Is anesthesia safe?

Over the past several decades, the specialty of anesthesiology has made great strides in improving safety, through the use of newer medications and better monitors. These improvements have been cited by the Intitute of Medicine, of the National Academy of Sciences. The risk of anesthesia is related to a patient's medical status, and, to a lesser extent, to the type of surgery. The chance of serious complications (death, stroke) are similar to the chance of death on a 200 mile car trip. Less serious complications (heart attack, pneumonia) are slightly more likely, but still very uncommon. You can discuss any specific concerns with your anesthesiologist.

It is important to realize that there is no difference in safety between the various types of anesthesia (see below). hide

Isn't a block safer than general anesthesia?

Many people believe that general anesthesia is more dangerous than regional anesthesia or conscious sedation, but numerous studies have failed to demonstrate this. There is no difference in safety for most patients. There are specific surgeries or patient conditions which may make one type of anesthesia preferable in a given case, and your anesthesiologist will discuss this with you, if appropriate. hide

What is "twilight" anesthesia?

Conscious sedation is often referred to as twilight anesthesia. This is appropriate for patients having local anesthesia or procedures that are uncomfortable, but not extremely painful. The American Society of Anesthesiologists has published a patient brochure covering this in more detail, available on our download page or by clicking here. hide

Can I just have local anesthesia?

Local anesthesia, with no sedation, is appropriate for many types of minor surgery. Local anesthesia refers to injections of numbing medication at the site of surgery. However, many patients will feel something (not necessarily pain), and will be excessively anxious about this. A good solution in these cases is conscious sedation (see Services). For more extensive surgery, it is impossible to make a patient comfortable with just local anesthesia, and one of the other choices is appropriate. hide

Why can't I eat the day of surgery?

Not eating the day of surgery helps to ensure your safety during and after the procedure. During anesthesia your muscles relax, and normal reflexes do not function. You are more likely than normal to have stomach contents pass up to the mouth, and you will not be able to cough. If stomach contents reach the lung, you can develop serious respiratory complications. If your stomach is empty, this is much less likely to happen. hide

How much will it hurt after surgery? How will my pain be controlled?

Everyone's pain after surgery is different. Most patients require at least some narcotics after surgery, and this is usually arranged by your surgeon. Narcotics can be given by mouth, or intravenously. Patients who have had painful procedures will often have a "pain pump," which delivers narcotics that the patient controls. This delivery method is very effective and has a very low complication rate. Some patients have severe pain despite narcotics, or have pain that is treatable or preventable with nerve blocks. In these cases, pain physicians from Morris Anesthesia Pain Group will be involved in the management. Your anesthesiologist will discuss your pain management concerns with you before surgery. hide

I have had nausea and vomiting after anesthesia in the past. Can I avoid this in the future?

We will make every possible effort to minimize and nausea and vomiting associated you're your surgery and anesthesia. Nausea and vomiting are two of the most distressing side effects of general anesthesia and narcotics. It is not possible to avoid prevent these symptoms in all patients, but your anesthesiologist can 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 give you powerful anti-nausea medications to help avoid symptoms. If you have had severe symptoms after anesthesia in the past, you should alert your surgeon and the nurse who contacts you pre-operatively. Some of the best medications to prevent post-operative nausea and vomiting are most effective when taken before surgery. hide

I have a living will. What happens with this during surgery?

It depends on your personal preference. A living will is important to guide your family and caregivers on what to do if you are incapable of making decisions and your situation is hopeless. This situation rarely arises during or soon after surgery, but it could. You should discuss this with your surgeon and anesthesiologist, to be sure your wishes are followed. hide

I do not wish to be resuscitated (DNR) in the event of a cardiac arrest. Will this be honored during surgery?

A DNR order is a very personal decision, and should be carefully considered. Routine and normal anesthesia and surgery involve many things that could be considered "resuscitation," so it is very important to discuss this with your surgeon and anesthesiologist. hide

I am scared of being awake during surgery. Can this be avoided?

We take every effort to prevent awareness during surgery. True awareness under anesthesia can be a terrifying experience, in which the patient is awake and aware of what is happening during surgery, but unable to alert the staff in the operating room. With this awareness, there may be pain, or the patient may be comfortable. Awareness under anesthesia is more likely in emergency situations such as emergency cesarean sections or severe trauma when patients may not be stable enough to receive adequate anesthesia. In other cases, awareness under anesthesia is very rare, and there are drugs and techniques that can reduce, but not completely eliminate, the chance of awareness. Thankfully, true awareness for any type of surgery is extremely rare. The American Society of Anesthesiologists has prepared information on this, available in our download section or by clicking here. hide

I remember having a sore throat after surgery. Will I have this again?

You may. Many surgeries performed under general anesthesia require insertion of a breathing tube or another device to assist with breathing. This commonly causes irritation and pain in the back of the throat, which can last about a day. hide

What is malignant hyperthermia?

Malignant hyperthermia (MH) is a life-threatening complication of anesthesia, in which the patient's temperature climbs dramatically. A genetic (hereditary) disorder makes people susceptible to MH, so patients with prior episodes of MH, or family members who have had MH are at increased risk. Luckily, MH is preventable and mostly treatable if recognized early. Be sure to discuss this with your anesthesiologist if you think you might be at risk. For more info, visit the The Malignant Hyperthermia Association of the United States website. hide

Should I take my medication on the day of surgery?

It depends on the specific medicine. Do not take aspirin, coumadin, heparin, or oral diabetes medication, unless instructed to do so by the doctor who prescribed it, or by your surgeon. Stopping these medications can be dangerous for some patients, so be sure to ask your regular doctor or surgeon what to do about them. In general, you should take other regular medication at the normal time, with a sip of water. It is most important to take your regular medication for your heart or blood pressure. For a complete list, see Medications. hide

I take pain medication -- do I have to stop it?

Again, it depends on the specific medicine. Narcotics, Ultram, acetominophen (Tylenol), and Celebrex can be taken up until the time of surgery. The non-steriodal anti-inflammatory (NSAID) medications can cause increased bleeding, and should be stopped 24 hours before surgery. This class of medications includes ibuprofen (Advil, Motrin), and naproxen (Aleve). Medications containing aspirin can also cause increased bleeding, and should be stopped 7 days before surgery. hide

Should I stop taking my herbal medication before surgery?

The safest option is to stop taking herbal medications one week before surgery. Patients take herbal medications for many chronic conditions, and to prevent illnesses. Unfortunately, herbal medications are not FDA-controlled, or labeled with safety warnings. Some herbal medications can cause bleeding problems or blood-pressure problems during surgery. For more information, see the American Society of Anesthesiology patient brochure "What You Should Know About Herbal and Dietary Supplement Use and Anesthesia" available in our download section or by clicking here. hide

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. hide

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" which is available in our download section or by clicking here. hide

Should I get an epidural?

It's a personal decision whether one should get a labor epidural. Epidurals have been proven to be safe and provide much better pain relief during labor than other options such as intravenous medications. The vast majority of patients (>95%) elect to receive epidurals although there are a select few who elect to deliver without one. hide

Are epidurals safe?

Epidurals have been proven to be very safe and effective and are used routinely throughout the U.S. and world. As with any medical procedure, there is a very small chance of complications. Your anesthesiologist can discuss this with you in detail. hide

Will an epidural affect my baby?

In the vast majority of cases the baby and mother are not affected in any adverse way. However, because an epidural can decrease blood pressure in the mother and thus affect blood flow to the placenta, patients receiving epidurals are monitored closely. The baby will also be monitored closely with an electronic fetal monitor. Any changes are detected and treated immediately. hide

Can I still have surgery and anesthesia if I'm pregnant?

Many types of surgeries, including major ones, have been performed safely in pregnant women with no adverse outcome to the mother or child. However, there is always a small risk to the baby when a pregnant woman receives anesthesia. It is recommended than pregnant women not undergo surgery if possible. If you are pregnant and must have surgery, your surgeon, anesthesiologist, and medical care team will work closely with you to help avoid any complications. hide

How will my child be put to sleep?

To avoid placing an intravenous (IV) line in an awake child, most children are put to sleep with a mask. Most often, this entails giving the child a combination of nitrous oxide (laughing gas) and another anesthetic gas. Typically, it takes only a few minutes for a child to fall asleep in this manner. If needed, an IV will be placed after the child is asleep. hide

My child is afraid of masks. Is there another option?

Using a mask to put a child to sleep is not mandatory. The other option is to place an IV pre-operatively as is done with most adults. Medications can be given through the IV to put the child to sleep. hide

Does my child have to have an IV for surgery?

It depends on the type of surgery. For some smaller surgeries, such as myringotomy tube (ear tube) placement, your child may only require mask anesthesia without an IV. For other surgeries such as for tonsils and adenoids, IVs are mandatory to ensure safety. Most often, IVs can be placed after a child is put to sleep with a mask. hide

How long will my child be groggy?

This depends on the type of surgery, length of surgery, medications that were used, and the child. Anesthesia affects people in different ways so some children may be more likely to be groggy than others. Typically, children may be groggy for only an hour or two for smaller surgeries such as ear tube placement and for many hours for larger surgeries such as tonsil removal. For the most part, children should be alert and active within 24 hours after surgery. hide

How can I prepare my child for his anesthesia/surgery?

The most important thing is to tell the child as much about the surgery as possible beforehand. The American Society of Anesthesia "My Trip to the Hospital" coloring book is a great tool for parents to use and is available in our download section or by clicking here. hide