About Anesthesia
 
What is anesthesia?
Anesthesia is the use of medicine to keep you safe, comfortable and as pain free as possible during surgery.
 
Can I choose my anesthesia?
Yes, in certain situations.  Some procedures can be done using different anesthetic methods.  After the anesthesiologist reviews your individual situation, you can discuss your options with him or her.
 
What are the types of anesthesia?
 
  • Local anesthesia numbs only the part of the body where you will have surgery.  Anesthetic medicines are injected or applied topically to temporarily block nerves in the surgical area. This type of anesthesia is used for minor (simple) procedures. Because local anesthesia affects just the nerves in the surgical area and not your brain, you will be awake during the procedure.
  • Regional anesthesia involves injecting anesthetic drugs near nerves and results in numbing larger portions of the body, so pain signals cannot reach the brain. This type of anesthesia is used for certain procedures to the abdomen, pelvis, arms or legs. The common types of regional anesthesia are spinal anesthesia, epidural anesthesia, and nerve block anesthesia. You may be awake during the procedure, but you may be given medication that will make you feel relaxed or sleepy. There is always a possibility that a local or regional anesthetic may have to be converted to a general anesthetic if it wears off sooner than expected or there are any other problems during surgery.
  • Monitored anesthesia care (MAC) is intravenous (through the vein) sedation. You may still be awake during the procedure, but you will be in a more relaxed state. This type of anesthesia may be used for less invasive (not deep into the body) surgery. 
  • General anesthesia temporarily produces unconsciousness and is needed for major operations, so your brain does not perceive any pain signals. It involves both intravenous and inhalational agents. With this type of anesthesia, you will be completely unconscious during a surgery, with no sensations, feeling of pain, awareness, movement, or memory of the surgery. Most of our procedures at City of Hope involve a general anesthesia.

Why do you ask about my medical history?
The anesthesiologist is responsible not only for the anesthesia, but also for your medical care during the entire course of surgery.  Therefore, the anesthesiologist must be very familiar with your medical condition.

Why do you ask about drinking and smoking?
Tobacco and alcohol affect your lungs, heart, liver and blood and can change the way an anesthetic drug will work during surgery.  Alcohol interacts with all medicines used for anesthesia.  In addition, smoking may delay or prevent tissue or wound healing after surgery.

Why do you ask about herbal preparations?
Many herbal products on the market are considered safe, but others may be potentially harmful.  Some of these products can cause side effects or react with your other medicines.  They may intensify the effect of the anesthetic, interfere with blood pressure or cause bleeding.  It is essential that you tell your doctor if you are using herbal preparations and which ones you use.  Your doctor will discuss this with you and may make recommendations about continuing, changing or stopping them before surgery.

Why does the anesthesiologist ask me all these same questions again?
Asking you the same question again serves several purposes.  First, the pre-operative interview serves as an additional means to verify your identity.  Second, it is not unusual for patients to recall significant events or details during the interview that were left out of written responses.  Third, it gives you one more opportunity to ask questions that you may not have thought of or not had a chance to ask.

Can I get addicted to the drugs you give me?
There is no evidence that any drug given during anesthesia may cause addiction.

Why can I not eat or drink before surgery?
Your doctor may tell you to fast (no food or liquids) before surgery so there is less chance of vomiting and aspirating (inhaling into the lungs) any undigested food or liquids during the procedure.  This can cause pneumonia or even death.

Will I be completely asleep during the procedure?  Will I wake up in the middle of my operation?
If you are having a general anesthetic, you will be completely asleep and will not wake up in the middle of a procedure.  There are reports of awareness under anesthesia, but they are extremely rare.  If this issue concerns you, ask your anesthesiologist more details before surgery. If you are having a local or regional anesthetic, with or without intravenous sedation, you may be more or less aware of what is going on, as your surgeon requires and as your medical condition allows. Sometimes surgeons want the patient to be able to follow commands and answer questions; in that case, the patient needs to be more awake.

How do you adjust the duration of anesthesia?
The anesthesiologist will give an initial dose of anesthetic based on the patient's weight and general health condition.  The patient is then given the medicine continuously until the end of the surgery.  Once the anesthetic is stopped, most patients generally wake up within 10 to 20 minutes.  Most anesthetic drugs in use today have a very short duration.

Why do people sometimes have a sore throat after general anesthesia?
During general anesthesia your breathing is controlled through a tube inserted in your throat.  Sometimes this tube causes irritation and a sore throat.  This is temporary and will go away in a day or two without further treatment.

How will my nausea be controlled after my procedure?
This is a common side effect after surgery and can range from none or mild to severe.  Your doctor will order medication to lessen nausea as you recover.  Your doctor or nurse may suggest other nondrug methods to help control your nausea.

I have had many anesthetics; will that make me lose my mental abilities? 
No, there are many patients who have received multiple anesthetics and never had any effects on their mental abilities.