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1. What is an anesthesiologist?
Anesthesiologists are physicians who have specialized training that
allows them to provide pain control, pain relief and care for the
general well-being of the patient in the operating room. They are
able to regulate changes in breathing, heart rate, blood pressure,
etc., that are important to your condition while undergoing surgery.
The anesthesiologist acts as the advocate for the patient when the
patient is under anesthesia and unable to perform that role themselves.
Anesthesiologists have completed college, four years of medical
school, a medical or surgical internship and three years of anesthesiology
residency.
2. Is
there anything else that anesthesiologists do?
Anesthesiologists also fulfill a role outside of the operating room
with their knowledge of pre-operative assessment and planning, analgesia
for labor and delivery, critical care in the intensive care unit
and recovery room, postoperative pain management and management
of chronic pain syndromes.
3. What
are the pre-surgical appointments for? Why are there so many questions?
The pre-surgical appointments serve a dual purpose. First, they
are a chance to gather important information about you and your
medical condition in order to ensure your safety and your comfort.
In addition, it is a chance for you to ask any questions you might
have about what is going to happen, make decisions about your options
and give informed consent.
4. What
is informed consent?
Informed consent means that you, the patient, has been presented
with the options for treatment, the common and serious risks and
expected benefits of each option and the likely outcomes of the
treatment, or of no treatment. In addition, you should be given
a chance to ask questions. Informed consent is usually given in
writing and requires a signature (exceptions are extreme emergencies).
5. What
do I need to tell the anesthesiologist?
It is important that you are complete and honest when answering
questions prior to surgery. These questions relate to your general
health and any specific medical conditions that may present a risk
to you. You should be prepared to discuss your health history, the
history of your blood relatives (if known), any medications including
over the counter products, smoking, drug use, past experiences with
surgery and anesthesia, etc.
6. What
kind of anesthesia will I have?
The type of anesthesia will be chosen based on the type of surgery,
your medical condition and your preferences. There are four types
of anesthesia commonly employed - general, regional, monitored anesthesia
care (MAC) and local. In very broad terms: general affects your
entire body and may be given intravenously or as an inhaled gas.
These medications make you dizzy or drowsy and cause you to lose
consciousness. As a result of these medications, you might stop
breathing on your own and therefore you might have breaths given
to you through a mask or a small tube gently inserted into your
lungs through your mouth. Regional anesthesia only affects a section
of your body, making it numb. You may remain awake or be sedated.
Monitored anesthesia care (MAC) involved medications given to make
you drowsy and to relive pain. Local anesthesia affects only the
location of surgery. It is usually injected, but can sometimes be
given as a ointment, cream or spray. You may remain awake or be
sedated for this as well.
7. What
does the anesthesiologist do during the surgery?
In short, the anesthesiologist is responsible for your comfort and
your safety. In addition to giving you the medications needed for
the anesthesia, the anesthesiologist monitors your vital signs (such
things as heart rate, blood pressure, oxygen content, body temperature,
breathing...) and alters them as necessary. He or she is also in
charge of fluids that you might receive and, if necessary, blood
transfusions. Lastly, any other medical conditions that you might
have (diabetes, asthma, hypertension, heart problems) will be treated
by the anesthesiologist while you are in their care.
8. Will
I need to receive blood for the surgery?
Whether you will need a blood transfusion will depend on your medical
condition, the type of surgery you are having, your personal beliefs
and preferences, etc. This should be a topic of discussion with
your surgeon and anesthesiologist.
9. Can
you give me more information on general anesthesia?
General anesthesia is given either intravenously or through the
inhalation of certain gases. Sometimes, the two are combined to
achieve general anesthesia. When you are under general anesthesia
you are unconscious - and thus unaware of what is happening to you
and around you. Your vital signs such as heart rate, blood pressure
and heart rate are carefully monitored and controlled. You may cease
breathing on your own during general anesthesia and the anesthesiologist
may assume control of your breathing. Sometimes this requires a
breathing tube to be inserted - it goes through your throat and
into your lungs.
10. Do
I have to have a breathing tube?
General anesthesia often results in the loss of the ability to breathe
on your own. There are different ways to assist your breathing -
one of which is the breathing tube (known as an endotracheal tube).
There are many situations when the placement of the tube is the
safest and most reliable method to assure adequate breathing. There
are alternatives in other cases including breathing through mask
or other devices. You can discuss this issue with your anesthesiologist
to see if these other alternatives are applicable to your specific
situations.
11. What
is regional anesthesia?
Regional anesthesia refers to the process by which an injection
of local anesthesia is given near your nerves and results in numbness
of the area of surgery. You may remain awake or be sedated. Spinal
and epidural anesthesia are the most commonly known of the regional
techniques and involve injections in the back that result in numbness
of the lower half of your body. There are, however, other types
of regional anesthesia that can numb an arm, a single leg, etc.
12. Can
I request the specific type of anesthesia that I want?
To some degree you can. Some operations can be performed with different
types of anesthesia while some require one technique. Your anesthesiologist
will review your planned surgery and your medical condition. Then
they will be able to discuss your options with you and allow you
to make your preferences known.
13.
What are the common risks of anesthesia?
Luckily the common complications of anesthesia are not particularly
dangerous and the dangerous complications of anesthesia are very
rare. The most common complications include nausea, vomiting, sore
throat, blood pressure changes, and pain. These are usually mild,
not dangerous and easily treated with medication. The more serious
complications include such things as allergic reactions, genetic
conditions, stroke, heart attack, etc. which can lead to serious
disability or death. These more serious complications are very rare.
With the application of new technologies to the field of anesthesia
and the careful monitoring of the anesthesia provider anesthesia
is extremely safe.
14. What
is ambulatory surgery?
Ambulatory surgery refers to any procedure or surgery where an overnight
stay afterwards is not required. This allows a patient to return
quickly to home and complete their recovery in comfortable and familiar
surroundings. It has been proven to be a safe and cost-effective
method which has a high satisfaction rate among patients.
15. Are
there differences in anesthesia?
There are different concerns for the anesthesiologist when presented
with a patient that is supposed to go home after the surgery. Short
acting medications and other anesthetic techniques are utilized
in combination to make this possible. Your surgeon and anesthesiologist
will evaluate your specific medical condition and the type of surgery
you are having to determine if ambulatory surgery is appropriate
for you.
16..
What about eating and drinking?
You should not eat or drink anything before your surgery. The pre-op
nurse will give you instructions about how long you need to fast.
Anesthesia is a risk when it is given with a full stomach as well
and can result in what is known as aspiration. Basically, aspiration
occurs when stomach contents end up in the lungs - this can lead
to a serious pneumonia and a life threatening situation. After the
surgery, you will be given sips of clear liquids first and then
allowed to eat a light meal when you are able.
17. Why
do I need someone to take me home?
The effects of the medications used in anesthesia may last up to
twenty-four hours before they fully disappear. You may also need
someone to stay with you at home during this first twenty-four hours
to assist with your care. This is for your own safety - often patients
feel awake and normal while still under the effects of anesthesia
and might believe that they can perform all their normal activities.
This is not true! Be safe!
18. What
about medications?
The pre-op nurses will give you instructions concerning what medications
to take on the morning of surgery. Once your surgery is completed,
you will receive instructions about when to resume your normal medication
regimen. You may also receive additional medications such as pain
killers or antibiotics after the surgery.
19. Will
I feel sick? What about other side effects?
It is possible that you might experience some nausea and vomiting.
This is usually not serious and can be treated with medication.
You might have a sore throat if you received general anesthesia
with a breathing tube. This is not dangerous or life threatening
and should resolve on its own in a few days. You may have pain from
the surgery and should inform your medical care team so that you
can receive medications for pain control. It is natural to feel
sore from the surgery, but there is no reason for you to be in severe
pain.
20. When
will I be able to go home?
Both LHC and CASC have guidelines that ensure you can take care
of your own basic needs once you leave and return home. Examples
are the ability to stand, walk, go to the bathroom, eat and drink
without nausea, etc. Rarely, it may be necessary for you to stay
overnight and arrangements will be made for this should the need
arise.
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