What to Expect
Surgery can be a stressful time for patients. Anesthesia and Pain Consultants goal is to ensure our patients comfort and safety during their procedure. We utilize a number of techniques for both adults and pediatric procedures including cardiac, neurosurgical, obstetrical, and general surgery procedures. APC chooses to use a care team approach consisting of an anesthesiologist and a CRNA (certified registered nurse anesthetist) to deliver a safe anesthetic on every case. After meeting with our patients and discussing their medical history, our team will formulate a customized plan and appropriate anesthetic for their surgery.
Pre-Op: Meeting your Anesthesiologist
Meeting the anesthesiologist is an important step in preparing our patients for surgery. When the anesthesiologist meets with our patients, they will obtain a history and perform a physical exam. The history will consist of a review past anesthesia experiences, medical history, and any medications or over the counter medicines or supplements the patient may be taking. During the physical exam there will be a check of the patients current vitals and condition. Generally there will be an assessment of the patient’s airway, heart, and lungs as well as any other relevant physical problems with the patient. The anesthesiologist explains to the patient the plan and what they can expect during and after the surgery in regards to regaining consciousness, recovery, and dealing with discomfort and pain. Any questions will be answered at this time. .
During the Surgery/Procedure
Throughout the surgery or procedure, the anesthesiologist and/or the CRNA will administer various medicines to provide the optimal level of anesthesia. Monitoring the patient’s vital signs during surgery is also the primary responsibility of the anesthesia care team. A member of this care team will be with the patient thorough out the entire surgery. The vital signs that are monitored go beyond blood pressure, pulse, and body temperature. They may critically watch respiration as well as heart and nervous system function. The anesthesia personnel are also in control of the IV and all fluids, including blood transfusions, that use the IV. During surgery, if the patient experiences dangerous or life-threatening issues, it is the anesthesiologist and CRNA who assesses the situation and takes corrective action to protect the patient’s health (including adjusting anesthesia and giving other medications as needed).
After surgery, patients usually go to a recovery room to wake up. Some patients feel fine after waking up, but some experience nausea or shivering. They may have a sore throat from a tube that was inserted and maintained in their throat during surgery to assist breathing. During recovery, the anesthesiologist will continue to monitor vitals and need for pain medication. Depending on the condition of the patient and the type of surgery or procedure, after recovery the patient may go home or be transferred to a hospital room. Patients will be re-assessed by the anesthesiologist prior to being discharged from the recovery room. Patients returning home the same day as surgery must plan for a ride home.
Anesthesia for Surgery
No procedure is routine. Neither is the choice of anesthesia. We tailor the anesthetic plan to the individual patient taking into consideration the patients medical conditions, type of surgery/procedure, and patient preference. Each individual case gets our full evaluation and assessment prior to development of a plan. We then fully discuss all options and potential risks.
Acute Pain Management
In conjunction with our patient’s anesthesia, we assist in developing and implementing a pain management strategy for the post operative course. We utilize a number of different tools and techniques including medications, nerve blocks, spinals, and epidurals. Our goal is to minimize postoperative pain and discomfort to enhance our patient’s recovery.
Epidurals for Labor
This service is one of our most popular requests. Labor pain is frequently managed with an epidural. Our expert staff is available 24/7 to consult and place epidural catheters and assist with any obstetrical need that may arise during the delivery process.
Types of anesthesia
We offer various forms of anesthesia. The type of anesthesia received will depend on the type of surgery and the patient’s medical conditions. Sometimes we use a combination of techniques.
Sedatives are medications that will alter consciousness making the patient more relaxed and less anxious about their surgery. Analgesics are medications used to ease the pain. Both sedatives and analgesics are used during sedation in varying dosages to enable the patient to tolerate the procedure..Sedation is typically used for minor procedures or in combination with a regional anesthetic.
Local anesthetics (numbing medicines) are a type of medication that are given to temporarily block feeling in a particular area of the body. For minor surgery, a local anesthetic are given through an injection to the site or allowed to absorb into the skin. You remain conscious during a local anesthetic. However, when a large area needs to be numbed, or if a local anesthetic injection will not penetrate deep enough, doctors may use other types of anesthesia.
Regional anesthesia is used to numb only the portion of the body that will undergo the surgery. Usually an injection of local anesthetic is given in the area of nerves that provide feeling to that part of the body. There are several forms of regional anesthetics:
- Spinal anesthetic: A spinal anesthetic is used for lower abdominal, pelvic, rectal, or lower extremity surgery. This type of anesthetic involves injecting a single dose of the anesthetic medicine into the area that surrounds the spinal cord. The injection is made into the lower back, below the end of the spinal cord, and causes numbness in the lower body. This type of anesthesia is most often used in orthopedic procedures of the lower extremities.
- Epidural anesthetic: The epidural anesthetic is similar to a spinal anesthetic and is commonly used for surgery of the lower limbs and during labor and childbirth. This type of anesthesia involves continually infusing an anesthetic medicine through a thin catheter (hollow tube). The catheter is placed into the space that surrounds the spinal cord in the lower back, causing numbness in the lower body. Epidural anesthesia may also be used for chest or abdominal surgery. In this case, the anesthetic medicine is injected at a higher location in the back to numb the chest and abdominal areas.
- Nerve Blocks: Blocks are a type of regional anesthesia where numbing medication is injected around a nerve or group of nerves to eliminate sensation from a specific area of the body.
General Anesthesia is the medicines and techniques used to make the patient unconscious during their procedure. Multiple types of medications are utilized in varying dosages. Many times the patients breathing is controlled or assisted with the help of the anesthesia provider with the aid of breathing devices. During the anesthetic, the care team will be continuously present with the patient to monitor the patients well being and deliver the anesthesia agents, IV fluids, pain relief, and muscle relaxation.