NWA Anesthesia Q & A

Anesthesia Questions and Answers

Anesthesia Basics

What is a General Anesthetic?
A general anesthetic is a medically-induced sleep to facilitate surgical procedures. Most general anesthetics produce amnesia (transient memory loss), analgesia (pain relief) and muscle relaxation. General anesthesia results from the administration of one or a combination of several anesthetic medications given by specially trained anesthesia professionals.
What is a Regional Anesthetic?
Regional anesthesia typically refers to the use of nerve block techniques to provide numbness in a “region” of your body to facilitate surgical procedures and pain control.
What is a MAC Anesthetic?
MAC is an acronym for “Monitored Anesthesia Care” and is used to describe sedation anesthetic techniques used when general anesthetics are not needed or desired. MAC anesthetics use IV medications to provide sedation and pain control and are typically used in combination with surgeon-placed local anesthetics.
What is a Local Anesthetic?
Local anesthetics provide numbness or lack of sensation via injection of local anesthetic medications (lidocaine, bupivicaine, others) at the surgical site. Surgical procedures performed with only local anesthetics – not using sedation or other IV or inhalational anesthetic agents — are considered to be performed under “local anesthesia”.

Before Surgery

What is a Preoperative H&P?
Prior to the date of your surgery, you will be required to obtain a “preoperative” history and physical examination by your primary care physician. Typically, the date of this exam must be within 30 days of the scheduled surgery. This is a general medical exam performed to provide a current medical history and physical exam, as well as obtain any laboratory or other workup you may require prior to surgery.
What Medications Should I Take Before Surgery?
In general, you should take all prescription medications as you typically do before surgery. You can take your medications the morning of surgery with a sip of water. There are a few medications that may be held or changed prior to surgery including; insulin, oral diabetes meds, anticoagulants including plavix, coumadin and others – check with your physician. Some medications are important to take prior to surgery according to your regular schedule including medications for acid reflux (Aciphex, Prilosec, Protonix, Prevacid, Zantac, Pepcid and others), beta-blocking medications (atenolol, metoprolol, propranolol) and certain pain medications including opioids and opioid-like agents (hydrocodone, oxycodone, MS Contin, morphine, Dilaudid and Tramadol) . Take these according to your prescribed schedule, including the morning of surgery, with a sip of water. Please note, if you are talking particulate antiacids (Maalox®, Tums®, Rolaids®, others) please stop taking these 8 hours prior to your scheduled procedure.
When Should I Stop Eating and Drinking?
We generally recommend nothing to eat or drink after midnight the night before surgery. Clear liquids (those you can easily see through) are generally safe up until 2 – 4 hours prior to surgery. It is typically safe to drink clear liquids (water, sport drinks, black or sweetened coffee without cream or cream substitutes) until 4 hours prior to surgery. For certain patients, a light meal (carbohydrate-based, low-fat) may be acceptable the morning of surgery for procedures planned later in the day – those schedules for 8 hours or more after the meal. The safety of this recommendation typically assumes an otherwise healthy, non-obese patient having an outpatient procedure.
What about Smoking?
We recommend stopping smoking at least 48 hours prior to your scheduled procedure. The sooner you quit smoking prior to your surgery the better. Benefits included reduced airway secretions, improved lung function, improved oxygen levels, reduced airway irritability, improved wound healing and reduced risk of infections.
What about Alcohol?
We recommend abstinence from alcohol use for at least 48 hours prior to your scheduled procedure. Patients who typically consume at least 3 drinks per day are at higher risk for postoperative complications including; wound infections, surgical bleeding, cardiac arrhythmias, and increased stress responses to surgery (blood pressure, heart rate, etc.). Patients who drink 3 or more drinks per day benefit from longer periods of abstinence, with improvement in body system functions with 2 – 8 weeks of abstinence.

The Day of Surgery

When Will I Meet My Anesthesia Team?
You will typically meet the members of your anesthesia team the day of surgery prior to heading to the operating room. An anesthesiologist will generally perform a preoperative anesthesia assessment prior to surgery. This assessment will help us formulate the appropriate anesthetic plan for your procedure.
What Is An IV And Do I Need One?
IV is short for “intra-venous” and refers to a medical catheter placed into a vein in your body. IVs are used to give medications and fluids before, during and after your procedure. Nearly every surgical procedure will require placement of an IV. IVs are typically placed in the preoperative care area unless you have an existing IV (you are an inpatient in the hospital for example).