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Individualized anesthesia care

The anesthesia team at USAP is dedicated to assuring your comfort and safety during your surgical procedure. Over the years, advances in anesthesia types and techniques have dramatically improved how a patient feels after their surgery. However, anesthesia medications can remain in your system for a day or so after administration and you may feel some effects until they are completely eliminated.

How we help patients

We spend a lot of time and focus getting patients through surgery safely and comfortably. Here are the different ways we help you along the way:

  • In-depth study of your health status, which often includes ordering indicated testing
  • Given your profile and status, selection of the most appropriate anesthetic techniques and drugs
  • Administering of anesthetics
  • Constant patient monitoring throughout your procedure
  • Monitor, support or control your breathing
  • Making any corrective changes as needed to control blood pressure, pulse, temperature
  • Administer all types of fluids and transfusions,
  • Administer all the in-OR drugs as needed (for example antibiotics, blood thinners, etc.)
  • Continuously adjust the anesthetic depth as indicated by the patient's response
  • Manage and direct resuscitation when warranted
  • Wake you up carefully, smoothly and comfortably
  • Oversee your progress in the Recovery Room to insure that all is well

Preparing for your surgery

In working with your care team, there are certain things they'll need you to do in preparation for your surgery.

 

Stop certain medications

SOME medications may need to be stopped before surgery. It is extremely important to discuss all medications you are taking with your surgeon and physicians prior to surgery. The following are examples of what should be discussed with your physicians prior to surgery:

  • Warafin (Coumadin)
  • Enoxaparin (Lovenox)
  • Clopidogrel (Plavix) and other "blood thinner" medications
  • Lisinopril (should be stopped 24 hours before surgery)
  • Persantine
  • Fosamax
  • Monoamine Oxidase Inhibitors, discuss with your surgeon and physician fourteen (14) days prior to surgery
  • Dietary Supplements (for example: Minerals, Vitamins, Herbal Supplements and Holistic Supplements), discuss with our surgeon and physician fourteen (14) days prior to surgery
  • Non-steroidal anti-inflammatory drugs such as aspirin and ibuprofen (Motrin, Advil)

In order to achieve a clear understanding of your needs, information regarding your medical condition will be obtained by your anesthesiologist either on the day of surgery, the day preceding surgery, or a few days before surgery during your preoperative visit. Frequently at such preoperative visits, blood and laboratory tests, or other preliminary examinations, such as ECG or x-rays will be completed.

This prior evaluation gives you the opportunity to discuss your medical history, various anesthetic options and their risks, and pertinent questions of concern with the anesthesiologist. It also gives you the chance to learn about the many safety precautions that your anesthesiologist will provide during your surgery.

 

Bring a list of all your current medications

You should bring a list of all medications that you take on a regular basis or have taken recently with you to the preoperative visit. It is best to include the dose information from the medication label on your list. The dose is commonly shown in milligrams (mg). For example, "100 mg" stands for 100 milligrams. Providing your anesthesiologist with your detailed medical history and drug list is very important. This information, combined with the laboratory data from your tests, is the basis upon which many anesthetic decisions are made.

The night before

For most procedures it is necessary for you to have an empty stomach so that the chances of regurgitating any undigested food or liquids is greatly reduced. Some anesthetics suspend your normal reflexes so that your body's automatic defenses may not be working. For example, your lungs normally are protected from objects, such as undigested food, from entering them. However, this natural protection does not occur while you are anesthetized.

So, for your safety you may be told to fast (no food or liquids) before surgery. It is very important that you follow these instructions carefully about fasting and medications; if not it may be necessary to postpone surgery.

The American Society of Anesthesiologists has recommended the following practice guidelines with respect to preoperative fasting (nothing by mouth). USAP strictly adheres to these guidelines for all elective cases requiring anesthesia or sedation.

Most surgical facilities will request that patients take nothing by mouth either after midnight or for 8 hours prior to surgery. It is important to remember that your surgery may take place prior to the scheduled time, so you may want to start your fast earlier than the times recommended below to anticipate such scheduling changes.

 

Need help with fasting?

It's helpful to follow the ASA Perioperative Fasting Guidelines:

  • Clear Liquids
    • It is appropriate to fast from intake of clear liquids for 2 or more hours. Examples of clear liquids include, but are not limited to, water, fruit juices without pulp, clear tea, and black coffee. These liquids should not include alcohol. The volume of liquid ingested is less important than the type of liquid ingested.
  • Breast Milk
    • It is appropriate to fast from intake of breast milk for 4 or more hours
  • Infant Formula
    • It is appropriate to fast from intake of infant formula for 6 or more hours
  • Solids and Non-Human Milk
    • It is appropriate to fast from intake of a light meal or non-human milk for 8 or more hours
    • It is important to note that the intake of fried or fatty foods or meat may prolong gastric emptying time, and may require a longer fasting period

Your participation in providing the most accurate information about your general health, medical and past surgical history, medications (including herbals) and allergies will help your anesthesia team recommend the safest and most effective anesthesia options for your procedure. After carefully considering the nature of your surgery, your overall health, medical history, lab tests, and your own concerns and preferences, the final recommendation will be made about the type of anesthesia that is both safe and best suited for you.

After your surgery

If you go home the same day as your surgery, here are a few things to consider to help in your recovery process:

  • Arrange to have a responsible adult with you in the first 24 hours after your surgery
  • Give your body adequate time to rest and recover
  • Drink fluids in small, frequent amounts and eat light lightly to minimize the chance of becoming nauseated
  • Do gentle and progressive activity
  • Minimize discomfort by taking pain medication as directed by your surgeon. To avoid nausea, do not take these medicines on an empty stomach. Be aware that many pain medications are constipating and a stool softener is often very helpful
  • Following general anesthesia, taking frequent deep breaths will help to expand your lungs and minimize the chance of developing complications
  • If you had a general anesthetic, it is not unusual to experience a sore throat. Ice chips and cool fluids (non-carbonated) can be very effective in soothing the soreness
  • Do not drive, consume alcohol, make any important decisions or operate heavy equipment during the first 24 hours following your procedure
  • You can return to work when you feel able to do so, as guided by your surgeon and family doctor
  • Side effects depend on your individual condition and type of surgery
  • Your surgeon will provide discharge instructions with additional guidance
  • Should you have any questions, do not hesitate to call the facility or our team for more information

Frequently Asked Questions

What kind of anesthesia will I have?

You, your surgeon and your anesthesiologist will all participate in choosing the best anesthetic for your situation.

  • General Anesthesia- a state of total unconsciousness resulting from anesthetic drugs
  • Regional Anesthesia- anesthesia affecting only a part of the body, such as a limb
  • Monitored Anesthesia Care (MAC)- a physician supervises or personally administers sedative and/or analgesic medications that can reduce patient anxiety and control pain during a diagnostic or therapeutic procedure
  • Local Anesthesia- anesthesia of a small part of the body such as an area of the skin

 

May I choose my anesthesiologist?

This question is a very common one as today more and more patients search for medical specialists. Many people find their doctors through recommendations from other doctors or through family and friends and the same situation exists when choosing your anesthesiologist. You do have a choice as to who your anesthesiologist will be. However, you must make that choice known in advance so that arrangements may be made to honor your request. In most situations where no request exists, the surgeon who has scheduled the operation will arrange the services of an anesthesiologist with whom he or she is familiar. However, if for any reason you are not comfortable with the recommended anesthesiologist, you may request a different anesthesiologist.

 

May I request what type of anesthesia I receive?

Yes, in certain situations. Some operations can be performed using different anesthetic procedures. Your anesthesiologist, after reviewing your individual situation, will discuss any available options with you. If there is more than one type of anesthetic procedure available, your preference should be discussed with your anesthesiologist in order for the most appropriate anesthetic plan to be made.

 

What are the complications and risks of anesthesia?

The most common complication is nausea and vomiting. However, multiple modalities are being used to decrease the incidence of nausea and vomiting and are quite effective. While the risks of complications from anesthesia will never be completely eliminated, we do everything we can to minimize them. Your anesthesiologist will be available to answer any questions you have.

All operations and all anesthesia have some small risks, and they are dependent upon many factors including the type of surgery and the medical condition of the patient. Fortunately, adverse events are very rare. Your anesthesiologist takes precautions to prevent an accident from occurring just as you do when driving a car or crossing the street. The specific risks of anesthesia vary with the particular procedure and the condition of the patient. You should ask your anesthesiologist about any risks that may be associated with your anesthesia.

To help anesthesiologists to provide the best and safest patient care possible, national standards have been developed by the American Society of Anesthesiologists to enhance the safety and quality of anesthesia. Specific standards have been developed regarding patient care before surgery, basic methods of monitoring patients during surgery, patient care during recovery, and for anesthesia in obstetrics. New standards continue to be developed to further ensure patient safety.

 

What can you eat and drink before surgery?

What you can eat and drink depends on your age.

  • Adults:
    • No solid food and/or non-clear, full liquids up to eight (8) hours before surgery. This includes food, milk, juice, nectar, vegetable juice, Jell-O, gum and mints

    • Only clear liquids up to four (4) hours before surgery. This includes clear apple juice, water, 7-up, balanced salt solution- i.e. Gatorade

    • Nothing by mouth for the four (4) hour period immediately before surgery

  • Children less than 6 months old:
    • No clear liquids up to three (3) hours before surgery

    • No breast milk up to four (4) hours before surgery

    • No formula milk up to six (6) hours before surgery

    • No solid food up to eight (8) hours before surgery

  • Children 6 months or older:
    • No clear liquids up to three (3) hours before surgery

    • No breast milk up to six (6) hours before surgery

    • No formula milk up to eight (8) hours before surgery

    • No solid food up to eight (8) hours before surgery

 

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.