Frequently Asked Questions

For Patients Having Aesthesia For Surgery

What is an anesthesiologist?
What is an anesthetist?
Can I request the anesthesiologist and/or anesthetist for my procedure?
What are the different types of anesthesia?
Can I request the type of anesthesia I want?
How do you put me to sleep?
Is it possible to wake up during the surgery?
Why can't I eat or drink before I have anesthesia?
What drug will I receive to put me to sleep?
What is a spinal block?
Will there be someone with me during the operation?
How long will I be at the hospital if I am having "Same Day Surgery"?
How will my pain be managed after my surgery?
What are the side effects of anesthesia?
What are the risks of anesthesia?
Is the anesthesia included in my hospital bill?


Answers

What is an anesthesiologist?
An anesthesiologist is a doctor who completed medical school and specialized in anesthesiology. The training required after medical school to be an anesthesiologist includes a one year internship followed by three years of anesthesiology training. Some anesthesiologists spend additional years studying a subspecialty of anesthesiology, such as pain management.

What is an anesthetist?
An anesthetist is an individual who graduated from college and completed additional training in anesthesia school. Their training may be as a nurse (certified registered nurse anesthetist, CRNA) or an anesthesiologist assistant (AA). Together an anesthesiologist along with an anesthetist make up what's known as the anesthesia care team.

Can I request the anesthesiologist and/or anesthetist for my procedure?
Yes. However, for a variety of reasons it may not be possible to honor all requests. For instance, the individual you requested may be assigned to a different facility on the day your procedure is scheduled. We make every effort to honor your request if possible.

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What are the different types of anesthesia?
There are three types of anesthesia. The first is local anesthesia. This is when the surgeon injects medication under the skin to numb the area of the surgery and is similar to when a dentist numbs your tooth before a filling. New London Anesthesia may be asked to be with you and monitor you during local anesthesia. Sometimes you are given sedative medications during local anesthesia to reduce anxiety and pain but you are typically awake.

The second type of anesthesia is regional anesthesia. This is when a larger region of your body is anesthetized. An example of regional anesthesia is a spinal block which numbs the lower half of your body. You may be given sedative medications to reduce anxiety and you may not remember everything during your surgery but you are not completely asleep.

The third type of anesthesia is general anesthesia, or being put to sleep. This is the most common type used for major surgery. It involves giving you medications that cause you to lose consciousness completely.

Can I request the type of anesthesia I want?
Yes, but not every type of anesthesia is appropriate for every surgery or procedure. Furthermore, your medical history may make one type of anesthesia safer than another type for you. During your consultation with the anesthesiologist you will have the opportunity to discuss this.

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How do you put me to sleep?
For adults it is usually accomplished by injecting medication slowly into an IV until you lose consciousness. Then you are given additional medications, either into your IV or by inhaling it, which keep you asleep. It is often necessary to place a tube in your throat or windpipe after you go to sleep to assist you with breathing. When the surgery is over the anesthesia medicines are discontinued and you begin to wake up as their effects wear off. The breathing tube is removed when you are able to breathe well enough on your own, usually before you wake up fully.

In children it is common to use an inhaled anesthetic to go to sleep. After your child is asleep an IV may be inserted to give fluids and other medications through.

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Is it possible to wake up during the surgery?
As with all medical procedures there are risks. The risk of waking up during your surgery is extremely rare and usually involves only hearing bits of conversation but not feeling pain. Situations where the normal amounts of anesthesia cannot be used, such as pregnancy, trauma, severe heart problems, or other medical problems, may increase your risk of this problem. If this has occurred to you before, make sure the anesthesiologist is aware of it during your preoperative consultation.

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Why can't I eat or drink before I have anesthesia?
When you have anesthesia of any type you may lose your protective reflexes such as the "gag" reflex. This may allow stomach contents to be vomited and then inhaled into the lungs. This condition is referred to as aspiration and can lead to pneumonia and even death. It is important that you follow the instructions of the doctors and nurses who speak to you preoperatively as to the last time that you may eat solid food or drink liquids. Even chewing gum, breath mints, hard candy, or ice chips may increase your stomach contents and/or the acid in your stomach. If you require emergency surgery and have recently eaten, special precautions are taken to reduce this risk but it is not possible to eliminate it altogether so it is safer to not eat or drink before surgery whenever possible.

What drug will I receive to put me to sleep?
This is actually a very complicated question to answer. In most cases you will receive between 5 and 10 different medicines during your anesthesia. There are medications given to prevent anxiety, pain, or nausea. There are medications given to induce sleep and muscle relaxants may be given to allow the surgeon to operate in a muscular area. Some medicines are used to reverse the side effects of other medicines. Sometimes medications may be needed to lower the heart rate, raise the heart rate, or to raise or lower the blood pressure. It may be necessary to give you medicines to prevent or treat breathing or heart problems. Some of the medications are given orally, some IV, and some are inhaled. The specific medications you need may not be fully known until after the surgery is over as no two people will respond exactly the same to anesthesia and surgery.

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What is a spinal block?
A spinal block is a type a type a regional anesthetic where the lower half of your body is anesthetized or numbed. Your back is cleansed with an antiseptic solution and the skin is numbed in the lower, or lumbar, area with a small needle. Then another needle is inserted into this area and between your back bones into the spinal fluid. Anesthetic medication is placed in the spinal fluid and the needle is removed. The choice and amount of medication used depends on how long the surgery is expected to last and a spinal block can numb you from 1 hour to several hours.

Will there be someone with me during the operation?
Yes. The anesthesiologist or anesthetist will stay with you the entire time you are in the operating room.

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How long will I be at the hospital if I am having "Same Day Surgery"?
Same day surgery usually refers to being able to go home on the same day as the surgery. You will be instructed as to your arrival time, which is usually between 1 & 1 hours before the surgery is to start. Most people will be ready to go home between 2 and 3 hours after surgery if they have general or spinal anesthesia and 1 hour afterwards if they have only local anesthesia.

How will my pain be managed after my surgery?
You will be given pain medicines in your IV during your surgery to minimize the pain upon waking up. In some cases local anesthesia will be injected by your surgeon in the wound while you are asleep to reduce your pain. If you go home on the day of your surgery, you will be given prescriptions by your surgeon for pain pills as necessary. If you stay in the hospital after your surgery there are a variety of methods for controlling your pain. One is a patient controlled analgesia (PCA) pump which is connected to your IV drip. You will be given a hand control with a button on it to push anytime you need pain medication and the pump will deliver some to you. A second method of pain control is a nerve block such as a shoulder block for shoulder surgery or an epidural for abdominal or leg surgery.

What are the side effects of anesthesia?
Side effects after anesthesia depend on the type of anesthesia you have, the part of your body that you are having surgery on, and your own body's individual response to the anesthesia. Some of the common side effects include: nausea, vomiting, grogginess, sore throat, muscle pain, headache, backache, and amnesia. These effects usually only last a few hours but some people report longer effects. Discuss any previous problems you may have had from anesthesia with your anesthesiologist before surgery.

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What are the risks of anesthesia?
Anesthesia has become much safer over the past 30 years as we have more understanding of how anesthesia affects you, have newer anesthesia medications to choose from, and use better methods to monitor your well being during surgery such as heart and oxygen monitors. Patients are now better prepared for surgery as well. It is common to give anesthesia to older patients and to those with more serious medical problems than were once seen.

However, as with all medical procedures there are risks from anesthesia. Some of the risks include infection from a needle site or pneumonia, drug reactions including allergic reactions, or injury to a fetus or miscarriage if you are pregnant. It is possible to have an injury to your vocal cords, damage to your teeth, or injury to your tongue or lips because it is frequently necessary to put a breathing tube in your throat or windpipe. In very rare cases you may suffer an eye injury or loss of vision, nerve injury from laying in one position during surgery, brain damage from lack of oxygen or stroke, awareness during surgery, heart attack, and even death.

In addition to these there are other risks from epidural or spinal anesthesia including: backache, headache from a leakage of spinal fluid, seizures from the anesthetic medication being injected into a blood vessel, difficulty breathing from the numbness level being too high or inadequate anesthesia. Nerve blocks can cause an injury to a blood vessel or nerve, permanent weakness, or lung collapse if the needle is in the area of the lung. These will be discussed with you more specifically during your consultation with the anesthesiologist.

Is the anesthesia included in my hospital bill?
The anesthesiologists are private practicing physicians just like your surgeons are and you will receive a separate bill from New London Anesthesia and Pain Consultants, P.C. We will usually bill your insurance company for you first and let you know what the remaining co-payments and deductibles are.

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