ACV desires to provide information that can help answer your questions with respect to any surgery procedure or recovery period. Our physicians have expertise in the following areas: General Anesthesia, Cardiac Anesthesia, Ambulatory Anesthesia, Orthopedic Anesthesia, Postoperative Pain Management, Thoracic Anesthesia, Obstetric Anesthesia, Neuro-anesthesia, Pediatric Anesthesia, and Trauma Anesthesia.
Your surgeon and/or referring physician will provide you with information important for the successful outcome of your surgery or procedure. For those concerns or questions specific to anesthesia, please click on the FAQs listed below. If these do not answer your questions, please contact our office and we will direct you to someone who can help.
What is an Anesthesiologist?
Anesthesiologists are highly skilled medical doctors (M.D. or D.O.) who specialize in the field of Anesthesiology.
As physicians with significantly longer and more extensive training than other classifications of anesthesia practitioners, anesthesiologists are the most qualified to make anesthesia related perioperative medical decisions. Anesthesiologists are primarily responsible for the safety and well-being of patients before, during, and after surgery. This may include placing them in the state of controlled unconsciousness called “general anesthesia”, the provision of “regional anesthesia” where only a portion of the body is made numb, or administering sedation when indicated for the relief of pain or anxiety. These anesthetics provide continuous pain relief and sustain patients’ critical life functions as they are affected throughout surgical, obstetrical, or other medical procedures. An Anesthesiologist is the director of the Anesthesia Care Team.
The role of the anesthesiologist extends beyond the operating room. The anesthesiologist is responsible for the preoperative assessment of the patient, an evaluation process that carefully considers both the patient’s current state of health and the planned surgical procedure that allows anesthesiologists to make judgments about the safest anesthesia plan for each individual patient. The anesthesiologist is also responsible for the well being of the patient postoperatively while the patient emerges from the effects of anesthesia. They are often involved in the management or acute postoperative pain, as well as chronic and cancer pain; in cardiac and respiratory resuscitation; in blood transfusion therapies; and in respiratory therapy.
Anesthesiologists in the United States complete a four year undergraduate college degree that includes satisfying pre-med requirements. Like other medical doctors, anesthesiologists must follow undergraduate education with four years of medical school. After medical school, a physician specializing in anesthesiology completes a four-year anesthesiology residency.
Following completion of a residency program, residents are eligible to sit for the American Board of Anesthesiology (ABA) exam. Almost 90 percent of anesthesiologists are board certified.
Although anesthesiologists complete a minimum of eight years of medical training after college, many of our anesthesiologists have completed an additional fellowship year of specialty training in specific areas such as pain management, cardiac anesthesia, pediatric anesthesia, neuro-anesthesia, obstetric anesthesia or critical care medicine.
Anesthesiologists may also seek certification in one of the following subspecialties which require additional training and examinations: Critical Care Medicine, Hospice and Palliative Medicine, and Pain Medicine.
What is an Anesthesia Care Team?
Directed by an anesthesiologist, the Anesthesia Care Team consists of anesthesiologists supervising qualified non-physician anesthesia providers 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 physician anesthesiologists, non-physician nurse anesthetists, and student nurse anesthetists.
What is informed consent?
Informed consent means that you have been presented with your treatment options and that the most common risks and possible side effects have been explained. You will have an opportunity to ask questions, and if you wish to proceed with the anesthesia, to sign an informed consent indicating that this process has occurred. Clearly, in extreme emergencies it may be necessary to waive this step.
What are the different kinds of anesthesia?
In this form of anesthesia, you are unconscious and have no awareness or other sensation. There are a number of general anesthesia drugs; some are gases or vapors inhaled through a breathing mask or tube and others are medications introduced through a vein. During anesthesia, you are carefully monitored and cared for by your anesthesia care provider. The length and level of anesthesia is calculated and constantly adjusted throughout your anesthesia. At the conclusion of surgery, your anesthesia care provider will reverse the process and you will regain awareness in the recovery room.
In this form of anesthesia your anesthesia care provider makes an injection near selected nerves to numb the area of your body that requires surgery. Types of regional anesthesia include epidural, spinal, and selected individual nerve blocks. Epidural and spinal anesthesia are common in obstetrics, orthopedics, and other specialty areas. Selected individual nerve blocks are also widely utilized not only to provide pain relief during the operation but well into the postoperative period. Nerve stimulation and/or ultrasound is often employed in the placement of these blocks to ensure their success.
MAC (monitored anesthesia care)
In this form of anesthesia, the anesthesia provider administers sedation and monitors vital body functions while the procedure is ongoing. In many instances a local anesthetic is also administered, usually by the surgeon, at the site of the surgery. These patients are sedated, but not completely unconscious.
What are the risks of anesthesia?
All operations and all anesthesia have some risks, and they are dependent upon many factors including the type of surgery and the medical condition of the patient. Fortunately, adverse events are very rare. Your anesthesiologist takes precautions to prevent problems from occurring. The specific risks of anesthesia vary with the particular procedure and the condition of the patient. You should ask your anesthesiologist about any risks that may be associated with your anesthesia.
As with any other medical procedure, results cannot be guaranteed. Unexpected reactions or complications may occur. Patients with apparently similar medical conditions may have varying responses to certain anesthetics or procedures. Possible risks include, but are not limited to allergic reactions; infection; pneumonia; inflammation of the veins; nerve injury or paralysis; damage to or failure of the heart, liver, kidneys and/or brain; and death. These more severe complications are highly unlikely but can occur in some cases, regardless of the experience, care, and skill of the anesthesia provider.
What about eating or drinking before my anesthesia?
As a general rule, you should not eat or drink anything after midnight before your surgery. Under some circumstances, you may be given permission by your anesthesiologist to drink clear liquids up to a few hours before your anesthesia. The reason for this is to minimize the risk of stomach contents entering your lungs during your anesthesia. In some situations this can be life threatening.
Should I take my usual medicines?
Some medications should be taken and others should not. It is important to discuss this with your surgeon. Do not interrupt medications, unless your anesthesiologist or surgeon recommends it.
Could herbal medicines, vitamins, and other dietary supplements affect my anesthesia?
Anesthesiologists are conducting research to determine exactly how certain herbs and dietary supplements interact with certain anesthetics. They are finding that certain herbal medicines may prolong the effects of anesthesia. Others may increase the risks of bleeding or raise blood pressure. It is very important to tell your doctor about everything you take before surgery. As a general rule, we recommend that you stop all herbal medications and dietary supplements for one week prior to surgery.
Will I be nauseated after my surgery?
The cause of postoperative nausea and vomiting (PONV) is thought to be multifactorial, involving individual, anesthetic, and surgical risk factors. The incidence of nausea and vomiting within the first 24 hours after surgery affects 30% of all patients and up to 80% of patients deemed to be high risk. If you have a history of PONV be sure to tell your anesthesia provider. We desire to employ medications and techniques to eliminate PONV to the best of our ability. However, despite these efforts some individuals may still experience some PONV.
Should my throat be sore after surgery?
A sore throat after general anesthesia is not uncommon, occurring about 20-30% of the time. In most cases, it is mild, and gets better without treatment over a couple of days. It is unusual for the soreness to last longer than a few weeks. If this does occur, please contact your doctor.
How will my pain be managed after my surgery?
The most common method of pain control immediately after surgery in the recovery room is by pain medication administered through an intravenous line. For patients going home, a transition is usually made to pain medication taken by mouth. For those patients spending the night in the hospital, a “PCA” pump is often used.
PCA stands for patient controlled analgesia. Your surgeon will usually order a PCA if you have had major surgery or are spending more than one day in the hospital. You will control the dosing of the pain medication by pressing a button attached to a pump. The pump has built in safety controls that keep you from getting too much pain medication.
In addition to the traditional approaches mentioned above, your anesthesia provider has skills in placing epidurals, spinals, and selected nerve blocks which can provide many hours, and in some cases days of pain relief after your operation.