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Frequently Asked Questions about Anesthesiology

(Originally posted May 1999 on About Anesthesiology)

See also the sections on:

(Disclaimer: These answers represent my personal opinion. Although they reflect my professional training and judgement, the only person who can determine what a specific individual needs and answer all the pertinent questions is that person's own doctor after talking to the patient, examining the patient, obtaining any tests that are indicated, etc.)

  1. What is an anesthesiologist?
  2. Is there anything else that anesthesiologists do?
  3. What are the pre-surgical appointments for? Why are there so many questions?
  4. What is informed consent?
  5. What do I need to tell the anesthesiologist?
  6. What kind of anesthesia will I have?
  7. What does the anesthesiologist do during the surgery?
  8. Will I need to receive blood for the surgery?
  9. Can you give me more information about general anesthesia?
  10. Do I have to have a breathing tube?
  11. What is regional anesthesia?
  12. Can I request the specific type of anesthesia that I want?
  13. What are the common risks of anesthesia?

 

1. What is an anesthesiologist?

Anesthesiologists are physicians who have specialized training that allows them to provide pain control, pain relief and care for the general well-being of the patient in the operating room. They are able to regulate changes in breathing, heart rate, blood pressure, etc. that are important to your condition while undergoind surgery. The anesthesiologist acts as the advocate for the patient when the patient is under anesthesia and unable to perform that role themselves. Anesthesiologists have completed college, four years of medical school, an medical or surgical internship and three years of anesthesiology residency.

2. Is there anything else that anesthesiologists do?

Anesthesiologists also fulfill a role outside of the operating room with their knowledge of pre-operative assessment and planning, analgesia for labor and delivery, critical care in the intensive care unit and recovery room, postoperative pain management and management of chronic pain syndromes.

3. What are the pre-surgical appointments for? Why are there so many questions?

The pre-surgical appointments serve a dual purpose. First, they are a chance to gather important information about you and your medical condition in order to ensure yor safety and your comfort. In addition, it is a chance for you to ask any questions you might have about what is going to happen, make decisions about your options and give informed consent.

4. What is informed consent?

Informed consent means that you, the patient, has been presented with the options for treatment, the commone and serious risks and expected benefits of each option and what the likely outcomes of the treatment (or of no treatment) are. In addition, you should be given a chance to ask questiosn. Informed consent is usually given in writing and requires a signature (exceptions are extreme emergencies).

5. What do I need to tell the anesthesiologist?

It is important that you are complete and honest when answering questions prior to surgery. These questions relate to your general health and any specific medical conditions that may present a risk to you. You should be prepared to discuss your health history, the history of your blood relatives (if known), any medications including over the counter products, smoking, drug use, past experiences with surgery and anesthesia, etc.

6. What kind of anesthesia will I have?

The type of anesthesia will be chosen based on the type of surgery, your medical condition and your preferences. There are four types of anesthesia commonly employed - general, regional, monitored anesthesia care (MAC) and local. In very broad terms: general affects your entire body and may be given intravenously or as an inhaled gas. These medications make you dizzy or drowsy and cause you to lose consciousness. As a result of these medications, you might stop breathing on your own and therefore you might have breaths given to you through a mask or a small tube gently inserted into your lungs through your mouth. Regional anesthesia only affects a section of your body, making it numb. You may remain awake or be sedated. Monitored anesthesia care (MAC) involved medications given to make you drowsy and to relive pain. Local anesthesia affects only the location of surgery. It is usually injected, but can sometimes be given as a ointment, cream or spray. You may remain awake or be sedated for this as well

7. What does the anesthesiologist do during the surgery?

In short, the anesthesiologist is responsible for your comfort and your safety. In addition to giving you the medications needed for the anesthesia, the anesthesiologist monitors your vital signs (such things as heart rate, blood pressure, oxygen content, body temperature, breathing...) and alters them as necessary. He or she is also in charge of fluids that you might receive and, if necessary, blood transfusions. Lastly, any other medical conditions that you might have (diabetes, asthma, hypertension, heart problems) will be treated by the anesthesiologist while you are in their care.

8. Will I need to receive blood for the surgery?

Whether you will need a blood transfusion will depend on your medical condition, the type of surgery you are having, your personal beliefs and preferences, etc. This should be a topic of discussion with your surgeon and anesthesiologist.

9. Can you give me more information on general anesthesia?

General anesthesia is given either intravenously or through the inhalation of certain gases. Sometimes, the two are combined to achieve general anesthesia. When you are under general anesthesia you are unconscious - and thus unaware of what is happening to you and around you. Your vital signs such as heart rate, blood pressure and heart rate are carefully monitored and controlled. You may cease breathing on your own during general anesthesia and the anesthesiologist may assume control of your breathing. Sometimes this requires a breathing tube to be inserted - it goes through your lungs and into your lungs.

10. Do I have to have a breathing tube?

General anesthesia often results in the loss of the ability to breathe on your own. There are different ways to assist your breathing - one of which is the breathing tube (known as an endotracheal tube). There are many situations when the placement of the tube is the safest and most reliable method to assure adequate breathing. There are alternatives in other cases including breathing through mask or other devices. You can discuss this issue with your anesthesiologist to see if these other alternatives are applicable to your specific situations.

11. What is regional anesthesia?

Regional anesthesia refers to the process by which an injection of local anesthesia is given near your nerves and results in numbness of the area of surgery. You may remain awake or be sedated. Spinal and epidural anesthesia are the most commonly known of the regional techniques and involve injections in the back that result in numbness of the lower half of your body. There are, however, other types of regional anesthesia that can numb an arm, a single leg, etc.

12. Can I request the specific type of anesthesia that I want?

To some degree you can. Some operations can be performed with different types of anesthesia while some require one technique. Your anesthesiologist will review your planned surgery and your medical condition. Then they will be able to discuss your options with you and allow you to make your preferences known.

13. What are the common risks of anesthesia?

Luckily the common complications of anesthesia are not particularly dangerous and the dangerous complications of anesthesia are very rare. The most common complications include nausea, vomiting, sore throat, blood pressure changes, and pain. These are usually mild, not dangerous and easily treated with medication. The more serious complications include such things as allergic reactions, genetic conditions, stroke, heart attack, etc. which can lead to serious disability or death. These more serious complications are very rare. With the application of new technologies to the field of anesthesia and the careful monitoring of the anesthesia provider anesthesia is extremely safe.

 

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