PAAMG Frequently Asked Questions: Before Surgery

An anesthesiologist is a physician that has undergone specialized, post-graduate training in the field of anesthesiology. Like all physicians, after graduating from college, anesthesiologists undergo four years of medical school to learn all aspects of medicine.

After obtaining a doctorate in medicine, they proceed to a four-year residency specific to the medical discipline of anesthesia. Some continue to complete additional years of fellowship training within the specialty of anesthesia (i.e.,​ pediatrics, pain, or cardiovascular anesthesia).

A CRNA is an advance-practice registered nurse who is certified in anesthesia.

A CRNA has a masters or doctoral degree, specializing in the administration of anesthesia.

A CRNA administers anesthesia for surgery or other medical procedures.

A CRNA has certification achieved through a program of study recognized by the American Association of Nurse Anesthetists.

​Yes. We have board-certified/board-eligible physician anesthesiologists and CRNA’s rendering anesthesia services for surgery at Providence Alaska Medical Center.

An anesthesiologist or CRNA will be with you in the OR from the beginning to the end of surgery. Only after you are medically stable enough for your care to be transferred to our specially trained, recovery room nursing team will we depart from your care and focus on the next patient.

Yes. Except in an emergency, you will meet your anesthesiologist or CRNA in the pre-operative areas of the ambulatory surgery or main operating room. He or she will discuss your pertinent pre-operative medical history and physical findings important to your anesthesia and surgical services. This is a good time to ask any remaining questions that you may have about your anesthesia care.

Yes. You may call the scheduling office and request a specific anesthesiologist or CRNA to render your care. We ask that you give us three selections to increase our chances of providing a selected physician for your care.

On any given day, we have people on vacation, recovering from an over-night call, or people requested to serve a surgeon on a special case where their particular skills are needed. We schedule a vacation, call coverage, and cases, months in advance. Giving us three choices will help us match your need with a provider of choice.

You may call the Providence operating room scheduling office to indicate these choices at (261-4088)

Bring a list of the medically prescribed and self-prescribed medications (including vitamins and herbal therapies) that you take. Please include the dosages from the bottle labels and how often you take them. Bring your medical insurance information. Bring all paperwork from the surgeon’s office or the pre-operative consultations that you have been given. This may include lab work, x-rays, and EKGs.

If you use a CPAP/BiPAP at night, please bring your machine with you on the day of surgery. If you have an implantable cardiac device (pacemaker, defibrillator, etc.), please bring the wallet card with information on this device.

For exact documentation of your medications, it is always helpful if you bring your medications with you to the hospital, in addition to the list itself. It is particularly important to bring any inhaler medication you may be using. You may be asked to take your inhaler immediately before entering the operating room. By bringing your medications the nursing staff can determine more exactly what type of medications you may need and what dosages you require. If you are required to stay in the hospital after surgery, you will be dispensed medications from the hospital pharmacy during your hospital stay. The medications prescribed to you during your stay may vary slightly from your normal medications used prior to surgery.

Most medications and inhalers can and should be taken on the day of surgery, but there are a few important exceptions. for specific instructions on which medications to take (and which ones to hold) on the day of surgery, please call PAMC Pre-admission Testing (PAT) at 907-212-6013, open 8:00 AM – 6:30 PM, Monday – Friday. The PAT staff can also give you specific instructions on insulin, diabetic medication, amphetamine-type medications, and herbal supplements. While you may be given some instructions by your surgeon’s office, this clinic will provide you with specific instructions, to minimize the chance of any delay or cancellation on your day of surgery.

Due to the risk of post-operative nausea and vomiting and other complications related to the intake of food and fluids, all anesthesiologists have strict criteria on this issue. If your surgeon has asked you to adhere to very strict nothing by mouth orders (for example, nothing to eat after midnight), please follow them. PAAMG anesthesiologists have the following requirements for your safety:

Adult Patients
We request that patients have no food or fluids eight hours prior to your scheduled surgery. If your surgery is scheduled late for the day, we suggest clear liquids in the morning and nothing eight hours prior to the time of surgery. If you are scheduled to take medications during the time you are waiting for your surgery, you may take them with a small amount of water. Clear liquids are liquids that you can see through. These include water, apple juice, and black coffee or tea. Liquids that are NOT clear and should NOT be ingested are orange juice, milk, coffee with cream, and any alcoholic beverages. Please refrain from drinking these beverages on the day of surgery. If a patient has been found to have eaten or drank non-clear liquids within eight hours of surgery, the surgery may be delayed or cancelled.

Children
Children age eleven years old and under may have clear liquids two hours or more before surgery, breast milk four hours prior to surgery, and formula six hours prior to surgery. Food, especially fatty food, should not be consumed for eight hours prior to surgery. Oral medications may be taken one to two hours before surgery and taken with one ounce of water (30 cc)

Please do not eat candy or chew gum on the day of surgery. This increases the amount of stomach fluid and defeats the purpose of not eating prior to surgery. You can brush your teeth as long as you do not swallow the water and toothpaste.

Patients recover from anesthesia better if they refrain from smoking for 24 hours or longer prior to surgery. Smoke containing carbon monoxide may decrease the safety of anesthesia.

Outpatient Surgery: If you are scheduled as an outpatient, you should have an adult with you to take you home and be responsible for your car for the first twenty-four hours after surgery. Your caregiver will need to be able to drive you home and take care of you for a day after the surgery.

Inpatient Surgery: If you are scheduled for surgery followed by a hospital stay overnight, you may come alone to the hospital. However, you will need an adult to drive you home and take care of you the day after you are discharged.

Yes, you may. Please remember that you may be anxious before surgery and want to limit the number of visitors. Please note that visitors are not allowed in the recovery room in order to protect your privacy and that of others. Only special needs patients may have visitors in the pre-operative holding area of the main operating room.

The lobby in front of day surgery is the normal waiting area. After surgery, the surgeon will discuss findings and results with family if that is your wish. Confidentiality is always important to us and we will strive to protect your privacy. Please note your desires to us before surgery.

We normally require patients to arrive at Providence one and one half hours prior to scheduled surgery. Your surgeon may request an earlier time if you need additional testing. Scheduled surgeries are always subject to other emergencies and other complications. Cases ahead of yours may delay your scheduled surgery time. You may also have an earlier case time as cases are moved to fit available operating rooms and case openings. Please give us a number where you can be contacted the day of surgery.

You should refrain from making any legal decisions, major purchases, or using any mechanical equipment for twenty-four hours after surgery. Do not drive a vehicle of any kind during this time.

Bring these items with you with their respective cases to safely store them. We will leave these items in place until the last possible moment and return them to you as soon as possible. If you have any loose teeth or teeth that need to be extracted, please be sure to alert the anesthesiologists prior to the day of surgery. You may need to see a dentist before surgery is possible.

It is safer not to wear make-up into the operating room. Makeup can be a source of skin and eye irritation; eye makeup in particular. You will not make tears or blink during anesthesia. Flecks of makeup can cause eye irritation. Jewelry represents a risk of constriction to fingers (rings) and electro-surgical burns (body piercing, earrings, etc). Please remove all jewelry prior to arriving at the Hospital to prevent their loss and risk to you. If you cannot get them off, get the help of a jeweler prior to arrival.

Yes, in most cases you can receive preoperative anxiety medications. In most cases we will want you to talk with a provider first.

Please stop consuming herbal products unless they are prescribed by your physician two weeks prior to surgery. Please consult with your physician about your prescription medications prior to surgery.

These substances can affect the anesthesia agents we use to care for you. We need to know if you have consumed these substances to adjust your care. We may have to cancel your surgery if the level of these substances in your body exceeds our safety thresholds for your care.