Anesthesiologists are physicians. They have completed an undergraduate degree, four years of medical school, and four years of residency. Anesthesiologists then navigate through board certification, a rigorous process of written and oral examinations. This extensive training and education equip anesthesiologists to be leaders in the delivery of anesthesia for procedures and surgeries.
A CRNA is an advance practice registered nurse with extensive experience and education. CRNAs have completed an undergraduate degree, a masters or a doctoral degree, and they have several years of critical care experience.
You will have either an anesthesiologist or an anesthesia care team with you in the operating room. The anesthesia care team consists of a CRNA that is directed by an anesthesiologist; this kind of team model is extensively used across the country. You will always have an anesthesia provider with you in the operating room.
We will minimize the likelihood that you have postoperative nausea and vomiting by assessing your risk factors and administering several different medications. Some risk factors cannot be changed (age and gender), but others like the dose and types of opioids or anesthetic agents can be modified.
Reducing your pain as much as possible is one of our highest priorities. Managing your pain is a major component of your anesthetic plan. This will involve using several medications that have different mechanisms of action and regional anesthesia (spinal anesthesia or nerve blocks) may be used.
The amount and type of opioids you need will depend upon several factors including your pain history, medical problems, and your surgery. Some procedures can be performed without opioids, but most surgeries will require some opioids for optimal pain management. Non-opioids alternatives (like acetaminophen or ibuprofen) are frequently used, but sometimes these cannot be given (if you have allergic reactions, gastrointestinal bleeding, or kidney disease).
Absolutely. We are almost always able to utilize non-opioids during surgery. As mentioned above, there are some patient risk factors or disease states that may prevent us from using specific types of non-opioids. Local anesthetic will be used when possible either by your surgeon or anesthesia care team. Regional anesthesia, including nerve blocks, spinal or epidural anesthesia, is used as much as possible too.
Providing safe anesthesia frequently requires drawing upon the strengths of several different medications. Using a large dose of only one kind of medication is not only likely to fail, but it increases the change of adverse side-effects. The best approach is typically one that uses low doses of several different medications.
If you are having major surgery, you will likely have general anesthesia. Sleep is actually a unique state of consciousness with activity, but limited awareness. In contrast, general anesthesia is a state of unconsciousness with much less activity in the brain so that you do not respond to surgical stimulation.
Anesthetic awareness is rare under general anesthesia. While sedation is less reliable in providing amnesia (or a lack of awareness or memory), it is usually well-tolerated for selected procedures or surgeries.
Anesthesia is very safe for most patients undergoing procedures or surgery. This medical specialty has become much safer over the past several decades because of improvements in monitoring, medications, technology, and from simulation and analysis of human factors. The risks posed by your anesthetic will depend upon your state of preoperative health, coexisting medical conditions, and the complexities associated with the surgery.
It is unlikely that we will be able to provide a very accurate duration. If you ask our team, we will try to provide you with an approximation. Please be aware that time in the operating room is required for positioning, placing monitors, either sedating or rendering unconsciousness, and emerging from this anesthetized state.
This will depend upon the type of anesthesia that you require. Sometimes procedure or surgeries can be performed under spinal, epidural anesthesia or sedation, but many surgeries require general anesthesia. General anesthesia is a profound state of unconsciousness where your breathing needs to be carefully controlled - this usually requires a breathing tube. A breathing tube is made from flexible plastic with a small balloon that forms a cuff around it.
No. You will be in a very deep sleep when this is placed. In very rare cases, the breathing tube is placed when the patient is awake or sedated, but this is usually predicted and discussed preoperatively.
Despite numbing your throat with local anesthetic, your chance of throat discomfort after having a breathing tube may be as high as fifty percent. This is usually mild and resolves on its own by the next day.
Most of the time we will be able to do this for you. Your health, medical conditions, and risk factors will affect this decision-making. All consents will need to be signed before you are given this type of medication.
Yes, most of the time we can accommodate requests, especially if requests are made weeks in advance.
The stomach takes hours to empty depending upon the quantity and content of what is eaten or drunk. Small amounts of clear liquids usually leave the stomach in two hours, but fat-rich food (like a hamburger) can take up to 8 hours. If stomach contents flow backwards and up into the esophagus and mouth, they can find their way into the lungs. This dangerous event is called aspiration. Fasting decreases the likelihood of this event. Sometimes surgery is not elective (and it is urgent or emergent) and the risk of aspiration may be outweighed by the risk of surgical delay.
Yes. It is important to take certain medication on the day of surgery, while stopping others. Your primary care doctor, surgeon, and consultants (i.e. specialists like cardiologists) should guide you as to which you need to continue or discontinue on the day of surgery.