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Information on Anesthesia
Today’s anesthesiologists serve a central and critical role before, during, and after surgery. They make informed medical judgments to protect and regulate the critical life functions that are affected by the surgery being performed. These medical specialists are physicians who immediately diagnose and treat any medical problems that may arise during surgery or the recovery period. In some hospitals, nurse anesthetists may assist the anesthesiologists in providing anesthesia care. However, the anesthesiologist is responsible for the interpretation of the monitoring; he/she makes educated medical judgments concerning your responses, and when it is and when it is not appropriate to treat you.
It is our goal that you have your surgical procedure with the utmost safety, efficiency and comfort. We strive to do everything possible to help you to recover quickly and easily. In creating this web page, we wish to tell you how the experts in anesthesiology at the University of Rochester Medical Center (URMC) hope to achieve these goals. It is our privilege to participate in your care.
Preoperative Evaluation
Proper anesthetic management begins with a preoperative evaluation. This occurs before the surgical procedure, either several days in advance of your surgery or just before your surgery begins. A good preoperative evaluation looks at your overall state of health. This is important because it helps us tailor your anesthetic specifically for you and make sure you are in the best possible medical condition for surgery. It also helps us anticipate possible problems and take the proper steps to avoid them. Special emphasis is usually given to the health of your heart and lungs. During the preoperative evaluation you will have an opportunity to ask any questions or discuss any special concerns you may have regarding your anesthetic.
Types of Anesthesia
There are four main categories of anesthesia, each having many forms and uses. They are:
- General
- Regional
- Local
- Sedation
In 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.
In regional anesthesia, your anesthesiologist makes an injection near a cluster of nerves to numb the area of your body that requires surgery. You may remain awake, or you may be given a sedative; either way you do not see the surgical procedure and most likely will not feel any pain associated with it. There are several kinds of regional anesthesia; the two most common are spinal anesthesia and epidural anesthesia. It is also possible to block the nerves to a specific region of the body (arm or leg) and may be performed using ultrasound guidance.
In local anesthesia, the anesthetic drug is usually injected into the tissue to numb just the specific location of your body requiring minor surgery.
In sedation, intravenous medications are given to provide comfort and relieve anxiety during the surgery or procedure. It is possible to be awake and aware during many kinds of sedation. Again, the goal is to keep you comfortable.
Certain types of surgery may require certain types of anesthesia. Your anesthesia team, in consultation with your surgeon, will discuss what kind of anesthesia will be best for you.
Risks
Unfortunately, no medical procedure is without risk. This is also true for anesthesia. However, you should know that the art and science of anesthesiology have improved enormously over the past 60 years. Indeed, the field of anesthesiology has an excellent safety record, and continual efforts in education, training, and technology have insured that our safety record continues to improve. Anesthesiologists do their best to anticipate complications and avoid them whenever possible. The most common complications of anesthesia include a temporary sore throat, and nausea and vomiting after surgery. Rarely injury to the mouth, teeth or nerves can occur. Even more rare events which can be serious are possible, and can be discussed with you by your anesthesia team if you wish.
Going to the Operating Room
Your anesthesia team may give you a light sedative before entering the operating room. Once there, you will be transferred to the operating room table, and monitors will be placed. During surgery, advanced technology is used to monitor your body’s functions, and your anesthesiologist will interpret the information from these sophisticated monitors in order to appropriately diagnose, regulate, and treat your body while a personalized, delicate balance of anesthetic medications is administered.
Going to the Recovery Room
At the end of the surgical procedure, we will stop administering anesthetic medications (for general anesthesia and sedation) and allow you to wake up. Regional and local anesthetics are allowed to wear off naturally, and can provide pain relief after surgery. You will then be transported to the recovery area when it is safe to do so. There you will continue to emerge from anesthesia, and any discomfort you may have will be treated. You will be monitored during this time to insure your well-being.
For Further Information
Further information regarding the practice of anesthesiology can be found on the American Society of Anesthesiology’s informational website Lifeline to Modern Medicine