?

The incidence of intra-operative awareness during general anesthesia is extremely low, despite what we see in the movies, and estimated at 0.1-0.2%.
There are monitors which help us to judge your anesthetic depth, in unique circumstances recall may still occur; however, this is extremely rare. Please discuss this with your anesthesiologist if you have concerns.

+What does an anesthesiologist do during the surgery?

Your anesthesiologist remains at your bedside throughout the operation, continuously monitoring your well-being while the surgeon is working. Specifically, he or she will continuously monitor your heart rate and rhythm, blood pressure and oxygen level. Your anesthesiologists will ensure that your are receiving adequate anesthesia, pain medication, intravenous fluids and blood transfusions if necessary.

+Will I have a breathing tube?

This depends on you and your surgery.
General anesthesia (anesthesia care in which you are completely unconscious) requires a breathing tube. Many operations do not necessarily require a breathing tube, but given the length of the surgery or the position, it is often more comfortable for the patient to have a breathing tube and be completely unconscious throughout the operation.
Prior to your operation, your anesthesiologist will discuss this with you. If a breathing tube is required, you will be asleep when it is placed. Most patients have no memory of the breathing tube at all.

+Will I have nausea or vomiting after my anesthetic?

All patients have different responses to anesthesia and our medications. With the advancements in anesthetic techniques, the incidence of nausea and vomiting has decreased dramatically. Most patients are easily treated by anti-nausea medications.
A small number of patients still have severe nausea post-operatively. If you have motion sickness or have had post-operative nausea in the past, please let your anesthesiologist know and he or she will try to modify your anesthetic to reduce the risk of nausea.

+Which medicines should I take?

This question should be addressed by your surgeon and the pre-operative clinic prior to your operation. In general, you should take all of your normal medications until the day of surgery. Some surgeries may require you to change your medication routine prior to the operation (for instance, patients taking blood-thinning medications may be asked to change or stop taking these medications before proceeding to the operating room). Most of these changes will be discussed by your surgeon with you prior to surgery, but for any questions please call the pre-operative clinic.
If you do have medications that you are instructed to take on the morning of surgery, please take them with a small
SIP of water.
Oral diabetes medications should
NOT be taken on the morning of surgery. If you are a diabetic patient taking insulin, please call the pre-operative clinic for specific instructions on dosing your medication.

+Who will provide my anesthesia?

A physician-trained anesthesiologist will provide your anesthesia care throughout your peri-operative period. More than just "putting you to sleep," your anesthesiologist cares for your breathing, brain, heart, and lungs during all of your operation. Your anesthesiologist will be with you at your side monitoring your vital functions continuously during the entire operation.