Anesthesia

Choosing Your Anesthesia

You will always be given local anesthesia for your surgery, but you may also choose any of the supplemental forms of anesthesia listed below. Each choice requires different preparation on your part, and for your safety it is important that you read and follow the instructions carefully. If you are unclear about anything, please ask your doctor.

For all surgery, please wear comfortable, loose-fitting clothing. Tops/shirts should have sleeves that are easily drawn up above the elbow. Females should remove nail polish and jewelry before surgery, and apply as little makeup as possible.


LOCAL ANESTHESIA 

Local anesthesia will produce a numb feeling in the area being operated on and a feeling of pressure during surgery. You will be awake and recall the surgery if this is the only anesthesia used, but there should be no significant discomfort. This is the safest form of anesthesia.

Local Anesthesia Instructions:

  1. Have a light meal a few hours prior to surgery, unless you are also having intravenous or general anesthesia.
  2. For more extensive procedures you may wish to have someone drive you home.
  3. Plan to rest for a few hours after surgery.

Nitrous Oxide

Nitrous oxide is also known as “laughing gas.” You will be relaxed and somewhat less aware of your surroundings, but will recall most of the surgical event. Nitrous oxide may also be used to supplement one of the other anesthetics.

Nitrous Oxide Instructions:

  1. Have only a light meal several hours prior to surgery unless you are also having intravenous or general anesthesia.
  2. It is best to have someone drive you home but is not necessary unless you are combining this with other anesthetics.
  3. Plan to rest for the remainder of the day.

ORAL PREMEDICATION

This type of anesthesia may be used as a supplement to local anesthesia and consists of medication taken by mouth to produce relaxation before and during your operation.

Oral Premedication Instructions:

  1. Take the medication at the time directed before your surgery.
  2. Have only a light meal several hours prior to surgery.
  3. It is not safe to drive after taking sedative drugs, and you MUST have someone drive you to and from surgery.
  4. Plan to rest for the remainder of the day. Do not operate power tools, machinery, etc., for 24 hours after surgery.

INTRAVENOUS SEDATION

Medications are given through a vein in your arm or hand, which will cause relaxation and a state of semiconsciousness or unconsciousness, there will be very little recall (if any) of the events surrounding surgery.

Intraveneous Sedation Instructions:

  1. Do not eat or drink anything (including water) for six (6) hours prior to surgeryHowever, it may be important that you take some or all of your regular medications (high blood pressure, antibiotics, etc.) or any pre-medication prescription that we have provided, using only a small sip of waterTalk to your doctor about continuing or holding medicines on the day of surgery.
  2. Take any medications with only enough water to get the pill down if you are told to take them on the day of the surgery.
  3. You MUST have someone drive you home.
  4. Plan to rest for the remainder of the day. Do not operate power tools, machinery, etc., for 24 hours after surgery.
  5. Someone MUST watch you for at least eight hours after you leave for home and be prepared to watch you for up to 24 hours.

GENERAL ANESTHESIA

Medications are given through a vein and/or gases via a mask which will result in total loss of consciousness, complete lack of recall of the event and usually a longer recovery time. A tube may be placed into your airway via your nose or mouth and an anesthesia machine may be used to give you breaths. This is the deepest form of anesthesia and carries the highest risk. This is the most common form of anesthesia used for in-hospital procedures. General anesthesia has an excellent safety record as an office procedure, but may, if desired, be provided in a hospital setting. (Your health insurance may not cover you unless there is a bona fide medical reason for hospitalization.)

The same instructions offered above for intravenous sedation apply for general anesthesia.

Our goal is to provide you with a safe, pleasant and effective anesthetic. In order to do this it is imperative that we have your full cooperation. Please feel free to ask or call about any questions concerning your surgery or anesthetic.


Pre-Operative Instructions for By-Mouth-Sedation

  1. If you wish you may have a light meal a few hours before surgery, but keep in mind the anesthesia can give you nausea.
  2. Take preoperative medications if prescribed: (Take with a sip of water)
    1. If you have a heart murmur inform me. If a Cardiologist recommends Subacute Bacterial Endocarditis (SBE) prophylaxsis then inform me and take regimen as usual or I can give you the necessary prescription.
    2. Antibiotic (e. g. Penicillin, Amoxicillin, Cephalexin, Clindamycin). Start first dose at least one day prior to surgery if prescribed.
    3. While taking antibiotics, birth control pills may become ineffective. Extra birth control methods should be taken if you are on antibiotics.
    4. Dexamethasone if prescribed; start one to three hours prior to surgery.
    5. Sedatives, such as Ativan (Lorazepam), should be taken one hour before sleep the night before your appointment (if prescribed) (and) one to two hours prior to surgery. Do not take any pain pills at this time and do not take any mood altering substances such as alcohol with this medication. To do so could be life threatening.
  3. A responsible adult must accompany the patient. The person must be able to drive because the patient will not be allowed to drive for 24 hours. Someone must watch the patient for at least 4 hours after the surgery. They cannot be dropped off alone.
  4. If you have a severe cold, sore throat or sinus infection with excessive drainage immediately prior to the procedure please call the office to speak to the doctor. He may want to see you in advance of the procedure or reschedule until after you have recovered.
  5. No makeup or jewelry should be worn on the day of surgery. In particular at least one fingernail should be without nail polish to facilitate monitor placement. Loose clothes should be worn to facilitate starting an intravenous line in the patient’s upper arm, and to place monitors on the chest if needed. Flat comfortable shoes should also be worn.

Pre-Operative Instructions for Intravenous Sedation or General Anesthesia

  1. Nothing to eat or drink after midnight on the night before surgery or for at least six hours before surgery.
  2. No smoking at least 48 hours before anesthesia.
  3. Take preoperative medications if prescribed: (Take with a sip of water)
    1. If you need antibiotic prophylaxis for a heart condition, prosthetic implant such as a hip-joint or a heart valve or because of immune system compromise then inform me well before the procedure. We can give that medication via the I.V. at the time of surgery.
    2. Antibiotic: Start first dose one day prior to surgery, if prescribed. But do not take any the morning of the surgery. This will be given through your IV during surgery. (ie; Penicillin, Amoxicillin, Cephalexin, Clindamycin).
    3. Sedatives such as Valium may be prescribed to be taken the night prior to surgery and /or the morning of surgery. (If so take with a sip of water)
    4. Some medicines should not be stopped such as heart medicines please discuss all your regular medications with your surgeon.
    5. Discontinue all herbal medications and vitamin supplements except for a small daily multivitamin 2 weeks prior to surgery if possible.
    6. A daily multivitamin is advisable to optimize healing. But do not take it the morning of surgery.
  4. A responsible adult must accompany the patient. The person must be able to drive because the patient will not be allowed to drive for 24 hours. Someone must watch the patient for at least 8 hours after the surgery. They cannot be dropped off alone.
  5. Loose clothes should be worn to facilitate starting an intravenous line in the patient’s upper arm, and to place monitors on the chest. Flat comfortable shoes should also be worn.
  6. If you have a severe cold, sore throat or sinus infection with excessive drainage prior to surgery please call the office to inform the doctor. He may want to see you in advance of the procedure or reschedule until after you have recovered.
  7. No makeup or jewelry should be worn on the day of surgery. In particular at least one fingernail should be without nail polish to facilitate monitor placement.

Anesthesia Forms