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Monday Medical: Anesthesia basics

Susan Cunningham/For Steamboat Pilot & Today

If you’re heading in for surgery, the anesthesia you’ll be getting might not be top of mind. But it’s a critical part of many medical procedures.

Below, Dr. Sarah Gebauer, an anesthesiologist at UCHealth Yampa Valley Medical Center, outlines what you need to know about anesthesia.

There are different types

“Anesthesia is a spectrum — from making people less anxious but still completely awake, to making people insensitive to pain, so they can tolerate procedures or surgeries,” Gebauer said.

In general anesthesia, a patient is unconscious and has no awareness or sensation. Typically, a patient is put under general anesthesia with medication through an IV and is kept asleep by breathing anesthetic gases.

In regional anesthesia, only part of the body is numbed with a local anesthetic drug. Spinal anesthesia, in which medicine is injected into the fluid of the spinal cord, may be used for C-sections, hip surgeries and any other surgery below the waist. Epidural anesthesia, in which medicine is injected just outside the spinal cord’s surrounding fluid, may be used for labor or to provide pain relief after larger surgeries. Nerve blocks, in which a group of nerves that cause pain to a certain organ or area are numbed, can be used to treat or determine sources of pain.

In local anesthesia, a very small part of the body, such as a finger, is numbed.

In monitored anesthesia care, patients are sedated to varying degrees. That might mean a patient feels a little groggy, or it might mean a patient is fully asleep.

Depending on the procedure, multiple types of anesthesia may be used.

The type of anesthesia depends on the procedure

Smaller, faster procedures may require less anesthetic, while longer, more uncomfortable procedures require more. Patient preference may come into play. For arthroscopic knee surgery, some patients have a spinal anesthetic, so they can watch the surgery and even talk with the surgeon.

An anesthesiologist is always present

Worried that you’ll be left alone in surgery? You don’t have to be.

“I always like to reassure people that we stay with them the whole time,” Gebauer said. “There’s an anesthesiologist sitting there and monitoring your vital signs every single second.”

Follow pre-surgery eating and drinking guidelines

Eating or drinking too close to a surgery can result in aspiration, in which food from your stomach enters the trachea and lungs. During anesthesia, natural reflexes that keep food out of the trachea are decreased or eliminated.

“Aspiration can be very dangerous,” Gebauer said. “We don’t want your surgery to be delayed, and we want to keep you safe, so follow the recommendations that your medical provider makes.”

Talk with your anesthesiologist

Be sure to tell your anesthesiologist about any drugs you use, including marijuana, as they can affect how much anesthetic should be given and is safe. And tell him or her if you’ve had previous experiences with anesthesia.

“Let us know if you’ve had nausea or vomiting after anesthesia,” Gebauer said. “There are several techniques we can use to decrease that risk. Even if it was mild, we want to know about it, as we take it seriously.”

It’s possible to have a vague memory of the procedure

Though it’s extremely unlikely that a patient would wake up during general anesthesia, a patient under monitored anesthesia care may remember part of the procedure. “Some will remember hearing voices or seeing lights,” Gebauer said.

And don’t worry about saying anything you’ll later regret. “People are always worried about saying something embarrassing before they go to sleep, but they don’t,” Gebauer said.

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.


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