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Patient FAQs

Here are some frequently asked questions about anesthesia. Please reach out to your anesthesiologist and doctor(s) for any questions or concerns you may have in regards to your personal anesthesia care.

What are the risks from anesthesia?

While your exact risks will depend on your anesthetic and your personal health history, anesthesia is very safe overall. 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. Advancements over the last twenty years in monitoring and equipment have made our profession among the safest in the medical specialties.

Nevertheless, any procedure assumes some amount of risk. The most frequent complications with anesthesia include reactions to medications, high or low blood pressure, and breathing or airway problems. More common complications include scratched cornea of the eye, sore throat, chipped teeth, sore muscles, or nerve injury.

Risks include:

  • Death or serious injury from anesthesia--Extremely rare, less than 1:100,000
  • Injury to nerves - may occur two ways. In some cases your position while you are asleep may put pressure on a nerve that leaves it injured after the surgery. We go to great lengths to pad pressure points and ensure this does not occur, but on rare occasions nerve injuries have occurred without obvious cause. In the case of a nerve block, there is a remote risk that the needle used to do the block may injure the nerve.
  • Reactions to medications - True drug allergies are very rare, and in most cases the safest place to have an allergic reaction is under the care of an anesthesiologist, so complications are very uncommon. More common problems are nausea, itching, and low blood pressure, though these are usually manageable.
  • Aspiration - this refers to the inhalation of stomach contents into the lungs. Again, this is rare, but this is why we insist on patients fasting before coming to the operating room.

General Anesthesia

  • In addition to the risks above, teeth may be chipped or dislodged when the breathing tube is inserted. This is not common, but patients with small mouths and/or poor dental condition are at higher risk. Also, minor injuries to lips and the tongue may occur, and sore throat after surgery is possible due to the presence of the breathing tube. Some patients experience sore muscles, and nausea and vomiting is a post-operative risk.

Spinal or Epidural Anesthesia

  • A specific risk of spinals and epidurals is headache, specifically a post-dural-puncture headache, and occurs around 1% of the time (less with epidurals). Some patients experience itching. Both of these complications can be treated. An extremely rare but serious complication is epidural hematoma, though this is primarily a concern in patients with clotting problems or on blood thinners

If I have a regional anesthetic, I don't want to see or hear anything.

Whenever we perform a regional block, we will usually provide sedation during the surgery itself, and the majority of patients don't remember the operation at all.

Still, it is possible that you will remember being in the operating room. For cases like these it is important to remember that you will be completely numb, that you will not be able to see the surgery because of the sterile drapes, and that at all times your anesthesiologist will be sitting right next to you.

If you are uncomfortable, nervous, or just want some reassurance, he or she is at your side to take care of you. Our only concern is your comfort and well-being.

Will I wake up during surgery?

The occurrence of a patient being aware during surgery undergoing general anesthesia is extremely low, despite what is show in movies.

We have a number of methods to monitor a patient's sedation and comfort during surgery. Rarely, extremely rarely for general anesthetics, patients may have some recall of the operation. If you are concerned, please speak to your anesthesiologist or healthcare provider before the surgery.

What does the anesthesiologist do during the surgery?

He or she is at the head of the bed, monitoring your vital signs, breathing, ensuring you are receiving adequate anesthesia and pain medication, and giving you whatever fluids (or blood transfusions) are necessary. There is always an anesthesiologist or nurse anesthetist present during the surgery.

Do I have to have a breathing tube?

The short answer is that it depends on you and your surgical procedures.

Some surgeries, namely large surgeries in the chest, abdomen, or head, virtually always require a breathing tube to protect your airway and ensure you are breathing. Many other surgeries do not require a breathing tube per se but it may be advisable given the length of surgery or your medical conditions.

Your anesthesiologist will be able to discuss this with you. Bear in mind that if a breathing tube is required you will be asleep when it is placed. The vast majority of patients have no memory of the breathing tube.

Will I experience nausea and vomiting after the surgery?

Everyone is different with regard to their sensitivity to anesthesia and nausea. Many patients have no problems at all. Some patients experience minor nausea that is readily treated with medications.

A small percentage of people consistently have severe nausea post-operatively. If you have had severe nausea in the past, be sure to alert your anesthesiologist as he or she may be able to modify your anesthetic to reduce the risk.

Should I take my regular medications?

This is definitely a question you want to ask your surgeon and the preoperative clinic, as many medications should be taken and many others should not. Be sure you are given clear instructions on which of your medications to take and which to skip the morning of surgery.

If you do have medications you are instructed to take the morning of surgery, it is generally permissible to take them with a small sip of water (not a glass of water, a sip!).

Diabetes Medications: Do not take oral diabetes medications on the morning of surgery (this group includes drugs like metformin, glyburide, glipizide, etc.) If you take injectable insulin the clinic will provide you with specific instructions on your insulin dosing for the day of surgery.

Who will give my anesthesia?

Before your surgery, you will meet an important physician specialist, your anesthesiologist. A vital member of the surgical team, your anesthesiologist has the responsibility for your welfare when you undergo anesthesia. The anesthesiologist is your advocate in the operating room. It's more than just "putting you to sleep." Your anesthesiologist cares for your breathing, your brain, your heart, your blood circulation, your kidneys and other important bodily functions during an operation. He/she gives you anesthesia to ensure unconsciousness, prevent and treat pain, and relax your muscles during surgery so the operation can be done. He/she cares for you so that your surgeon can focus on the operation. An anesthesiologist is a physician specialist who looks after patients during surgery. Because of the anesthesiologist's involvement, surgery or diagnostic procedures can be performed safely, without pain and stress. The specialized anesthesiology training allows this physician to safely anesthetize patients and to recognize and treat medical problems that may arise during and after surgery. Your anesthesiologist is also responsible to wake you up comfortably and safely, and take care of you during the immediate postoperative period.

Anesthesiologists have been instrumental in reducing the incidence of deaths and medical complications during this period.

How an anesthesiologist is qualified to serve you?

Anesthesiologists are doctors of medicine who, after graduating from college with a strong background in physics, chemistry, biology and mathematics obtain a medical doctorate degree after completing four years of medical school. Following medical school, they learn the medical specialty of anesthesiology during an additional four years of post medical school training - one year of internship and three years in an anesthesiology residency program.

During the first year, anesthesiologists must complete training in diagnosis and treatment in other areas of medicine - such as internal medicine, neurology, obstetrics, pediatrics or surgery - or complete a rotating internship where they spend an equal amount of time training in each of the other areas of medicine.

Today's anesthesiologists then spend three intensive years of training in anesthesiology learning the medical and technical aspects of the specialty. In addition, they may further specialize in a subspecialty, such as neurosurgery, pediatrics, pain or intensive care by completing one to two more years in a subspecialty-training program.

Today's anesthesiologists are innovators in their field, continuing a long tradition of advancing the practice of modern medicine. Even after residency training is completed, they continue studying new medical advances and anesthetic techniques, so that every patient experience can be safer than the next. They specialize in cardiology, critical care medicine, internal medicine, pharmacology and surgery to be able to fulfill their role in modern medicine.

What is the Center for Perioperative Care?

The purpose of your interview by the Center for Perioperative Care is to verify information about your health history to allow the anesthesia team to make the best plan for you to have the best experience possible. There are special features of a medical history important to anesthesiologists, and this will also allow you the time to ask questions you may have and receive teaching about your upcoming anesthetic.

What is an Anesthesia Care Team?

Directed by an anesthesiologist, the Anesthesia Care Team consists of anesthesiologists supervising qualified non-physician anesthesia providers and/or resident physicians in training in the provision of anesthesia care.

In an Anesthesia Care Team, anesthesiologists may delegate patient monitoring and appropriate tasks to non-physician anesthesia providers while retaining overall responsibility for the patient.

Members of the Anesthesia Care Team work together to provide the optimal anesthesia experience for all patients. Core members of the anesthesia care team include both physicians (anesthesiologist, anesthesiology fellow, anesthesiology resident) and non-physicians (anesthesiologist assistant, nurse anesthetist, anesthesiologist assistant student, and student-nurse anesthetist). Other health care professionals also make important contributions to the peri-anesthetic care of the patient.

To provide optimum patient safety, the anesthesiologist directing the Anesthesia Care Team is responsible for management of team personnel, patient pre-anesthetic evaluation, prescribing the anesthetic plan, management of the anesthetic, post-anesthesia care and anesthesia consultation.