FAQ

The pre-anesthesia visit is an important visit when you will have a chance to learn about your options for anesthesia and to ask questions. It is also a time when the Anesthesia Care Team can review your medical records, do a focused physical exam and make decisions about ordering additional tests and consultations.

The interview with the physician anesthesiologist is a key part of this review. During this interview, the physician anesthesiologist may ask questions that cover the following:

• your general health, including any recent changes
• allergies to medications or other items
• chronic (long-term) medical problems, such as high blood pressure, heart disease, diabetes, asthma, acid reflux and sleep apnea
• recent hospital admissions, including surgery or procedures
• previous experiences with anesthesia, especially any problems

Some people keep their own health records on paper or in an electronic format. To help you answer these questions, it is a good idea to bring any documents that describe your health history, as well as a list of all your medications.

When there are different anesthesia alternatives, such as general or regional (nerve block) anesthesia, your physician anesthesiologist may give you information about these options and then ask about your preferences.

At the conclusion of your visit, you should:

• have clear instructions on when to stop eating and drinking before surgery
• know what medications you should or should not take on the day of surgery (and sometimes even a few days leading up to surgery)
• know what type of anesthesia will be given to you (keep in mind that things may change between the day of your pre-operative visit and your procedure that may result in modifying the anesthesia plan)

There is no single or right amount of anesthesia for all patients. Every anesthetic must be tailored to the individual and to the operation or procedure that the person is having. Individuals have different responses to anesthesia. Some of these differences are genetic and some differences are due to changes in health or illness. The amount of anesthesia needed can differ according to such things as age, weight, gender, medications being taken or specific illnesses (such as heart or brain conditions).

Among the things the physician anesthesiologist measures or observes, and uses to guide the type and amount of anesthetic given are: heart rate and rhythm, blood pressure, breathing rate or pattern, oxygen and carbon dioxide levels and exhaled anesthetic concentration. Because every patient is unique, the physician anesthesiologist must carefully adjust anesthetic levels for each individual patient.

It is very important that patients have an empty stomach before any surgery or procedure that needs anesthesia. When anesthesia is given, it is common for all the normal reflexes to relax. This condition makes it easy for stomach contents to go backwards into the esophagus (food tube) and mouth or even the windpipe and lungs. Because the stomach contains acid, if any stomach contents do get into the lungs, they can cause a serious pneumonia, called aspiration pneumonitis.

Sedation allows patients to be comfortable during certain surgical or medical procedures. Sedation can provide pain relief as well as relief of anxiety that may accompany some treatments or diagnostic tests.

During light or moderate sedation, patients are awake and able to respond appropriately to instructions. However, during deep sedation, patients are likely to sleep through a procedure with little or no memory. Breathing can slow and supplemental oxygen is often given during deep sedation.

Your anesthesiologist is personally responsible for your comfort and well being before, during and after your surgical procedure. In the operating room, the anesthesia provider will direct your anesthesia and manage vital functions, including heart rate, blood pressure, heart rhythm, body temperature and breathing. The anesthesia provider is also responsible for fluid and blood replacement, when necessary. He or she will regulate the anesthesia so that you will be comfortable until your anesthetic care is completed.

Frequently, people requiring surgery may have other medical conditions, such as diabetes, asthma, high blood pressure, arthritis or heart problems. Because of your preoperative evaluation, your anesthesiologist will be alert to these conditions and well prepared to treat them during your surgery and immediately afterward. Your continued medical management during surgery is necessary to help you have a speedy recovery. As doctors, anesthesiologists are uniquely qualified to treat not only sudden medical problems related to surgery itself, but also your chronic conditions that may need special attention during your procedure. This is because their medical training provided a strong background in the principles of internal medicine and critical care.

Your anesthesiologist continues to be responsible for your care in the recovery room, often called the post anesthesia care unit. Here, the anesthesiologist directs specially trained staff members who monitor your condition and vital signs as the effects of the anesthesia wear off. Your anesthesiologist will determine when you are able to leave the recovery room.

Your anesthesiologist is a physician specialist like your surgeon or internist, and you will be billed for your anesthesiologist's professional service, as you would from your other physicians. Anesthesia billing is provided by Tenzing. If you have any financial concerns, your anesthesiologist or an office staff member will answer your questions. Please note that your hospital charges separately for the medications and equipment used.

Many people are apprehensive about surgery or anesthesia. If you are well informed and know what to expect, you will be better prepared and more relaxed. Talk with your anesthesiologist. Ask questions. Discuss any concerns you might have about your planned anesthetic care. Your anesthesiologist is not only your advocate but also the physician uniquely qualified and experienced to make your surgery and recovery as safe and comfortable as possible.