Anesthesiology

Anesthesia is usually safe for healthy people, but you might be at higher risk for problems if you:

• Have abused alcohol, medicines like opioids or narcotics, or street drugs in the past.
• Have allergies or a family history of allergies to medicines, especially anesthetics.
• Have heart, lung, or kidney problems.
• Are a smoker.

Some side effects of anesthesia can include:

• Temporary mental confusion
• Nausea
• Constipation
• Trauma to the teeth or tongue
• Allergic reaction to the drugs
• Harm to your vocal cords
• Anesthesia awareness (waking up during anesthesia)
• Lung infection
• Stroke
• Heart attack
• Death

The side effects, especially the more severe ones, are rare. Most people have anesthesia and recover from it with no serious side effects.

Since surgery involves operating on your body by cutting or changing it, these procedures would be extremely painful without anesthetic. Another problem with surgery is that the body can go into shock when it loses blood or is in too much pain. Shock can cause serious problems and death.

Anesthesiology stops you from feeling pain or even being awake for the surgery, and it can also stop the symptoms of shock. This lets your surgeon and your medical team operate on you more safely and with fewer risks. It also makes more complicated surgeries possible, since the anesthetic can last a long time.

Having surgery can be stressful, and an anesthetic, especially combined with a sedative, can make you less anxious and worried about your surgery and the steps needed to prepare for it.

If your healthcare provider recommends a surgery or procedure that includes anesthesia, you should tell them as much as you can about your health, including:

• Any new illnesses, injuries, or other conditions.
• Any medicines you’re taking, including prescription and over-the-counter medicines, as well as supplements, herbs, and vitamins.
• Allergies to medicines, foods, latex, rubber, or anything else.
• Chronic medical conditions like high blood pressure, heart disease, kidney or liver disease, acid reflux (heartburn), sleep apnea, asthma, or diabetes.
• Any problems you or a family member have had with anesthesia in the past, like allergic reactions, bad reactions, or the medicine not working as well as it should.
• Any hearing or language problems that could stop you from understanding everything the doctor, surgeon, or anesthesiologist tells you.
• If you are or could be pregnant.

Your healthcare provider will have specific instructions for you to follow on the day of your surgery or procedure. They might tell you to:

• Avoid eating or drinking for a certain period of time before the surgery.
• Patients with a diagnosis of gastroparesis (mild stomach paralysis) or prior aspiration (breathing fluid into the lungs) under anesthesia should not have any food or drink after 11 PM prior to the day of surgery.
• All other patients should follow these instructions unless otherwise directed by their doctor:
• Avoid any solid food after 11 PM the night before surgery. This includes alcohol, mints, gum, or candies.
• Avoid drinking any nonhuman milk 6 hours prior to your scheduled check-in time. This includes cow, soy, or rice milk.
• Infants may drink formula up to 6 hours prior to scheduled check-in time.
• Breastfed infants must finish their last feed 4 hours prior to check-in time.
• You are encouraged to drink clear liquids up to 2 hours prior to your scheduled check-in time. Clear liquids include water, glucose (sugar) water, fruit juices without pulp, carbonated beverages, sports drinks, clear tea, and black coffee. Clear liquids do not include alcohol, orange juice, broth, milk, or infant formula.
• Take essential oral medicines as needed on the day of surgery with a sip of water.
• Take certain medicines with a small sip of water. Your doctor might prescribe certain medicines to calm you before the surgery or prepare your body for your procedure.
• Arrive at the hospital on time.

These are just general guidelines. Your anesthesiologist, surgeon, and other healthcare providers will have specific instructions for you to follow. You should ask questions to make sure you understand exactly what you need to do.

Your doctor or anesthesiologist might prescribe you a medicine that you take before the surgery. Sometimes, this is a sedative that will calm you down and help the anesthetic work better.

When it’s time for your surgery, your anesthesiologist and surgical team will:

• Make sure you’re comfortable on the bed or table you’re lying on.
• Attach you to equipment that will monitor your heart rate, breathing, and oxygen levels to make sure you stay safe during the surgery.
• Put an IV in your arm to deliver the anesthetic and other medicines.
• Put a mask over your face and ask you to breathe in the medicine (if you are getting a gas-based anesthetic).

Anesthesia is a treatment that is done during surgery so you won’t feel any pain during the surgery or other procedure. If you are taking a general anesthetic that puts you to sleep, you will fall asleep before the surgery starts and won’t be awake during it.

Usually, no follow-up is needed after anesthesia. You should talk to your doctor, surgeon, or anesthesiologist if you experience any of the side effects listed above, but these are rare.

During recovery, you will likely experience some pain related to your surgical procedure. After you leave the hospital:

• Try to manage the pain with acetaminophen or ibuprofen first. If this doesn’t take the edge off then take pain medicine as prescribed by your surgeon. Remember the purpose of pain medicine is to help manage your pain. It will likely not take away all the pain. If your pain is not manageable while using pain medicines, ice, and other recommendations from your surgeon, please contact your doctor.
• Take your regular medicine when you get home or when your doctor says it’s okay.
• Always take your pain medicine with food.
• Never drink alcohol or use street drugs while taking pain medicine.
• Never take more pain medicine than what your doctor prescribed.
• Be careful as you walk or climb stairs. Pain medicine may make you dizzy or sleepy.
• Do not drive if you are taking pain medicine.
• Consider taking an over-the-counter stool softener or laxative to prevent or treat constipation. Pain medicines cause constipation, which will slow your recovery and increase your pain. If you don’t have a bowel movement (poop) about every 3 days after surgery, call your doctor.

Anesthesiology [ann-ess-TEE-see-AH-loh-jee] is the study and use of anesthetics [an-es-THET-iks], medicines that stop you from feeling pain. Anesthetics are given by a nurse anesthetist or an anesthesiologist, a special doctor who has training in using these medicines safely.

Your anesthesiologist might use several different kinds of anesthesia depending on the procedure or surgery you need. The basic types include sedation, local, regional, and general anesthesia.

• Sedation is the use of medicines to help you relax without losing consciousness.
• Local anesthesia only affects a small part of your body, like part of your arm or a certain part of your mouth. It is often used for smaller procedures like removing a small lump from your skin or filling a cavity in one of your teeth.
• Regional anesthesia makes part of your body numb. The area is usually larger than it is for local anesthesia; for instance, regional anesthesia might numb your entire arm or your leg. Spinal and epidural [eh-pee-DOO-ruhl] anesthesia are types of regional anesthesia given by an injection into your spinal cord. The nerves in your spine send and receive signals from every part of your body, so injecting a numbing medicine into your spine can stop you from feeling pain in different parts of your body.
• General anesthesia affects your whole body. It makes your entire body numb, and lets you fall asleep so you’re not awake for the surgery or procedure.

Anesthetics are often combined with sedatives, which are medicines that help you relax so you will be less anxious and stressed about the surgery. Sometimes you can take a sedative and stay awake so your surgeon can ask you questions during the procedure, but higher doses of sedatives can make you fall asleep and might be combined with anesthetics.