by: Edward R. Mariano, MD
"You will be asleep for your surgery," anesthesiologists often reassure their patients. Just before the start of anesthesia, a patient may hear the nurse saying, "Think of a nice dream as you go off to sleep."
Read morePhysician anesthesiologists work with your surgical team to evaluate, monitor, and supervise your care before, during, and after surgery—delivering anesthesia, leading the Anesthesia Care Team, and ensuring your optimal safety.
All types of anesthesia are administered to keep you comfortable and pain-free during surgery, medical procedures, or tests. But there are some key differences. The type you receive will depend on factors like the procedure, your health, and your preference.
General anesthesia is administered by a physician anesthesiologist through a mask or an IV placed in the vein. While the anesthesia is working, you will be unconscious, and many of your body’s functions will slow down or need help to work effectively. A tube may be placed in your throat to help you breathe. During a procedure, the physician anesthesiologist will monitor your heart rate, blood pressure, breathing and other vital signs to make sure they are normal and steady while you remain unconscious and free of pain. Once the procedure is complete, your physician anesthesiologist will reverse the medication and be with you as you return to consciousness, continually monitoring your breathing, circulation and oxygen levels. Some patients feel fine as they wake up; others experience symptoms such as nausea, vomiting, or chills. Your throat may be sore from the breathing tube. Your physician anesthesiologist will help you manage these symptoms. If you’ve had major surgery, you probably will have pain and discomfort from the procedure as you recover, which might get worse as the effects of the general anesthesia wear off. Your physician anesthesiologist will advise you about how to manage your pain during recovery in the hospital and at home.
Local anesthetics have made it possible to perform many surgical procedures quickly, with less preparation and a shorter recovery time. With local anesthesia, side effects and complications are rare and usually minor, like soreness where the medication was injected. In rare cases, you could have an allergic reaction to the anesthetic. For many procedures, your doctor will recommend a local anesthetic. If you prefer not to be sedated, ask your surgeon or the physician anesthesiologist if your procedure can be performed safely and comfortably with local anesthesia. Not only will you recover and get home faster, but the procedure may be less expensive.
Sedation and analgesics are usually provided through an IV placed in a vein. Depending on the procedure, the level of sedation may range from minimal (you’ll feel drowsy but able to talk) to deep (you probably won’t remember the procedure). Moderate or deep sedation may slow your breathing, and in some cases, you may be given oxygen. Analgesia may also contribute to drowsiness. But even with deep sedation, you won’t be unconscious, as you would be with general anesthesia. Most patients wake up quickly once the procedure is over and the medications are stopped. Possible side effects include headache, nausea and drowsiness, but you will likely experience fewer effects than you would from general anesthesia — and you’ll probably recover faster and go home sooner. Sometimes IV sedation and analgesics will be combined with other types of pain control — such as local anesthesia or regional anesthesia.
Regional anesthesia is a type of pain management for surgery that numbs a large part of the body. The medication is delivered through an injection or small tube called a catheter and is used when a simple injection of local anesthetic is not enough, and when it’s better for the patient to be awake. This type of anesthesia, including spinal blocks and epidurals, is often used for childbirth. In fact, an epidural is the most common type of pain control used for labor and delivery. It allows the mother to be awake and able to push when it’s time to deliver the baby, but numbs the pain. A spinal block is stronger and is used during procedures such as cesarean deliveries. Spinal blocks and epidurals allow the doctor to surgically deliver the baby without causing pain to the mother, and without subjecting the baby to sedating drugs that might be harmful. Regional anesthesia is very safe and doesn’t involve the potential complications and side effects that can happen with sedation and general anesthesia. But it does carry some risks, and it’s important that it be provided and monitored by a physician anesthesiologist.
If you’re planning to have surgery, you probably know that your surgeon is not the only person who will be taking care of you. An entire team of physicians, nurses and other medical professionals will be working together to make sure your surgery and recovery are safe and successful.
One of the key members of that medical team is the physician anesthesiologist. This physician often leads the Anesthesia Care Team, which might include nurse anesthetists, anesthesiologist assistants and anesthesiology resident physicians who will guide you throughout your entire surgical experience — before, during and after the procedure.
If you’re having surgery, you most likely will have some type of anesthesia to keep you from feeling pain during the procedure. While anesthesia is very safe, it can cause side effects both during and after the procedure. Most side effects of anesthesia are minor and temporary, though there are some more serious effects to be aware of and prepare for in advance.
The most important thing you can do to prevent anesthesia side effects is make sure a physician anesthesiologist is involved in your care. A physician anesthesiologist is a medical doctor who specializes in anesthesia, pain management, and critical care medicine.
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