The anesthesiologist is a perioperative physician, which means that s/he provides medical care to patients throughout the surgical experience. The anesthesiologist evaluates the patient before surgery (preoperative), consults with the surgeon about providing pain control and monitoring vital life functions during surgery (intraoperative), and supervises medical care until the patient’s discharge from the recovery room (postoperative). There are three main types of Anesthesia: 1) general, 2) regional, and 3) local.
1) General Anesthesia
Often used for extensive surgery, such as on the heart, chest, or brain. There are a number of general anesthetic drugs. Some can be given as a gas that you breathe through a mask or tube, and some are administered as medications that are injected intravenously through an IV line. Once the anesthetic is started, you will lose consciousness. During anesthesia, your body functions will slow down and your anesthesiologist or nurse anesthetist will carefully monitor your heartbeat, blood pressure, body temperature, and other vital signs. A breathing tube may be inserted through your mouth and into the windpipe to maintain proper breathing, and a ventilator may be used to help you breathe. The duration of anesthesia is carefully calculated and continuously adjusted during surgery. When your surgery is complete, the anesthesia provider will give you medications to help you regain consciousness and you will wake up in the recovery room.
2) Regional Anesthesia
Often used for less complex surgical procedures. The anesthesiologist or nurse anesthetist makes an injection with great precision near a cluster of nerves to numb the area of the body that requires surgery. The patient might be awake, or the patient may be given a sedative to help him/her relax. There are several types of regional anesthesia.
Nerve blocks – An anesthetic is injected into a cluster of nerves, numbing an entire limb.
Epidural and caudal anesthesia – This type of anesthesia involves continually infusing drugs through a thin catheter that has been placed into the space that surrounds the spinal cord in the lower back. This anesthetic is commonly used for surgery of the lower limbs and during labor and childbirth.
Spinals – An anesthetic is injected directly into the spinal cord in the lower back, which causes numbness in the lower body. This type of anesthesia is commonly used for surgery of the lower abdomen, pelvic, rectal, or lower extremity.
3) Local Anesthesia
Often used for minor surgery. The anesthesiologist or nurse anesthetist makes an injection to the surgical site to temporarily stop the sense of pain in a particular area of the body. It could also be applied as a cream, drops, or spray, and applied to the eyes, throat, or skin.
Risks of Anesthesia:
Complications from anesthesia have declined dramatically due to today’s new, safe, and short-acting medications, as well as sophisticated monitoring anesthesia machines and devices. All surgical and anesthesia procedures involve some risk. Adverse events are rare and can depend upon many factors including the type of surgery and the medical condition of the patient. Generally, risks are higher for patients with heart or lung disease, diabetes, and malnutrition or obesity. The anesthesiologist or nurse anesthetist will discuss the risks and possible complications of anesthesia with you during the preoperative evaluation. Some of the more common risks are:
Dental incident – An endotrachial tube, or breathing tube, is used during general anesthesia to help the patient breath. A dental incident can occur when the patient has an involuntarily reflex and bites down on the tube during intubation or extubation, which can result in a chipped or broken tooth. During the preoperative evaluation, please tell your anesthesia provider about any special dental conditions, such as having a bridge, false teeth, a loose tooth or tooth decay.
Sore throat – A sore throat after general anesthesia is fairly common and can be caused by the endotrachial tube. In most cases, the sore throat will be mild and will get better during the next couple of days after surgery.
Nausea and vomiting – It is not uncommon to experience nausea and vomiting after surgery. Let the anesthesiologist know if you’ve experienced nausea and vomiting after a previous surgery, and s/he may give you medications to reduce or eliminate nausea.