Awareness and Anesthesia
Individuals who are undergoing any type of major surgery or procedure are likely to receive general anesthesia. General anesthesia puts the patient to “sleep” during the procedure. Very rarely do patients become aware or conscious during the procedure. However, when this does occur, it is called anesthesia awareness, and it occurs in only one or two out of every 1,000 medical cases that involve general anesthesia in adults. Individuals who experience anesthesia awareness report different levels of awareness. Some individuals have vague recollections, while others remember a specific moment during surgery. The risk of anesthesia awareness can be reduced by a number of steps. First, your physician and anesthesiologists will meet with you prior to surgery to learn about any health conditions that you may have, as well as your prior experiences with anesthesia. You will also share any medications you are only, and if you have a history of drug or alcohol abuse. All of this information can help your medical team to provide the best possible care and reduce the risk of problems.
Herbal and Dietary Supplements and Anesthesia
If you are undergoing a medical procedure, your doctor will ask for a list of medications that you are taking. It is important that you mention all medications, including vitamins and dietary supplements, as these may cause issues during your surgery such as reacting with the anesthesia. While prescription and over-the-counter medications are closely inspected by the FDA, supplements are not. Some supplements may increase the risk of surgery because they may:
- Cause heart issues
- Interfere with other medications
- Raise blood pressure
- Increase the risk of bleeding
- Prolong the effects of anesthesia
Obesity, Sleep Apnea, and Anesthesia
Extra weight can often affect an individual’s health. This is especially true for those who are obese. Excess weight can also make surgery more challenging, especially when it comes to anesthesia. One concern is that individuals who are overweight are more likely to suffer from obstructive sleep apnea, which is a condition that causes someone to temporarily stop breathing while they sleep. This makes anesthesia riskier. Common signs of sleep apnea include:
- Feeling tired even after a long night’s sleep
- Difficulty staying asleep
- Moving around a lot at night
- Making snorting noises in your sleep
If you believe or know that you have sleep apnea, talk to your physician anesthesiologist, and he will work closely with the health care team to ensure a safe procedure.
Outpatient Surgery and Anesthesia
When it comes to outpatient surgery, there are a number of different anesthesia options available. These include:
- Local Anesthesia- A one-time injection of medicine that is used to numb a smaller area of the body. Patients will be awake, but unable to feel the numbed area.
- Regional Anesthesia- Pain medication that is used to numb a larger area of the body and may be provided through an injection or a catheter. Patients will be awake, but unable to feel the numbed area.
- Monitored Anesthesia Care or Intravenous (IV) Sedation- Medication will be given through an IV to relax the patient. Depending on the procedure, the level of sedation may vary. IV sedation is sometimes combined with regional or local anesthesia.
- General Anesthesia – Is provided through an IV or anesthesia mask and causes the patient to lose consciousness. This type of anesthesia is most likely to be used during a major surgery.
Overall, the type of anesthesia that will be used will depend on the type of procedure, your individual health, and in some cases, your preference.
Tips to Prepare for Outpatient Surgery
- When it comes to outpatient surgery, there are some tips that you should follow to prepare.
- Do not eat anything 10 hours before your check-in time.
- You may have water only (no other liquids) up to 4 hours before your check-in time.
- Bring a friend or family member to drive you home after the procedure.
- Wear comfy, loose clothes that cover your bandages and incisions.
- Plan for recovery; take off work and school for the necessary time to recover.
Learn About: Physician Anesthesiologists
Physician anesthesiologists are doctors who specialize in anesthesia, pain, and critical care medication. They undergo 12-14 years of education and 12,000-16,000 hours of clinical training. They also have extensive education and training to evaluate, diagnose, treat, and manage a spectrum of medical conditions, including potentially life-threating complications that may occur during surgery. Physician anesthesiologists will guide you through your surgical experience from helping you prepare to recovery. During surgery, they will manage your pain control and closely monitor your anesthesia and vital body functions during the procedure. They will also manage medical issues if they occur during the procedure, as well as any chronic conditions such as diabetes, asthma, high blood pressure, or heart problems.
Sedation, Analgesia, and Anesthesia
There are a number of types of anesthesia available to help keep individuals comfortable during medical tests and procedure. Sedation is a common option that relaxes the patient and sometimes makes them fall asleep. Sedation is also known as monitored anesthesia care, conscious sedation, or twilight sedation, and is usually used for minor surgeries. Analgesia is used to provide pain relief. Both sedation and analgesia are provided through an IV placed in a vein. Most patients wake up from sedation quickly once the procedure is over. Possible side effects may include headache, drowsiness, and nausea. However, you will likely have fewer side effects that you would from general anesthesia, and most people recover faster. In some cases, sedation and analgesia may be combined with another form of pain control such as local anesthesia.
Seniors and Anesthesia
Elderly patients are at a higher risk for some side effects from monitored sedation or general anesthesia. This is because the aging brain may be more easily affected by medication. Some anesthesia-related side effects that are more common in seniors include:
- Postoperative delirium- Following surgery, older people may become confused, have trouble remembering things or focusing, or be unfamiliar with their surroundings. This delirium may come and go and usually dissipates after about a week.
- Postoperative cognitive dysfunction (POCD)- This condition can be serious and can cause long-term memory loss as well as a decreased ability to learn, think, and concentrate. Certain conditions may increase your risk for POCD, including heart disease, lung disease, Alzheimer’s disease, Parkinson’s disease and a previous stroke. Thankfully, there is research that provides guidance on how to decrease the risk of developing these issues, making anesthesia safer than ever before.
Stop Smoking for Surgery
It is a well-known fact that smoking can cause major health issues such as heart disease, asthma, and lung cancer. Smoking can also increase the risk of anesthesia-related problems from surgery like wound infections, heart attacks, and pneumonia. If you are planning on having any form of surgery, it is recommended that you quit smoking as soon as possible before the procedure, and for as long as possible (preferably forever) afterward. If you need help quitting smoking, you can call 1-800-QUIT-NOW (1-800-784-8669) for a free service that can help you stop smoking and stay off cigarettes. To print or download a pdf version, please click one of the links below:
- stop smoking for surgery
- seniors & anesthesia
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- Role of the anesthesiologist
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- awareness & anesthesia
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