Anesthesia

What is anesthesia?

Anesthesia uses medicine before and during procedures and surgeries to temporarily alter consciousness and block pain.

What are the types of anesthesia?

The anesthesia used depends on the type and scope of the procedure. Options include:

Local anesthesia

Local anesthesia numbs a small section of the body. The local anesthesia medication is often administered by the surgeon without an anesthesia provider present and the patient is awake during the procedure.

Regional anesthesia

Regional anesthesia blocks pain in a larger part of your body, such as a limb or everything below your chest. You may be awake during the procedure, or you may be given sedation. Regional anesthesia may be used during childbirth, a C-section, or minor surgeries.

General anesthesia

General anesthesia makes you unconscious, unable to feel pain, and unable to remember what happens during the procedure. General anesthesia is used for more invasive surgeries.

Sedation

Sedation is a state of sleeping that relaxes you. This type of sedation is used for outpatient procedures, such as a colonoscopy, where the patient is expected to go home after the anesthesia has completely worn off. The depth of your sleepiness depends on the type and dose of medications given through a vein. There are two main types of sedation used: conscious sedation and deep sedation. Conscious sedation makes you drowsy and forgetful but can still follow simple instructions while asleep. Deep sedation puts you more deeply asleep. At very high doses, it can achieve “general anesthesia” as used in surgeries. Deep sedation requires closer patient monitoring.

How is anesthesia administered?

Depending on the procedure and type of anesthesia needed, your healthcare provider may deliver the anesthesia via:

Inhaled gas
Injection, including shots or intravenously (IV)
Topical (applied to skin or eyes) liquid, spray, or patch

How should I prepare for anesthesia?

Make sure your healthcare provider has a current list of your medications and supplements (vitamins and herbal medications). Certain drugs can interact with anesthesia or cause bleeding and increase the risk of complications.

You should also:

Avoid food and drinks for eight hours before you go to the hospital unless directed otherwise.
Quit smoking, even if it’s just for one day before the procedure, to improve heart and lung health. The most beneficial effects are seen with no smoking for two weeks before.
Stop taking herbal supplements for one to two weeks before the procedure as directed by your provider.
Stop taking weight loss medication (i.e. Phentermine) one week prior to your procedure.
Not take Viagra® or other medications for erectile dysfunction at least 24 hours before the procedure.
You may take certain (but not all) blood pressure medications with a sip of water as instructed by your healthcare provider.

What happens during anesthesia?

A board-certified anesthesia provider:

Administers one type or a combination of anesthetics
Monitors blood pressure, blood oxygen level, heart rate, and respirations
Identifies and manages problems, such as an allergic reaction or a change in vital signs
Provides postsurgical pain management

What should I do after getting anesthesia?

For procedures using local anesthesia, you can return to work or most activities after treatment unless your healthcare provider says otherwise.

You’ll need more time to recover if you’ve received sedation, regional anesthesia, or general anesthesia. You should:

Ask a responsible adult to drive you home and remain with you overnight
Rest for the remainder of the day
Not drive or operate a car or equipment for 24 hours
Abstain from alcohol for 24 hours
Only take medications or supplements approved by your provider
Avoid making any important or legal decisions for 24 hours

After the procedure, you should call your healthcare provider if you experience:

Difficulty breathing
Extreme itching, hives, or swelling
Numbness or paralysis anywhere in your body
Slurred speech
Trouble swallowing

What are the potential side effects of anesthesia?

Most anesthesia side effects are temporary and go away within 24 hours. Depending on the anesthesia type and how providers administer it, you may experience:

Back pain or muscle pain
Chills caused by low body temperature (hypothermia)
Difficulty urinating
Fatigue
Headache
Itching
Nausea and vomiting
Pain, tenderness, redness, or bruising at the injection site
Sore throat (pharyngitis)

What are the potential risks or complications of anesthesia?

Every year, millions of Americans safely receive anesthesia while undergoing medical procedures. However, anesthesia does carry some degree of risk. Potential complications include:

Anesthetic awareness: For unknown reasons, about one out of every 1,000 people who receive general anesthesia experience awareness during a procedure. You may be aware of your surroundings but unable to move or communicate.
Aspiration: Anesthetic medications can relax the protective muscles of your airway, which can lead to stomach contents entering the respiratory tract. This can cause irritation of the lungs and even pneumonia, which may require close postoperative monitoring or even admission to the hospital. It is for this reason why following NPO (nothing by mouth) guidelines is extremely important.
Malignant hyperthermia: People who have malignant hyperthermia (MH) experience a dangerous reaction to anesthesia. This rare inherited syndrome causes fever and muscle contractions during surgery. It is important to relate a personal or family history of MH to your physician anesthesiologist before your anesthetic to avoid drugs that trigger this reaction.
Nerve damage: Although rare, some people experience nerve damage that causes temporary or permanent neuropathic pain, numbness, or weakness.
Postoperative delirium: Older people are more prone to postoperative delirium. This condition causes confusion that comes and goes for about a week. Some people experience long-term memory and learning problems. This condition is known as postoperative cognitive dysfunction.