Understanding anesthesia

Anesthesia and you

USAP’s anesthesiology professionals work closely together and with your physician and surgeon to make your surgical experience as positive as possible. Our commitment to providing high-quality anesthesia care and creating a positive experience for you is always our top priority. 

We want you to go into your surgery feeling comfortable and relaxed. Below, you’ll find a wealth of information, including dos and don’ts, FAQs and more to help you understand anesthesia, prepare for your procedure and know what to expect afterward. If you don’t find answers to your questions here, please contact us.

Types of anesthesia

The goal of anesthesia is to administer medications through various techniques to assure your comfort and safety during a surgical procedure. Your anesthesia provider will not leave your side during the procedure. He or she will maintain constant monitoring and vigilance to assess your response to both the surgery and anesthetic.  

 

General anesthesia

General anesthesia is achieved through a combination of intravenous medications injected through an IV in your vein and/or inhalational agents (gases) you will breathe through a mask or breathing tube. General anesthesia provides a total loss of consciousness and pain control so you will not be aware of sensation or pain during your procedure. It is the most common type of anesthesia technique.  

 

Regional anesthesia

Regional anesthesia blocks pain to a specific area of your body. Your anesthesiologist injects medication near a targeted nerve, cluster of nerves or the spinal cord. You may also receive medication to help you relax during your procedure. Two main types of regional anesthesia are: 

  • Peripheral nerve blocks: This type of block targets a specific nerve or group of nerves most commonly for procedures on hands, arms, feet, legs or face.
  • Epidural or spinal anesthesia: This is an injection for nerves in the spinal canal that blocks pain for a large area of the body such as the abdomen, hips or legs.

 

MAC (Monitored Anesthesia Care or Procedural/Conscious Sedation)

MAC involves IV medication to help you relax and reduce pain. You will not be completely “out” but can be very sleepy.  For more detailed information on several anesthesia topics, visit the When Seconds Count website created by the American Society of Anesthesiologists: www.asahq.org/whensecondscount

Common words and definitions

We've put together a list of common words with their definitions you may hear before and after your procedure:

  • Analgesia: Absence of normal sense of pain without loss of consciousness
  • Analgesic: A drug that relieves pain without causing loss of consciousness, such as an aspirin
  • Anesthesia: Partial or complete loss of feeling or sensation, with or without loss of consciousness, primarily for the purpose of surgery or other medical procedure. There are three main categories of anesthesia: general, regional, and local.
  • Anesthetic: a drug that produces anesthesia administered by inhalation (breathing) or intravenously (injection or through an IV)
  • Anesthesia Care Team: Anesthesiologists, CRNAs and AAs working together to administer anesthesia and monitor patient condition during surgery, other medical procedures, or delivery of a baby
  • Anesthesiologist: Physician specializing in administering analgesia and anesthesia
  • Anesthesiology: The branch of medicine concerned with reducing or eliminating pain or feeling in patients undergoing surgery, the delivery of a baby, or other medical procedures
  • Anesthetist: One who administers an anesthetic. In many parts of the world, and particularly in Britain, this term applies to both nurses and doctors. However, in the USA and Canada, physicians who administer anesthetics are referred to as anesthesiologists
  • Certified Registered Nurse Anesthetist (CRNA): A highly-trained nurse specializing in the administration of anesthetics
  • Endotracheal Tube (Breathing Tube): A tube placed in a patient's windpipe to help the patient breathe; commonly used during general anesthesia
  • Epidural Anesthesia: Anesthesia produced by injection of a local anesthetic into the peridural space of the spinal cord, frequently used during delivery, for surgeries below the waist, and for post-operative pain management
  • General Anesthesia: Anesthesia where the patient is rendered unconscious by administration of intravenous and/or inhalation anesthetics for the period of surgery. The patient's major bodily functions are closely monitored by a member of the Anesthesia Care Team. A breathing tube is usually required during general anesthesia
  • Local Anesthesia: Anesthesia where a small area is deadened by injection of a local anesthetic.
  • Narcotic: A drug that produces insensibility or stupor. The term is now generally used to describe a class of drugs, such as morphine, which are addictive analgesics
  • Regional Anesthesia: Anesthesia where an anesthetic is administered by injection to deaden a part of the body such as an arm or leg. The patient remains conscious, though often sedated, throughout the procedure
  • Sedation: Anesthesia where a drug is given to calm a patient during an otherwise excited, uncomfortable, or anxious period of time. Often administered to patients immediately prior to surgery or during uncomfortable medical procedures
  • Sedative: A substance that tends to calm, moderate, or tranquilize nervousness or excitement

The history of anesthesia

The conquest of pain

Try to imagine today's health care without surgery. It's almost impossible. Now try to imagine surgery without anesthesia. Equally impossible. Without anesthesia, many of modern medicine's greatest benefits simply would not exist.

More than 35 million surgical procedures are performed each year in the United States alone. Clearly, the health and well being of almost everyone you know has been touched by the science of anesthesiology. Surgical procedures are carried out in hospitals and outpatient settings by the thousands every day. You usually take them for granted, and you should; current safety figures are impressive. So much so, you may lose sight of how long a way physicians have come in only the last 100 years, and even in the last five years when more lengthy and complex operations than ever before have been made possible by recent advances in anesthesiology.

Today's anesthesiologists now practice one of the most complex disciplines of medical specialization. These doctors, along with their Care Team colleagues, command a vast amount of medical knowledge about the human body, about drugs and how they act upon the body, and about the sophisticated technology used to track every major organ system during surgery and to administer drugs in a variety of ways.

During a major operation, anesthesiologists choose from a variety of medications to fulfill many different functions such as stopping pain, making the patient unconscious, and relaxing the body's muscles. To do this, they may work with Care Team members to administer inhalational anesthetic agents, sedatives, muscle relaxants and many other medications that act to help maintain normal body functions. The anesthesiologist must skillfully orchestrate all of these medications in accordance with the individual medical and surgical needs of each patient.

At the same time, anesthesiologists have improved techniques for turning off a patient's response to pain in specific regions of the body; this means that patients may remain conscious and recover more quickly after certain surgical procedures.

Only 60 years ago, administering ether through a mask and monitoring the patient with a simple stethoscope was considered to be the state of the art. Today, ether is not used for anesthesia and very sophisticated monitors are standard procedure. Currently, medications designed molecule by molecule on computer screens for more effective applications within the human brain are in use in today's operating rooms. Dramatic advances in technology continue to create monitoring devices with even more subtle and accurate measuring capabilities. National and international anesthesiology conferences are regularly convened to transmit the explosion of research, new information and new applications for patient care.

The future of medicine-surgery in particular-will continue to benefit from new advances in anesthesiology. All of this progress will allow anesthesia providers to better perform their most crucial and basic task: safely caring for the health, comfort and quality of life of all their patients.

 

Role in modern medicine

Most people believe that anesthesiologists are the doctors who administer medications, which keep them from feeling pain and sensations. However, few people realize that beyond ensuring the patient's comfort, today's anesthesiologists' primary role in the operating room is to make informed medical judgments to protect and regulate the patient's critical life functions that are affected by the surgery being performed. Also, these medical specialists are the doctors who will immediately diagnose and treat any medical problems that might arise during surgery or the recovery period.

Anesthesiologists need a wide range of knowledge about medications, internal medicine, how the human body works, and its responses to the stress of surgery. As physicians, anesthesiologists are responsible for administering anesthesia to relieve pain and for managing vital life functions, including breathing, heart rhythm, blood pressure, and brain and kidney functions during surgery.

As doctors, they manage, and treat any medical problems which may be present before surgery or that may develop during or immediately after surgery. Those patients who have received medical evaluations or treatment from their physicians before surgery must have that same medical care continued during surgery by their anesthesiologist.

Prior to surgery, anesthesiologists evaluate the patient's medical condition and formulate an anesthetic plan for each individual patient taking into consideration that patient's physical status. During surgery, advanced technology is used to monitor the body's functions. Anesthesiologists must interpret these sophisticated monitors in order to appropriately diagnose, regulate and treat the body's organ systems while a personalized, very delicate balance of anesthetic medications is administered. In some hospitals, nurse anesthetists may assist the anesthesiologists with the monitoring responsibilities. However, it is the anesthesiologists who are responsible for the interpretation of that monitoring and who make educated medical judgments concerning the patient's responses, and when it is and when it is not appropriate to treat the patient.

At the conclusion of surgery, anesthesiologists reverse the effects of the anesthetic medications, and return the patient to consciousness once again.

They maintain the patient in a comfortable state during recovery, and are involved in the provision of critical care medicine in the intensive care unit. Anesthesiologists also are involved in the practice of chronic pain management.

 

Medical training

Anesthesiologists are physicians who, after graduating from college with a strong background in physics, chemistry, biology and mathematics obtain a medical doctorate degree after completing four years of medical school.

After medical school, today's anesthesiologists learn the medical specialty of anesthesiology during an additional four years of post medical school training (one year of internship and three years in an anesthesiology residency program).

During the first year, anesthesiologists must complete training in diagnosis and treatment in other areas of medicine-such as internal medicine, neurology, obstetrics, pediatrics or surgery-or complete a rotating internship where they spend an equal amount of time training in each of the other areas of medicine. Today's anesthesiologists then spend three intensive years of training in anesthesiology learning the medical and technical aspects of the specialty. In addition, they may further specialize in a subspecialty, such as neurosurgical anesthesiology, by completing one to two more years in a subspecialty training program.

But, even when residency training is completed, anesthesiologists continue to spend a great deal of time in special courses and seminars studying new medical advances and anesthetic techniques throughout their careers. Today's anesthesiologists are educated in cardiology, critical care medicine, internal medicine, pharmacology and surgery to be able to fulfill their role in modern medicine.

 

Please Note: The information provided on this website does not take the place of consultation with one’s physician. The advice given does not establish a physician-patient relationship.

I have had surgery many times, so I know what it is like to be a patient. My goal is to have a relaxed, informed patient going into the OR.

Mark Anderson, M.D., USAP-Florida