Anesthesia Topics

Anesthesia Links

Q:  Is anesthesia safe?

    A: Over the past several decades, the medical specialty of anesthesia has made great improvements in safety.  In fact, the specialty of anesthesia was cited as an innovator in patient safety by The Institute of Medicine. 
    Watch a 2 part video about what to expect before, during and after surgery:
  • http://youtu.be/gUxETUlxTcA
  • http://youtu.be/hHHfccUamZw

Q:  What type of anesthesia is right for me?

    A: During surgery, you will be administered some form of anesthesia.  The anesthetic technique used for your surgery depends on both the procedure being performed and your medical history.  Your anesthesiologist will help you decide which technique is best for you.  

    In general there are 3 major types of anesthesia:
    1. General Anesthesia – This causes you to be unconscious for the entire procedure.  You will be completely unaware and will feel no pain during the surgery.  The medication is given into a vein (intravenously) or inhaled.  A breathing tube may be inserted into the windpipe to maintain proper breathing during surgery.
    2. Local Anesthesia – The numbing medication is injected directly into the surgical site to temporarily block the pain sensations from a particular area.  A sedative medication may be administered for relaxation. 
    3. Regional Anesthesia – This involves injecting a local anesthetic (numbing medication) around major nerves or the spinal cord to block pain signals.  You are usually also given a sedative medication into a vein for relaxation.

      There are 2 types of regional anesthesia:  

    1. Spinal or epidural anesthesia – The numbing medication is injected around the spinal cord and blocks pain signals from the entire region of the body.  This is often used for leg, lower abdominal, gynecological and rectal procedures.
    2. Peripheral nerve blocks – The numbing medication is injected near major nerve groups to specific areas, i.e., the arm, hand or leg.  This blocks the pain signals from that area.

    View a video about the Anesthesia Experience : http://www.youtu.be/2kUSF-9JPcM

Q:  What should I tell my child about Anesthesia?

    A: If your child needs elective surgery, it’s important to educate yourself as much as possible.  While any hospital visit can be an anxious time for a parent and child, the more information that you have about the upcoming procedure, the easier it will be to discuss this with your child.  The more that you know, the calmer you will be and the better you will be able to comfort your child.
    1. Educate yourself about both the procedure and the anesthesia service required.  Ask questions of both the surgeon and the anesthesiologist.
    2. Provide age-appropriate information to your child.  Children tolerate surgery better when they are well-prepared.  Explain to your child what to expect throughout the entire process.  Reassure your child that everything will be explained beforehand.
    3. Stay calm.  Your composure is essential.  Nothing calms a child as much as a calm confident parent.  
    Watch a video on preparing your child for anesthesia and surgery.

Q:  Can I stay with my child during the surgical procedure?

    A: Not during the procedure but one parent may accompany the child to the preoperative holding area.

Q:  Who can administer anesthesia?

    A: You may be cared for by a single anesthesiologist or an anesthesiologist working with a certified registered nurse anesthetist (CRNA) in the care team model. 
    • An anesthesiologist is a physician who has completed at least 4 years of specialty training in anesthesia after completing medical school.  The anesthesiologist provides either direct patient care or acts as the leader of the anesthesia care team.
    • A nurse anesthetist (CRNA) is a registered nurse who has completed a training program in nurse anesthesia and most commonly works under the supervision of an anesthesiologist as a member of the anesthesia care team.  In Pennsylvania, a CRNA cannot practice independently and must work under the direct supervision of a physician.

Q:  Will an anesthesia service provider be with me the entire surgery?

    A: You will be cared for by either an individual anesthesiologist or an anesthesia “Care Team” which consists of a supervising anesthesiologist, (the physician) and a Certified Registered Nurse Anesthetist, (CRNA).   A member of the anesthesia care team will be with you throughout the entire procedure until you are delivered to the Post-Anesthesia Care Unit.

Q:  Will I remember anything during anesthesia?

    A:   No, in almost every case, you will not remember anything.  Only in rare circumstances does someone recall events during their operation.

    Recall or awareness under general anesthesia occurs when a patient regains consciousness and becomes aware of certain events that occurred during surgery.  While new brain-wave monitors may prove helpful in reducing the risk of awareness, at the present time, none of these technologies have been perfected.

    The incidence of awareness is reported to occur on 0.1 – 0.2% of adult patients undergoing general anesthesia.  A number of causes can be responsible for awareness under anesthesia. The most common cause is the use of light anesthesia as is common for emergency trauma surgery or high risk surgery where a deep level of anesthesia would not be tolerated by the patient.

    Because awareness under general anesthesia is extremely rare, it should not be viewed as a reason to avoid surgery.  In the unlikely event of intra-operative awareness, discuss this with your anesthesiologist as soon as possible after the procedure.

    Seven things every patient should know about anesthesia awareness: Watch an ASA video about anesthesia awareness:

Q:  What are the risks due to anesthesia?

    A:   All operations and all anesthetics have risks and they are dependent upon many factors including the type of surgery and the medical condition of the patient. Most patients operated on in surgery centers are of the healthier group of patients, and in these circumstances serious complications, while they can occur, are fortunately very rare.

    To repeat - the risk of a major complication in an otherwise healthy patient is extremely low. Your anesthesiologist will assess you preoperatively and every precaution will be taken to minimize your risk. Our equipment is the most advanced and up to date and all of our anesthesiologists are Board Certified or in the process of being Board Certified.

    However, we will routinely see minor problems such as nausea and vomiting, sore throat, dizziness, tiredness, headache, muscle aches, and pain, most of which are easily treated.

Q:  The last time I had surgery the anesthesiologist explained that my intubation was difficult.  What does this mean and what should I do or be aware of if I have surgery in the future?

    A:   For many surgical procedures a breathing tube, known as the endotracheal tube, is introduced using an instrument called the laryngoscope. This tube goes through the vocal cords into the windpipe and is sealed into position using a special cuff inflated with air. Ordinarily, there is little difficulty in inserting the tube once anesthesia has begun. Rarely, the anesthesiologist may experience difficulty in inserting that tube. This is called "difficult intubation". If your anesthesiologist encounters this problem, which occurs in about one in every hundred procedures, he/she has a protocol to deal with this problem. In some cases, this may involve using an alternative form of airway management or may involve waking the patient up and doing the procedure under regional anesthesia (e.g. epidural or spinal). The particular approach taken in this rather unusual circumstance will depend on the training or preferences of your anesthesiologist.   If your anesthesia service provider tells you after the surgery that he/she had trouble placing the breathing tube, it will be wise to get all the details in a form of letter or other document so that you will have this information at hand for other anesthesiologists who may care for you in the future. We also recommend a Medic-Alert Foundation bracelet and can provide the contact information.

Q:  How much pain will I have after my surgery?

    A:   Post-surgical pain varies with each patient and surgical procedure. If you experience pain after surgery, the PACU staff will give you medications until the discomfort is controlled. Your surgeon or anesthesiologist may recommend a regional anesthetic or nerve block for post operative pain. If this is recommended, please consider taking this course of care.

Q:  Will I feel sick after my surgery/procedure?

    A:   We make every effort to prevent or minimize nausea and vomiting.  Medications to minimize postoperative pain, nausea and vomiting are given as needed. Nausea and vomiting tend to be less of a problem today because of improved anesthetic agents and techniques, but it is not possible to prevent in every case. If you have had severe nausea and vomiting in the past, discuss this with your anesthesia service provider before surgery.

Q:  Why are there a physician and a nurse anesthetist involved in the delivery of anesthesia for my procedure?

    A:   Two heads are better than one!  As are two sets of hands. The “Anesthesia Care Team” approach to the delivery of anesthesia is a very efficient and effective staffing model. Each team member has a specific role to fulfill in the delivery of your anesthesia.

Q:  How are anesthesiologists paid?

    A:   You will usually receive a bill for the anesthesia services from the anesthesiologist.  You may also receive a bill from the hospital for the technology and supplies that they provided.  Most anesthesiologists will file your insurance claim as a courtesy to you.  As with other physician services, you are responsible for any deductibles or co-pays.

Q:  I received an explanation of benefits from my health insurer and I noticed that there is a charge from the doctor and the nurse. Why am I being charged twice?

    A:   Certain insurers, Medicare in particular, require the anesthesia service providers to submit a charge for both the Anesthesiologist’s services and the Nurse Anesthetist’s.  The amount paid is the same as if there was only a single provider.

Q:  Does my insurance pay more when there are two anesthesia providers involved in my surgery? Will I be responsible for a larger portion of the expense?

    A:   No to both!  When two providers are involved in the care of the patient it may be necessary, depending upon your insurance, to submit charges for both in order for the total reimbursement to be paid.

Q: Does SHAC participate with my health insurance plan?

    A:  Society Hill Anesthesia Consultants, PC, participates with all federal and state health insurance products as well as dozens of private commercial insurers. As with other physician services, you are responsible for any deductibles or co pay amounts.