PAAMG Frequently Asked Questions: Actual Surgery

Please note that the information provided on this website is not appropriate to all patients having surgery and should not be relied upon in making medical decisions. The following questions and answers are provided solely for informational purposes, do not constitute medical advice or guidance, and are subject to the disclaimers contained in this website’s Terms of Use. This information should be used only in consultation with an appropriate physician or anesthesiologist. Please contact your surgeon’s office or the anesthesia office if you have questions concerning you and your conditions.

Yes, at Providence Hospital, an anesthesiologist will routinely provide your anesthesia services in the operating room. There are some rare occasions when the surgeon or gastroenterologist may elect to use sedation in conjunction with their procedures and administer it themselves. Providence Anchorage Anesthesia Medical Group employs only physician anesthesiologists. Thus, when the surgeon asks for anesthesia services in the operating room be provided by our group, they will always be provided by an anesthesiologist.
Yes, but we ask that you specify three options to help us fulfill your request around other case demands and staff availability.
Yes, an anesthesiologist will be with you during your entire time under anesthesia. Many physiologic changes take place under anesthesia and we keep an anesthesiologist with you to monitor those changes and your care.
Yes, almost all patients need an IV for surgery and anesthesia to give you fluids and medications. A topical analgesic is used to minimize discomfort.
A general anesthetic involves putting the entire body into a state of unconsciousness for the period of surgery. This is a controlled unconsciousness. The medications used to induce general anesthesia affect all body organs. They are powerful and complex. Getting each patient, as an individual, to the right level of unconsciousness, while minimizing side effects, requires continuous monitoring and adjustments by your anesthesiologist. The induction of anesthesia involves the injection of IV meds or anesthesia gases by mask to quickly and smoothly induce an unconscious state. The maintenance of anesthesia during the surgery involves the use of anesthesia gases and IV meds to keep a patient asleep. Your anesthesiologists will be continuously monitoring your vital signs and anesthetic depth during this time.
No, in almost every case you will not remember anything. Only in rare circumstances does someone recall events during their operation. Your anesthesiologist can discuss this with you further.
Yes, in most circumstances, you will. General anesthetics inhibit our normal ability to breathe and cough on our own. When general anesthesia is used, assistance is needed for the purposes of breathing. This involves the use of a “breathing tube” placed behind your tongue. These tubes are usually placed and removed while the patient is asleep. You should have no memory of the tube or any pain involved with its placement, but some patients will have a sore throat after surgery.
There can be several types of side effects from general anesthesia. Their likelihood of occurrence, however, depends on your medical condition, type of surgery performed, your gender, type of anesthetic agents used, and many other factors. Your anesthesiologist will discuss these issues with you prior to surgery in detail. Most commonly, we will only see minor side effects, if any at all.
Regional anesthesia involves making a particular region of your body insensitive to pain or “numb”. This is often referred to as getting a “block”. The injection of a local anesthetic near a nerve or a group of nerves accomplishes this. With this technique, a limb or portion of your body can be made numb and insensitive to pain. In the operating room, this is a commonly used alternative to general anesthesia. Most patients are familiar with this type of anesthesia on a smaller scale from their trips to the dentist.

Although there are many types of regional anesthesia, the most common ones are spinal, epidural, and arm and shoulder blocks.

Particular surgical procedures are good candidates for blocks (i.e. carpal tunnel release and total knee replacements) – Certain medical conditions of the patient (i.e. severe emphysema is a reason to avoid general anesthesia)

• Patient preference
• Avoidance of general anesthesia (i.e. concern of post operative nausea)
• Avoidance of negative effects of general anesthesia to certain body organs (i.e. a patient with heart disease)
• Prolonged pain relief after surgery

These are two of the common types of regional anesthesia. These anesthetics are used to “numb” the loser half of the body for many surgical procedures. Both types of regional anesthesia involve the placement of a needle, and sometimes a small plastic tube (catheter), into the lower back region. After this is done, local anesthetics are injected to achieve numbness of the desired region. The numbness can last varying amounts of time based upon the amount and the type of anesthetic used.
First the proper monitors will be placed, such as an EKG and blood pressure cuff. An IV will be placed. You are then placed in a sitting position or on your side and sterile drapes are placed on the lower back. A local anesthetic (numbing medicine) is then placed in the area by the use of a small needle. Once the area is numb, a spinal or epidural needle is then advanced to the proper position while you stay still.

After the spinal or epidural is given, a warming sensation is initially felt and later numbness in the lower half of the body. The extent of the numbness and the duration is based on the type of surgery planned and the medications used. The patient also temporarily loses some muscle strength in the area affected.

As with general anesthesia, there are several risks that could occur. However, we rarely see more than a few. These include a minor backache and an occasional headache. Your anesthesiologist will discuss the potential side effects with you.
No, some surgeries are not possible under these types of anesthesia. Other reasons may preclude a patient from regional anesthesia (i.e. certain bleeding disorders and certain infections).
Yes. Your anesthesiologist will assist you with this decision. After the anesthesiologist performs an assessment of you as a patient, your medical history, and a physical examination, he or she will explain the recommended choice and alternatives for your anesthesia plan for you and the surgery that is scheduled. The length and type of surgery will guide the recommendations of the anesthesiologist for your anesthesia plan and the associated risks and benefits. We have years of training and experience in delivering anesthesia services to help us serve you and guide this decision. It is recommended that you follow the guidance of the anesthesiologist but it is ultimately your choice.