As a patient preparing to undergo a surgical procedure we understand that you may have questions, anxiety, and often a fear of anesthesia. Anesthesia is often portrayed as a negative and frightening experience in movies and television. At BPW Medical Associates we strive to alleviate these fears and educate you on what you can expect during your experience with us.
The following information is a basic guide to what you can expect from your surgery as well as the basics of the various methods of anesthesia.
All patients scheduled for surgery are screened by a telephone or in person interview prior to your scheduled procedure and your health information is reviewed by your PCP as well as one of our anesthesia professionals. After your information is reviewed we will choose the safest method of anesthesia and the best experience for you as a patient. At BPW medical associates will will always provide you with the safest and most appropriate method of anesthesia for your specific surgery and health history. We are often able to accommodate and tailor your anesthetic to your specific requests.
TYPES OF ANESTHESIA
General Anesthesia
Produces a loss of sensation throughout the entire body. General anesthesia places the entire body, including the brain, into a state of unconsciousness (sleep) during which the patient has no awareness and feels nothing, and will remember nothing of the surgical experience.
General anesthesia is administered by injection or through a breathing mask, or sometimes both. In order to control your breathing, patients are intubated, which is the insertion of a flexible tube down the trachea(windpipe). The tube is inserted after the anesthesia is given and removed as you are waking up and breathing adequately. Upon awakening from anesthesia, patients may experience disorientation and/or a mild sore throat from the intubation.
Laryngeal Mask Airway (LMA) –When possible, the anesthesia team will use a Laryngeal Mask Airway device instead of intubation because it is quicker and causes less discomfort for the patient. An LMA is a tube with an inflatable cuff that is inserted into the pharynx (the upper part of the windpipe).
Monitored Anesthesia Care (MAC) is the intravenous administration of mild sedatives to help a patient relax and relieve anxiety during minor procedures that do not require general anesthesia. These procedures, such as biopsies and colonoscopies, typically require the injection of a local anesthetic to numb the surgical site. This is often combined with regional anesthesia such as a nerve block or spinal anesthetic. During this procedure you may remember hearing some talking but will be comfortable and pain free. Often times patients feel as though they had a wonderful dream or a great nights sleep.
Regional Anesthesia- Produces a loss of sensation to a specific region of the body.
Regional anesthesia is the injection of a local anesthetic around individual nerves to block pain and sensation to a specific area of the body. Regional anesthesia provides muscle relaxation as well as postoperative pain relief since its numbing effects can last for 12-24 hours depending on the type of local anesthetic and dosage used. Nerve blocks are often preferred over general anesthesia as this reduces the need for pain medications including narcotics after surgery. Also the risk of postoperative nausea is reduced. Often you may receive sedation to help you relax or sleep during surgery.
TYPES OF REGIONAL ANESTHESIA ARE:
Axillary Nerve Block – Local anesthetic is injected around the nerve that passes through the axilla (armpit) from the shoulder to the arm to numb the feeling in your arm and hand. Typically used for surgery of the elbow, forearm, wrist, or hand.
Interscalene Nerve Block – Local anesthetic is injected around nerves in the neck which numbs the shoulder and arm. Typically used for surgery of the shoulder and upper arm.
Femoral Nerve Block – Local anesthetic is injected around the nerve block in the upper thigh/groin area to numb the leg from the knee to the hip. Typically used from surgery of the upper leg, hip or knee.
Ankle Block – Local anesthesia is injected around the ankle to block the five nerve branches that supply sensation to the foot. As the name indicates, used for surgery of the ankle, foot or toes.
Bier Block – Local anesthetics are injected intravenously to numb a limb, typically the arm, and then a tourniquet is applied to prevent the anesthetic from leaving the area. Typically used on surgeries of hand or arm that last less than an hour.
This is a small example of the numerous nerve blocks available, we will choose the most appropriate and safest nerve block for your individual procedure. Often times we will provide multiple nerve blocks to optimize you pain control and to keep you as comfortable as possible during and after your surgery.
Local Anesthesia: Produces a loss of sensation to a small specific area of the body.
Local anesthesia is administered by injecting a medication(local anesthetic) in the direct surgical area by the surgeon or a member of the anesthesia team. The area surrounding the injection site will be pain free and often a surgeon is able to remove a small area of tissue without a patient receiving sedation. Local anesthesia lasts for a short period of time and is often used for minor outpatient procedures (when patients come in for surgery and can go home that same day). For someone having outpatient surgery in a clinic or doctor's office (such as the dentist or dermatologist), this is probably the type of anesthetic used. The medicine used can numb the area during the procedure and for a short time afterwards to help control post-surgery discomfort.
Epidural and Spinal Anesthesia can be used for most surgeries below the belly button. In order to get an epidural or spinal anesthesia, an IV must first be inserted since these procedures require the patient to be properly hydrated. Both epidural and spinal anesthesia use a local anesthetic to numb the area where the needle is inserted. Depending on the type of surgery, patients may also be placed under general anesthesia or a mild sedative that allows them to relax and/or sleep.
Epidural anesthesia is administered in the lower back/lumbar region using a special needle that is inserted between the vertebrae of the spinal column into the epidural space around the spine. Once in place, a small catheter (tube) is placed into the epidural space via the needle, and then the needle is removed, leaving the catheter in place. Local anesthetics and narcotics are then given through the catheter. The procedure usually takes 10 to 25 minutes. Because an epidural uses a catheter, pain medicine can continue to be administered to provide post-operative pain relief if needed
Types of Procedures: Typically used for labor, cesareans (c-sections) and surgeries of the colon and gastrointestinal tract, or longer orthopedic procedures.
Spinal Anesthesia is administered in the lower back/lumbar region using a spinal needle that is inserted between the vertebrae of the spinal column into the dural membrane, which covers the spine and nerve roots. Once in place, medicines including a local anesthetic and sometimes a narcotic are given through the needle, and then the needle is removed. The entire process usually takes anywhere from 5 to 20 minutes.
Types of Procedures: Typically used for gynecologic (e.g. hysterectomies) and urologic (e.g. prostate) surgeries, as well as surgeries of the lower extremities (e.g. knee surgery).
For more information regarding Regional Anesthesia click here
