Most patients ignore the great importance of anesthesia as part of their surgery. The person who puts patients to sleep during their operation is a medical specialist is called the Anesthesiologist.
It is important that you understand the role of the Anesthesiologist as part of the surgical team. His/her role is as important as the Surgeon’s role itself, for your operation to be a success. The Anesthesiologist is a physician trained in anesthesia and other medicines used during surgery. They are in charge of your comfort before entering the operating room, but they also administer the medications required to produce minute-by-minute relaxation of your body during surgery, provide freedom from pain and control your breathing by the administration of oxygen. The Anesthesiologist is responsible for monitoring all body systems during the operation including respiratory, cardiac, brain, liver and kidney functions. He/she is alert to any changes and adjusts the administration of medications and oxygen to maintain normal function.
At the completion of the surgical procedure, it is the Anesthesiologist that slowly raises the level of consciousness to a dream-like state to full wakefulness, through the administration of medications that counteract the anesthesia. As no two individual are alike, every patient is closely monitored during the post-operative recovery period by the Anesthesiologist and administration of medication is adjusted according to individual responses.
Anesthesia involves the use of medicines to block pain sensations during surgery and reduces many of the body’s normal stress reactions to surgery. The anesthesia can be general, regional or local.
General Anesthesia is given into a vein (intravenously). It affects the brain as well as the entire body. You are completely unaware and do not feel pain during the surgery. After you are asleep, a tube will be plaplaced in the airway, connecting the respiratory system to a vnventilation system. This is called intubation. The tube will remain in plaplace during the entire procedure and is removed before you awaken.
Epidural and Spinal Anesthesia is a local anesthetic is injected near the spinal cord and nerves that connect to the spinal cord to block pain from an entire region of the body, such as the abdomen, hips, or legs. Some people are fearful when they hear the term “Epidural”. However, this technique has improved remarkably with the years, and with the modernization of anesthesia, in the same way that Plastic Surgery improves day-to-day. This technique, more correctly called “Epidural Block”, prevents pain sensation. Furthermore, it allows you to follow directions given by the Anesthesiologist and prevents “anesthesia hangover” which may occur following general anesthesia.
Regional Anesthesia involves injection of a local anesthetic (numbing agent) around major nerves or the spinal cord to block pain from a larger but still limited part of the body for example: the whole arm, or the lower half of your body. You will likely receive medicine to help you relax or sleep during surgery. Major types of regional anesthesia include:
Local Anesthesia involves injection of a local anesthetic directly into the surgical area to block pain sensations. It is used only for minor procedures on a limited part of the body, for example- to suture a skin wound or set a broken finger. You may remain awake, though you will likely receive medicine to help you relax or sleep during the surgery
It is extremely important to meet and talk to your Anesthesiologist before surgery. This will allow you to know both specialists, the Surgeon and the Anesthesiologist that will take part in your operation, providing you increased confidence as you prepare to undergo your surgery.
During the interview, your Anesthesiologist will ask questions about your health and previous anesthesia experiences that you have had. It is extremely important that you provide all necessary information.
In addition, the Anesthesiologist will do a brief physical examination. He/she will advise you of steps you will need to take in preparation for your surgery such as nail polish removal the day of your surgery, and care of dental appliances, etc.
This is the time for you to ask any questions you may have about your anesthesia. You may want to know what type will be used, the approximate time during which you will be asleep, the risks involved and any possible side effects that could occur. The Anesthesiologist is best suited to answer these and any other questions about anesthesia.
It has been my experience through hundreds of surgical cases, as a Plastic Surgeon as well as a General Practitioner (and as a patient, too!) that if a patient enters surgery in a state of relaxation, so he/she will wake up. The opposite also holds true: if he/she enters in a state of emotional or physical tension, he/she is going to wake up in tension. To have the best possible surgical experience possible, I offer the following advice:
- Follow all the instructions that the Anesthesiologist and I have given to you.
- General anesthesia requires a minimum of 8 hours of fasting. This means that your stomach must be completely empty (no solids, no liquids-including water-for at least 8 hours before the surgery. We cannot overemphasize this, it is of vital importance.
- Think positive. Stay focused on the benefits of your surgery.
- Practice relaxation. Allow your muscles to go loose. Center your attention on your breathing: drawing air into your lungs, and allow it to flow out smoothly and effortlessly.
- Once you start waking up, listen our voices: anesthesiologist, the nurse’s or mine. We will give you instructions to breathe. This is the time for you to focus on relaxing and performing controlled breathing exercises. Trust your body.
- If you unable to speak as you are regaining consciousness, stay calm. This is natural. A movement of your head or a signal will indicate to us that you can hear us and that you are ok.
- Do not touch the surgical sites. It will be difficult to assess the outcome of your surgery by blind touch and you may disturb the dressings that are protecting the sites.
- Once you are back in your own room, continue practicing your muscle relaxation, and controlled breathing. You will always have a nurse with you.
I hope these recommendations will prove useful. I wish you an excellent and quick recovery and that your anesthesia to be a pleasant experience.