What Are Your Options for Anesthesia?

The type of anesthesia you receive depends on the surgical procedure you're having, your age, and health status. Learn what you need to tell your anesthesia provider, including: past problems with anesthesia; major health problems or recent illnesses such as diarrhea, cold, or flu; drug or food allergies; medications or vitamins you're taking; dentures, crowns, or loose teeth.

Anesthesia, the medically induced loss of sensitivity to pain, is a major part of your operation. Have your surgeon explain the types of anesthesia available to you as well as their benefits and risks.

Types of Anesthesia

The type of anesthesia you will receive depends on the nature of your surgical procedure, your health, and your age. Your anesthesia provider also will consider your personal preferences if possible. You will receive one or more of four types of anesthesia.

  • General anesthesia: You will be unconscious (asleep) during the procedure. Major operations usually are performed this way. You will get the anesthetic medicine through an intravenous (IV) line hooked up to your arm or hand, or as a gas through an anesthesia mask. Sometimes the anesthesiologist may give you the anesthesia through a temporary breathing tube placed through your mouth and into your windpipe after you are asleep. Beforehand, you may receive sedatives. These medications make you calm and drowsy, in preparation for general anesthesia.
  • Regional anesthesia: You will receive an injection (shot) of a numbing local anesthetic into the nerves supplying the area to be operated on. This type of anesthesia is used when a large area needs numbing, such as an arm or leg or the lower half of your body. You also may receive sedatives, which may dim your memory of the procedure.
  • Local anesthesia: The doctor numbs a small area of skin near the place where the incision will be made, so that a painless cut can be made. A local anesthetic can be given as a shot or applied to the skin as an ointment or spray. If the medicine is applied to the skin, your doctor may call it a topical anesthetic. Local anesthesia often is used for minor outpatient procedures and does not require an anesthesia professional (see "Anesthesia Providers" in the next section for a definition). You remain fully alert during the procedure.
  • Conscious sedation: Formerly called twilight anesthesia, this technique uses sedatives to lower your level of consciousness without putting you into a deep sleep, as in general anesthesia. These medications cause temporary forgetfulness, so you may not remember the procedure. Depending on the level of sedation, you may be awake and able to talk to the surgeon or respond physically to the surgical team's questions or requests. You will receive pain medicine, usually through an IV. You also may get a local or regional anesthetic.

    With conscious sedation, it is sometimes possible for the patient to reach a deeper level of sedation than intended. For this reason, guidelines state that all patients should be monitored during conscious sedation, including their blood pressure and pulse. In addition, a monitor will be placed on your finger to determine oxygen saturation and to make sure that your breathing is adequate. It is advisable that an anesthesia professional or other qualified health care provider be dedicated to monitoring a patient receiving conscious sedation. The person who will monitor your condition during the procedure should have training in monitoring breathing and heart function and should be trained to take immediate corrective action if sedation becomes too deep. This professional should stay with you during the entire procedure.

Anesthesia Providers

Unless your surgical procedure requires only local anesthesia, you should expect that an anesthesia professional will assist your surgeon. This person will be a physician (anesthesiologist) or nurse (nurse anesthetist) who has received special training in anesthesia and is licensed to administer anesthesia. In some states, other persons, such as dental hygienists, are licensed to give conscious sedation.

If your surgeon will be the one administering anesthesia or conscious sedation, make sure that he or she is trained in anesthesia or conscious sedation as well as safety practices such as resuscitation. Ask if there will be a qualified person other than your surgeon who will continuously monitor your vital signs.

Usually you won't meet the anesthesia provider until right before your operation. At some surgical facilities, an anesthesia professional calls the patient the day before the procedure to explain the anesthesia technique and special requirements. If you have concerns or questions about the anesthesia, ask to speak with an anesthesia professional in advance or arrange a meeting.

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