What you might like to know about Anesthesia at Berger Hospital.

1. Who will do my anesthesia?

There are four Certified Registered Nurse Anesthetists and one Anesthesiologist at Berger Hospital. One of the five are available to provide anesthesia services 24 hours a day, seven days a week all year long. There is nearly 100 years of experience between all the providers!

2. Is anesthesia safe?

Because of modern advances in technology and on going research, anesthesia is fifty times safer today than it was in the early 1980s.

3. Do I have some risk?

There is always some risk to having surgery and anesthesia. Your risk is determined by the surgery you are having and your health problems. The anesthesia providers may sometimes ask for you to see your doctor prior to surgery to determine your risk and to optimize your health as much as possible before surgery. An anesthetist provider will discuss your risk and suggest the best type of anesthesia to you prior to surgery. They work hard to keep you as safe and comfortable as possible.

4. What are the different types of anesthesia?

You may have several options for anesthesia and for post-operative pain control. You, your surgeon and your anesthetist can choose the best option for you.

General Anesthesia means that you will be rendered unconscious for the surgery. Most often, medicine is injected into your IV line and an airway is placed in the back of your throat or a tube is inserted into your trachea (windpipe). Medicines to keep you asleep, relax your muscles, relieve pain, and treat any problems are given thru the IV line or breathed in by your lungs.

• Common side effects: nausea and vomiting; sore throat;
• Much less common risks: damage to lips, teeth, throat, or vocal cords; peripheral nerve injury; allergic reaction to medicines; difficulty breathing when awakening; awareness/waking up during surgery; aspiration pneumonitis; heart attack; stroke; cardiorespiratory arrest; death.

Regional Anesthesia means that a portion of your body will be made insensitive to pain. Most often, patients are given sedation medicines to help them sleep/dose during the procedure. Many do not even remember the surgery. A spinal or epidural involves the insertion of a small needle into the lower back then the injection of local anesthetic to the space around your spinal cord. This will cause the area from your chest or abdomen to your toes to get warm and tingly and then become numb. It will also make you unable to move that part of your body until the anesthetic wears off in 2-5 hours. Sometimes, just the arm or leg can be anesthetized or blocked for the purpose of decreasing post-operative pain.

• Risks: backache; decreased blood pressure; difficulty urinating in recovery room
• Much less common risks: inadequate anesthesia; headache after surgery; infection; allergic reaction to medicines; difficulty breathing; visual disturbances; ringing in ears; loss of consciousness; seizures; aspiration; nerve damage; heart attack; stroke; cardiopulmonary arrest; death.

Monitored Anesthesia Care (MAC) means that you will be sedated to varying degrees while your surgeon numbs the area on which he will be working. You will wear oxygen over your face or in your nose. The medicines will be injected into your IV line. You are less likely to feel nauseated and will likely be awake enough to bypass the recovery room after surgery.

• Risks: loss of airway control; inadequate analgesia; general anesthesia (and all the above risks)

5. Why am I told not to eat or drink after midnight before surgery?

It is important to not eat or drink before surgery because a full stomach will increase your chances of feeling sick to your stomach and aspirating (stomach fluid going into your lungs) if you vomit when you fall off to sleep. This could cause very serious lung problems and even death. It takes about 8 hours for your stomach to empty so it is important not to have anything to eat or drink after midnight.

6. What about my medicines?

The Pre Admission Testing Nurse will call you before surgery to tell you which of your medicines to take. Usually, it will be your heart, blood pressure, seizure, thyroid, and stomach pills. Please take these with a small sip of water.

7. Can I chew gum or tobacco products?

NO. These will increase the amount of juices in your stomach. This can be just as dangerous if you aspirate them. Nothing should pass thru your lips except the medicines you were told to take with a sip of water.

8. Can I smoke before surgery?

It is best to avoid smoking the morning of surgery to help reduce the irritability of your lungs. If you can quit smoking 6 weeks prior to surgery, that will improve your healing and your overall health during surgery and anesthesia.

9. Will I remember anything?

Awareness under anesthesia is a risk of General Anesthesia. However, it is very rare and most often occurs in trauma, heart or emergency caesarean deliveries. When you have regional anesthesia or monitored anesthesia care, it is not uncommon to remember parts of the experience even if you don't feel pain. You can ask for heavy sedation during these procedures but your ability to breathe is our first priority. The anesthesia provider will titrate sedation medicines based on your comfort level and your safety.

10. What kind of anesthesia will I have to deliver my baby?

Some women deliver babies with no anesthesia and others prefer some pain relief. Most commonly, an epidural is used for labor analgesia. This involves using a needle to insert a very thin catheter in your back, which gives you numbing medicine thru your labor. It does not take all the pain away but helps you to handle the pain. If you are having a C-Section and have an epidural in place already, you will be given more medicine thru the epidural to make your numb enough to have surgery. If you do not have an epidural, you will likely have a spinal anesthetic, which is similar to the epidural and will make you numb up to your chest. The most common side effects of these are a drop in blood pressure, a headache, or a sore back. It is more dangerous for the mother and the baby to have a General Anesthetic for a C-Section delivery so this is reserved for extreme emergencies.