We all have burning questions about general anesthesia, but, with all of the appointments and other business around scheduling surgery, it can be tough to remember to ask those questions. So the Allied Docs put together answers to some of the questions patients might have about this critical part of the surgical experience.
What, exactly, is general anesthesia?
Anesthesia is a medical way to control pain during surgery. The medicines we use during anesthesia are called “anesthetics.” There are several types of anesthesia that do various things, like help you relax, make you very sleepy and forgetful or render you unconscious, which some patients refer to as “going under.”
All forms of anesthesia block pain. What sets general anesthesia apart is that it affects your entire body, including your brain, making you completely unconscious. For general anesthesia, we typically give patients anesthetics intravenously (through an IV) and in the form of gasses they breathe in through a mask.
Why do I have to fast?
This is a very common (and very good!) question. It’s no surprise that fasting can be patients’ least favorite part of surgery, but fasting is extremely important! Here’s why: General anesthesia causes the muscles in your digestive tract and airway to relax so much that they have a very hard time doing one of their most important jobs—keeping food and acid from finding their way to your lungs, which can lead to severe pneumonia.
How does my anesthesiologist know how “much” anesthesia to give?
When you visit your anesthesiologist’s office for your preop consultation, the medical team will conduct all sorts of tests and will take many different measurements from you—your blood pressure, heart rate, temperature and so on. Your anesthesiologist will also ask you a long list of questions. All of this information, together with his or her thorough review of your medical records, plays a significant role in helping your doctor determine the amount of anesthesia you need. You may not know it, but your anesthetic during surgery is as unique as your fingerprints!
For example, through the preop interview, we learn if you might have an inherited tendency to react differently to anesthesia. And factors, such as existing illnesses and conditions, your gender, age, weight and even your hair color (red heads require approximately 20% more anesthetic), can affect your response to anesthesia.
But pre-surgery isn’t the only time we do calculations. During surgery, we also use measures of your blood pressure, heart rate and rhythm, breathing rate and pattern, carbon dioxide and oxygen levels and the amount of anesthetic you exhale to adjust your anesthetic.
Why do I have to stop some of my medications and supplements so far in advance?
A big reason we ask patients to stop taking certain medicines so far in advance is that it’s better to err on the side of caution. We know for sure that some medicines and supplements, like aspirin and St. John’s wort, could create complications during surgery. But there are so many supplements available today, it’s nearly impossible to test them all for safety when combined with anesthesia. We want to make sure there’s very little to none of these medicines left in your body at the time of surgery.
Why does someone have to drive me home?
Following surgery, we give patients special medications that actually help them wake up from an unconscious state. Once you’ve spent a couple of hours in recovery, you might feel relatively normal and awake. You might even think you can drive. But you can’t! We promise! The effects of general anesthesia can take many hours to wear off fully, and, during that time, they can change your reaction times and even your ability to make sound decisions. That’s one of the reasons we also advise patients to avoid making important decisions within 24 hours of receiving general anesthesia.
What if I wake up during surgery and no one knows?
This is the most important question out there, and one we believe should never be sidestepped. And here’s why: It’s important for patients to know that, although it is true—some people have awakened while under anesthesia—the chances of it happening to you are exceedingly rare! The most recent study showed the chance of experiencing an episode of consciousness of any sort during surgery is about 0.005%. It also showed that the majority of episodes have been when the patient was being put under or brought out of anesthesia, not actually during the surgery. That means your chances of waking up during actual surgery are way less than 0.005%. So keep in mind that the benefits you get from a surgery you need will astronomically outweigh the chances you’ll wake up.
Are there things I can do to prepare my body for surgery?
Absolutely! Things like exercise, eating a healthy diet, stopping smoking and reducing alcohol intake are important ways to prepare your body for surgery.
Exercise. General anesthesia and surgery can both lead to atelectasis, a condition in which the air sacs in the lungs collapse. This condition decreases oxygen levels, which slows wound healing and increases the chances of developing pneumonia. Daily exercise like walking, jogging, biking and practicing deep breathing help prevent atelectasis by allowing the tiny air sacs in the lungs to expand fully, increasing lung function.
Nutritious diet. When your body is getting all of the vitamins, minerals and nutrients it needs, your body is able to heal better and more quickly after surgery. Avoid junk foods and foods with high sugar and fat content. Instead, opt for lean meats, low-fat dairy products, fruits, veggies and whole grains.
Quitting smoking. Cigarette smoke contains many toxins—notably, nicotine—that impair wound healing. Nicotine constricts blood vessels, decreasing the amount of oxygen-rich blood traveling to the wound. Stopping smoking before surgery helps to reverse this problem. The longer you’ve been smoke free before surgery, the better your wound healing and the lower your chances of developing an infection after surgery.
Blood sugar. If you have diabetes, make sure your blood sugars are under control before surgery. High blood sugars are associated with greater risks for infection and other complications. Also, be sure the doctor managing your diabetes medications knows about your upcoming surgery.
Healthy weight. If you are obese, try to lose weight. Losing just 2–10% of your body weight prior to surgery has been associated with better outcomes. For example, if you weigh 200 pounds, losing just four pounds could result in a better surgical experience for you.
Most importantly, remember you can always talk about your concerns with your doctor ahead of time. If you have something on your mind, let us know. It’s part of our job (and one we truly enjoy) to make sure you are confident and comfortable every step of the way.
If you’d like to know more about the care Allied Anesthesia patients enjoy, take a look at our Patient Information Page.