Communication and cooperation between you and your anesthesia provider are essential to the anesthesia process and its safety. Before surgery, a preoperative interview with your anesthesia provider provides valuable information that helps determine your care and the type of anesthesia you will receive. It is equally important to communicate with your anesthesia provider after your surgery. The medications you have been given can remain in your body for 24 hours or more after they have been administered. You should never hesitate to ask your anesthesia provider any questions you might have — before or after your anesthesia is administered.
Drug Allergies – Your anesthesia provider needs to know if you have experienced any problems with drugs administered during previous surgical procedures. This information will help the anesthesia provider select and administer your anesthetic.
Vital Body Sign Sensors – Before you go to sleep, monitors will be attached to your body, which will connect to monitors in the operating room. These monitors allow the anesthesiology team to monitor your vital signs during your anesthetic.
Communicate with Your Anesthesia Team – During your preoperative examination, please feel free to ask your anesthesia provider any questions you have or to voice concerns. Be certain to inform the anesthesia team of:
• What food and drink you have consumed during the past 12-24 hours
• Any special dental work (false teeth, bridges, etc.)
• Any bad experience during previous surgeries
• All of your medications. This includes prescription, nonprescription, and herbal medications.
Pre Operative Anesthesia Instructions
ALL of these instructions must be strictly followed prior to receiving any anesthetic. These instructions are for your safety during your procedure.
• DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT
• Take your normal medications the night before/morning of surgery with a small sip of water (see exceptions below):
• Please do not take an Angiotensin Receptor Blocker (ARB) for high blood pressure such as losartan, candesartan, irbesartan, valsartan, olmesartan, Avapro, Diovan, Micardis, Cozaar, Hyzaar, Benecar, Atacand.
• If you take only oral diabetes medications, please do not take them the morning of surgery.
• If you take multiple oral diabetes medications and insulin, please follow the recommendations of the prescribing provider regarding those medications.
• If you take Plavix, Aggrenox, Pradaxa, Coumadin, clopidogrel, dabigatran, dipyridamole, warfarin, or other blood thinner, please follow the recommendations of your surgeon or prescribing provider.
• Street or recreational drug use can cause severe illness and even death under anesthesia. Please stop using at least 2 weeks prior to your surgery and disclose all usage to your anesthesia provider. This information will be kept strictly confidential and is for treatment safety purposes only.
• If you routinely use nebulizer treatments or inhalers for asthma, COPD, or any pulmonary disease, please take these the morning of surgery before you arrive and bring them with you.
• If you have experienced ANY changes in your health status (infections, colds, shortness of breath, or chest pain) in the 2 weeks before your surgery, please notify your surgeon immediately.
• Please drink plenty of non-caffeinated fluids the day before surgery.
• Please designate a driver, and an adult to stay with you for 24 hours after surgery.
There are 4 main types of anesthesia. They are:
Local Anesthesia: This type of anesthesia causes you to lose sensation in a very specific area. The anesthetic drug is usually injected into an incision area to numb the tissue around a specific area of your body that requires only minor surgery. Occasionally, an anesthesia provider may be present to administer a mild sedative.
Regional Anesthesia: This kind of anesthesia gets it name because a “region” of the body is anesthetized without making you unconscious. Regional anesthesia can be used to block very specific areas such as one arm, one leg, or one foot. You will not see or feel the actual surgery take place because intravenous sedation is usually administered.
Monitored Anesthesia Care (MAC): This stands for Monitored Anesthesia Care. It is most commonly known as “twilight” or a heavy sedation and is often combined with local anesthesia. Under certain circumstances, a general anesthetic, whereby the patient is completely unconscious, may be unnecessary and/or undesirable. Circumstances may include, but are not limited to, procedures that are minimally invasive or purely diagnostic (and thus not uncomfortable). Sometimes, the patient’s health may not tolerate the stress of general anesthesia. The decision to provide monitored anesthesia care versus general anesthesia can be complex involving careful consideration of individual circumstances and after discussion with the patient as to their preferences. It is not uncommon for the patient to hear voices or remember certain aspects of the procedure and commonly the patient will expected to follow commands and answer questions during these procedures.
General Anesthesia: This type of anesthesia will render you unconscious. You will be unaware of what is happening, immobile, pain free, and free from any memory of the period of time in which you are anesthetized. The length and level of anesthesia is calculated and constantly adjusted during the procedure. When the procedure is complete, the anesthesia provider will reverse the process and you will regain consciousness in the recovery room.
A. It is important that you follow the instructions you are given in regards to eating and drinking before surgery. When given anesthesia, you lose the ability to protect your lungs from inhaling solids or liquids from your stomach, they could come up into your mouth and then be inhaled into your lungs. This could cause serious, life threatening damage to your lungs.
A. Although all types of anesthesia involve some risk, major side effects and complications from anesthesia are uncommon. Your specific risks depend on your health, your age, the type of anesthesia used, and your response to anesthesia. You should ask your anesthesia provider about any risks that may be associated with your anesthesia.
Post-op nausea and vomiting (PONV) depends on the person and on the type of surgery. Almost everyone receives some type of preventive medication for PONV. If you have a history of PONV be sure to tell your anesthesia provider. They will treat you with the appropriate drugs, however some patients may still experience some PONV.
Research is currently being conducted on how various herbal medications and dietary supplements affect anesthesia. Some are believed to prolong anesthesia and others are believed to increase blood pressure or bleeding. For this reason, it is important to report anything that you take at your pre-op appointment.
Please see our ‘Pre-anesthesia Instructions’ section for more specific information. If you are required to obtain a clearance from another physician, including but not limited to your primary care, cardiologist, pulmonologist, or nephrologist, then you are to follow their recommendation regarding your medication routine. Typically, we have you take your heart medication, blood pressure medication with some exceptions, any lung treatments, and chronic pain and anxiety medications. Typically, we have you skip your morning diabetic medication unless your diabetic management is such that we feel you should consult your endocrinologist. It is important that you list all of your medications and dosages at your pre-op appointment, so that we can instruct you on what should and should not be taken.
YES. You will meet your Certified Registered Nurse Anesthetist (CRNA) and/or your Anesthesiologist (M.D. or D.O.) in the pre-operative area to discuss your health history and your anesthesia plan. Once you go to the operating room, a CRNA or Anesthesiologist will remain with you at all times until you are in the recovery room and an EAS anesthesia provider determines it is safe to transfer your care over to a Registered Nurse (RN) in the post anesthesia care unit (PACU); recovery room. While in the recovery room, your recovery room nurse will remain with you until you are able to be safely discharged. At all times in the post anesthesia recovery phase of your surgery an anesthesia provider will be immediately available.