Anesthesia

"Anesthesia" is a Latin word meaning, "without sensation." In 1842, a Georgia physician named Crawford Long used ether as an anesthetic agent to relieve the pain associated with surgery. Today, anesthesia ranks as one of American medicine's greatest gifts to the world.

What is Anesthesiology?

Anesthesiology is the practice of medicine that uses specific drugs to render your entire body -- or part of your body -- insensitive to pain. Anesthesia will enable you to tolerate a surgical procedure comfortably, with minimal emotional stress. It is also the provision of comprehensive medical care during such a procedure, so that any side effects of the operation or the anesthetic are anticipated and treated. Today's anesthesia practices allow a greater degree of safety and comfort than ever before, enabling a smooth start to your healing and recuperation. Based upon the type of surgery you are having, among other factors, there are different types of anesthesia.

 The modern anesthesiologist is a doctor of medicine with three or more additional years of specialty training in anesthesia. Anesthesiologists are involved in intensive care, cardiac resuscitation, respiratory therapy, and pain treatment. Their primary role, however, is to care for patient needs during surgery or obstetrics and in the immediate postoperative period.

 Thompson’s Anesthesiologists are a team of highly qualified, Board certified physicians. Many have additional expertise in anesthesia subspecialty areas such as obstetrics, pediatrics, intensive care, cardiovascular anesthesia, and pain therapy.

Note: The information below applies to the majority of patients having surgery, but it may not be appropriate for you. If you have any other questions, please contact your surgeon's office.

Anesthesia Frequently Asked Questions

  Will I always be given anesthesia care by an anesthesiologist at Thompson?

Yes. An anesthetist will remain with you from beginning to the end of surgery, and will transfer you to the recovery room nursing staff only when you are medically stable. The anesthetist may be your Anesthesiologist or a Certified Registered Nurse Anesthetist (CRNA) supervised by your Anesthesiologist.

  Can I request a particular anesthesiologist to care for me?

Yes, you can ask for one of our staff who has been recommended to you, or who has treated you before. We try to honor all requests, but please understand if it may not always be possible. The doctor whom you request may have been working on-call the night before your scheduled surgery, or be on vacation.

  Will I meet my anesthesiologist before surgery?

You will meet your anesthesiologist in the area where you are prepared for surgery. The anesthesiologist will ask many questions about your health history, and answer any questions you may have. No question is too small to ask if it is important to you. Before offering a plan for your anesthesia care, your anesthesiologist must consider all aspects of your medical history and the surgical procedure you will have. What you say to your anesthesiologist is confidential. Please answer all questions completely because they are important for your anesthesia care.

  My faith forbids me to receive any blood products or transfusions. How do I ensure that this does not happen in surgery?

We recognize that some people would refuse to receive a blood transfusion for religious reasons, or for personal choice. If you cannot receive blood, you are expected to tell your surgeon about your objections before you are scheduled for surgery. When you get to the hospital, you will sign a form that documents your refusal to receive a blood transfusion or blood products. It is important for the anesthesiologist to know about your objections before the day of surgery to help create a plan for alternatives to blood.

  What health information do I need to bring with me?

Medications
Bring a list of all the medications you take regularly, or as needed. Include the strength, or dosage listed on the bottle, and note how often you take them. They include:
  • Prescribed medications by any doctor
  • Over-the-counter medicines you take regularly
  • Vitamins, supplements and herbal treatments you take regularly
Health Information
You may have been given health information or reports from your surgeon, or other doctors and clinics before surgery. The reports could include:
  • Health histories or consultations
  • Laboratory results
  • Electrocardiogram (EKG)
  • Medical imaging (X-rays, CT, MRI, Ultrasound) films or reports
  • Your health insurance card and information

  Should I bring my medicines, vitamins, or herbs with me to the hospital?

We would prefer that you bring a list of all your medications, but if that is not possible, bring your medications with you. Keep them in their original bottles, so the surgery staff can see exactly which ones you take, and which dosages you require. Always bring any breathing inhaler medicines with you; the anesthesiologist may ask you to take a dose of these medicines before surgery to help your breathing.

  Do I have to tell about all the drugs I take?

If you take drugs that are not prescribed for you, or if you drink alcohol (liquor, wine or beer) regularly, you should inform your surgeon and anesthesiologist before surgery. They can affect your response to surgery, or to medications that you are given while in the hospital. What you discuss with your surgeon and anesthesiologist is confidential, and the information is important for your health and safety.

  Should I take my regular medicines as usual on the day of surgery?

This depends. Many medicines can be taken safely even on the day of surgery, but others must be avoided, or taken in reduced dosages, to keep you safe during surgery. You should discuss this with your surgeon during the pre-operative visits. The Preadmission Testing Nurse will also advise you as to which medicines you should or should not take the morning of surgery.

If you are being treated with diabetic medications, steroids, hormone replacements or anti-coagulants (blood-thinners), you should make certain to check with your surgeon before surgery. You should not continue taking vitamins, supplements and herbal treatments without informing both your surgeon and anesthesiologist.
If your doctor has agreed that you should take medicines on the day of surgery, you should take them with only a small amount of water to help keep your stomach empty.

  Can I eat or drink just before I have surgery?

Due to the risk of vomiting at any time with surgery, and other complications, anesthesiologists nationwide have established strict rules about eating or drinking before surgery.
Our anesthesiologists require the following for your safety:
Adults and Children
  • Solid food or liquids up to 8 hours before the time that surgery is scheduled
  • Water up to 4 hours before the time that surgery is scheduled
  • Take only sips of water at a time
  • Drink no more than 16oz of water (2 cups)
Infants
  • Formula up to 6 hours before the time that surgery is scheduled
  • Breast milk up to 4 hours before the time that surgery is scheduled
Your surgeon may give you instructions about eating or drinking that are stricter than those listed here. In that case, follow your surgeon's directions. Some surgical procedures require bowel preparation that further limit eating or drinking. Some surgeons may require you to have nothing by mouth after midnight before surgery. Or you may hear the term "NPO", which is a Latin abbreviation meaning "nothing by mouth".

  Can I suck on hard candy, chew gum or tobacco before surgery?

No. Please follow the same guidelines as for food and liquids. Even though you are not "eating or drinking", chewing or sucking on gum, candy or tobacco increases fluid in the stomach, which adds to the risk of anesthesia (The stomach thinks that food is coming down, and it gets ready to receive it).

  Can I brush my teeth on the day of surgery?

You may brush your teeth as usual, but do not swallow the water or mouthwash.

  Can I smoke before surgery?

Studies have shown that patients recover from surgery and anesthesia more quickly, and with fewer complications, if they do not smoke at least 24 hours before surgery. We always recommend that you stop smoking now. This is an opportunity for you to look at stopping smoking, or reducing the amount that you smoke. Even if you cannot stop, the more hours you can avoid smoking before surgery, the easier you will recover.

  Should I wear my glasses, contact lenses or hearing aids?

Please bring them and their cases with you to the hospital. Staff can help you remove them just before surgery, and help you wear them again as soon as it is safe for you.

  Should I wear makeup?

It is safer NOT to wear makeup during surgery. Makeup can lead to eye or skin irritation during surgery, especially if loose flecks contact the eye. You don't blink or make tears during general anesthesia, and you cannot tell us if it irritates you.

  I have dentures; do they need to be removed?

Tell your anesthesiologist if you have any dentures, partial plates, artificial or capped teeth. Dentures will need to be removed for some types of anesthesia or surgical procedures. We prefer that you bring your own container for your dentures, but if not, the hospital can supply one. Staff can help you remove them just before surgery, and help you wear them again as soon as it is safe for you.

  What does "monitoring vital signs" mean?

Your vital signs are facts about your health that can be measured, and changes in vital signs can be monitored over time. Vital signs include temperature, heart rate (pulse), breathing rate (respirations), blood pressure and presence of pain. In the perioperative areas, anesthesiologists and nurses will also measure other factors, such as blood oxygen saturation (pulse-oximetry). Most vital signs are measured constantly, using automatic devices, and monitored by the anesthesiologist and nursing staff. Monitoring is more than just watching. If changes in your vital signs indicate a danger to your health and safety, the anesthesiologist will begin appropriate treatment to correct it.

  Will I need to have an "I.V." for surgery?

Almost all patients need to have an I.V., or intravenous catheter, placed before surgery. This allows fluids and medications to be delivered quickly and safely through your vein. The I.V. will be started in the preoperative area by the nursing staff or the anesthesiologist.

Small children can be very afraid of needles, and some short surgical procedures may be safe without an I.V. before surgery. The anesthesiologist can have the child breathe in gas medications to cause relaxation and sleep, then start the I.V. if needed.

  If I am anxious while waiting for surgery, can I receive medication to help?

Many people feel anxious while waiting in the pre-operative area. In most instances, your anesthesiologist can prescribe and administer medications to help calm these feelings of fear. These medicines can be given as a pill, or by injection through the I.V. tubing.

  Do I have choices about what kind of anesthesia I have?

The best type of anesthesia for you depends on your medical history and on the type of surgical procedure, as well as your choice. Your anesthesiologist will review your health history and, if possible, give you options. There are three main types of anesthesia: General, Regional and Local.

  But do I get to decide which type of anesthesia I will have?

Yes, you will, and your anesthesiologist will provide information to assist you. S/He will first perform a thorough health history, and will physically examine you, focusing on your health related to anesthesia. The anesthesiologist also considers the length and type of surgical procedure planned, and your recovery after surgery. The anesthesiologist will describe all of the options for anesthesia during your surgery, and recommend the best one for you. This will include reasons for that recommendation, and the risks and benefits of the anesthesia options. We strongly advise you to follow your anesthesiologist's recommendation, but the final decision on anesthetic choice is yours to make.
Learn more about the types of anesthesia.

  Will I receive a separate bill from my anesthesiologist?

Just like the many other physician specialists (pediatricians, obstetrician, surgeons, etc.) from whom you receive health care, you will receive a bill from your anesthesiologist for professional services provided.
On your hospital bill, you may notice some hospital anesthesia-related charges. These are for the drugs, supplies and monitors used during your procedure and supplied by the hospital. There may also be a fee for the services of a Nurse Anesthetist (CRNA). These are not for the services provided by the physician anesthesiologist.

  Does the anesthesiologist fee differ depending on the types of anesthesia used?

Your fees from the anesthesiologist are not based on the type of anesthesia used.
Anesthesiology professional fees are charged based on the Relative Value Guide developed by the American Society of Anesthesiologists. Most major insurance companies accept this fee guide. However, the hospital fee related to anesthesia will vary with the medications and supplies that are used.