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Frequently Asked Questions

This section is intended to answer some Frequently Asked Questions regarding your surgery and anesthesia. In addition, the American Society of Anesthesiologists (ASA) answers many Frequently Asked Questions on their website here. Further information can be found on the ASA patient website. For your convenience, we have many of the ASA publications available for download here. If you still have questions regarding anesthesia, please do not hesitate to contact us.

What is Anesthesiology? What is an anesthesiologist?
Anesthesiology is the practice of medicine that deals with many aspects of patient care including keeping patients comfortable and safe during surgeries or medical procedures. Your anesthesiologist is a highly trained physician with expertise in many aspects of medicine including cardiology, pulmonology, pediatrics, pharmacology, pain management, and all types of surgery. Detailed information can be found on the American Society of Anesthesiologists patient website, Lifeline to Modern Medicine.

Is Anesthesia Safe?
The risk of serious, life threatening complications is low and has been quoted to be similar to the risk of death on a long mile car trip.

What is Ambulatory Anesthesia?
Ambulatory Anesthesia is anesthesia that is specifically tailored to ambulatory surgery. Ambulatory surgery is surgery in which the patient does not need to spend the night in the hospital and can go home shortly after the surgery is completed. This can be done in a hospital but is often done in a surgery center or office setting. Synergy Anesthesia physicians are experts in ambulatory surgery and tailor your anesthesia to specifically meet the needs of you and the surgery. This helps ensure that you will go home quickly after surgery with minimal side effects. The American Society of Anesthesiologists brochure, "Anesthesia for Ambulatory Surgery" provides more information.

Is it really that important that I not eat anything before the procedure?
Yes, it is extremely important that you not eat or drink anything after midnight the night before. As explained in the "What to expect" sections, anytime you undergo anesthesia you're at risk for aspiration. Aspiration occurs when food travels down your windpipe into your lungs and can cause serious complications. If your stomach is empty this is much less likely to happen.

Are some types of anesthesia safer than other?
Overall, there is no difference in safety between various types of anesthesia (general anesthesia, conscious sedation, or regional anesthesia). However, each has its own benefits that may be preferable depending on the patient and type of surgery. If one type of anesthesia may be better for your given situation, your anesthesiologist will discuss that with you.

What is general anesthesia?
General anesthesia refers to a type of anesthesia in which the patient is completely unconscious during the surgery. Often it involves placement of a breathing device after the patient is asleep to assist or control the patient's breathing. While general anesthesia is often as safe as other types of anesthesia, it can increase the likelihood of nausea.

What is twilight anesthesia? Is this what I will be getting?
The American Society of Anesthesiologists has published a patient education brochure on conscious sedation available and has more information available on its patient website.

I have been nauseous after surgeries before. Can this happen again?
We will make every possible effort to minimize nausea and vomiting associated with your surgery and anesthesia. While it is not possible to prevent these symptoms in all patients, we will take many steps to help. First, if your procedure can be done without general anesthesia, this will reduce the likelihood of nausea and vomiting. If you do require general anesthesia, your anesthesiologist can avoid certain medications and will give you powerful anti-nausea medications. If you have had severe symptoms after anesthesia in the past, you should alert your surgeon before the day of surgery. Some of the best medications to prevent post-operative nausea and vomiting are most effective when taken before surgery. GI procedures are usually done with conscious sedation and the likelihood of being nauseous afterwards is minimal.

Should I take my medication on the day of surgery?
It depends on the specific medicine. Do not take aspirin, Coumadin (warfarin), heparin, or oral diabetes medication, unless instructed to do so by the doctor who prescribed it, or by your surgeon or gastroenterologist. Stopping these medications can be dangerous for some patients, so be sure to ask your regular doctor, surgeon, or gastroenterologist what to do about them. In general, you should take other regular medication at the normal time, with a sip of water.

I sometimes use recreational drugs. Will this interfere with surgery?
Some recreational drugs are particularly dangerous in association with anesthesia. Cocaine is probably the most concerning drug, but all stimulants can be problematic. For your safety, be sure to tell your anesthesiologist about any recreational drug use. Illegal drug use will not be reported to anyone else.

What about herbal remedies?
Patients often take herbal remedies or medications for a variety of reasons including disease prevention and treatment. While some herbal medications may be effective, they are not regulated by the Food and Drug Administration and, therefore, may cause more harm than good. The decision to take herbal remedies is a personal one and should be carefully considered after discussion with your physician. Some herbal medications can complicate surgery by causing increased bleeding or affecting blood pressure. Generally, these herbal medications should be discontinued two weeks prior to surgery. See The American Society of Anesthesiologists (ASA) brochure "
What You Should Know About Herbal and Dietary Supplement Use and Anesthesia" or visit the ASA patient website for more information.

How about smoking? Does this affect my anesthesia or surgery?
Smoking is one of the most harmful things you can do to your body. Besides causing significant long-term damage it can put you at much greater risk during and after your surgery. While smoking at any time is damaging, it can be particularly dangerous when done close to your surgery. See the American Society of Anesthesiology publication "Be Smoke Free" for more details or visit the ASA patient website.

What information is important for me to tell my anesthesiologist?
Your anesthesiologist will take a detailed history from you before your procedure. He will ask you specific questions regarding your medical, surgical, and anesthetic histories. To help patients prepare for this, the American Society of Anesthesiologists has published the pamphlet, "Anesthesia and Me," For more information visit the ASA patient website.

I've had a sore throat after surgery before. Can this happen again?
A sore throat after surgery is most likely after general anesthesia. Many surgeries under general anesthesia require placement of a breathing device to assist in breathing. Often this can cause a sore throat that will last about a day.

What is an epidural? Is it safe for me and my baby?
An epidural is a small, sterile, catheter than is placed in a patient's back to allow delivery of medicine to help with pain during and after surgery or childbirth. Epidurals are extremely safe and are used routinely throughout the world. As with any medical procedure, there is a small chance of complications that your anesthesiologist will discuss with you. When used in childbirth, epidurals have been shown to be effective and safe. However, because they can cause changes in a mother's heart rate and blood pressure, you will be closely monitored if you choose to get an epidural. Any changes will be treated immediately.

Do I have to get an epidural for childbirth?
Epidurals for childbirth are optional and some women elect to give birth without them ("natural childbirth"). They have been proven to be more effective than other forms of pain relief such as intravenous medications. The decision to get an epidural is a personal one and should only be made after careful thought and discussion with your obstetrician and anesthesiologist. The American Society of Anesthesiologists publication, "Planning Your Childbirth: Pain Relief During Labor and Delivery" can provide you additional information. The ASA patient website has additional information here.

How will my child be put to sleep?
It depends on the age, maturity, and health of the child in addition to the type of surgery to be performed. To avoid placing an intravenous line (IV) many children are put to sleep with a mask which consists of giving the child inhaled anesthetic gas through the mask. This usually takes only a few minutes for the child to fall asleep and, if needed, an IV can be placed after the child is asleep. This can be safely for most surgeries in children under the age of ten. Another option is to place the IV while the child is awake then use the IV to give medicines to put the child to sleep. This is the method typically done with most adults and older children. After reviewing your child's specific case, your anesthesiologist will discuss the options with you in more detail.

Does my child have to have an IV for surgery?
It depends on the type of surgery. For some smaller surgeries, such as placement of ear tubes, often an IV is not needed. For other surgeries, such as removal of tonsils and adenoids, placement is an IV is mandatory for safety. As discussed above, IVs can often be placed after the child is put to sleep with a mask.

How should I prepare my child for surgery?
It is important to tell your child beforehand as much about the surgery. There are numerous publications that can be used to help with preparation. The American Society of Anesthesiologists (ASA) publishes two brochures that can help. "When Your Child Needs Anesthesia" provides information for parents. The coloring book, "My Trip to the Hospital" is a useful tool to help parents prepare children for surgery. In addition, the ASA patient website has a variety of resources to prepare both parents and children for anesthesia and surgery.

I (or a family member) have been told I am allergic to anesthesia. What does this mean?
True allergic reaction to anesthesia is extremely rare. Often "allergy" to anesthesia may refer to common side effects such as nausea and grogginess after anesthesia. Synergy Anesthesia goes to great lengths to decrease or eliminate these side effects (see question "I have been nauseous after surgeries before. Can this happen again?" above). However, one serious condition that is sometimes referred to as an anesthesia allergy is malignant hyperthermia. Malignant hyperthermia (MH) is a life-threatening complication in which the patient's temperature rapidly climbs after exposure to anesthesia. MH is a genetic disorder which means in runs in families. If you think that you or a family member may have had an episode of MH, it is extremely important to notify your surgeon and/or anesthesiologist before the day of surgery. For more information visit the Malignant Hyperthermia Association of the United States website.

I am worried about being awake during surgery. Can that happen to me?
True awareness under general anesthesia can be a terrifying experience. This is a situation in which the patient is awake and aware of what is happening during surgery, but unable to move or alert anyone in the operating room. This is only a potential issue with general anesthesia since patients are able to move with other forms of anesthesia such as sedation. Luckily, awareness under general anesthesia is extremely rare and usually only occurs in emergency situations such as emergency Cesarean sections or severe trauma when patients may not be stable enough to receive adequate anesthesia. At Synergy Anesthesia we take every possible step to eliminate the possibility of awareness under general anesthesia. For more information, see The American Society of Anesthesiologists publication, "Intraoperative Awareness" or visit the ASA patient website

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