During surgery, you will be given some form of anesthesia, which is medication administered for the relief of pain and sensation during surgery. The type and dosage of anesthesia is determined and administered by the anesthesiologist. When you arrive for surgery, you will meet with your anesthesiologist before the procedure. He or she will review your medical condition and history to formulate the most appropriate anesthetic for your surgery.
There are various forms of anesthesia. The type of anesthesia you will receive will depend upon the type of surgery and your medical condition. The different types of anesthesia include the following:
Local Anesthesia (LA)
Local anesthesia is an anesthetic agent given to temporarily stop the sense of pain in a particular area of the body. The patient remains conscious during a local anesthetic. For minor surgery, a local anesthetic can be administered via injection to the site. The patient does not feel pain, but may still feel pressure during the procedure. When a large area needs to be numbed, or if a local anesthetic injection will not penetrate deep enough, a regional anesthetic is usually more appropriate.
Regional Anesthesia (RA)
Regional anesthesia is used to numb only the portion of the body that will receive the surgical procedure. Usually an injection of local anesthetic is given in the area of nerves that provide feeling to that part of the body. Regional anesthesia is frequently a good option for orthopedic surgical procedures and can serve as the primary anesthetic or used in addition to general anesthesia to help with post-operative pain control. The arm and leg are the most common areas to perform a regional anesthetic. When used in combination with a general anesthetic, regional anesthesia typically helps reduce the total amount of anesthesia necessary to keep the patient comfortable both during surgery and post-operatively. Because regional anesthesia reduces the amount of pain experienced post-operatively, the need for pain medication is minimized and hence the associated undesirable side-effects, e.g., nausea and vomiting. In some children undergoing urologic procedures (e.g. circumcision), it is common to perform a caudal, or “saddle block,” in conjunction with general anesthesia to help ensure adequate post-operative pain control.
Monitored Anesthesia Care (MAC)
A monitored anesthesia care technique usually involves the administration of intravenous anesthetic drugs, oxygen (given with a nasal cannula or face mask), and standard patient monitoring procedures similar to those used during a general anesthetic. MAC implies that the trachea (windpipe) is not intubated. Because MAC usually entails the administration of lower doses of anesthetic drugs than with a general anesthetic, the recovery period tends to be shorter. The drugs that are used can definitely affect one`s ability to remember the procedure, but periods of awareness can occur during the procedure. The MAC technique is often combined with the use of local anesthesia. This anesthetic option is not always possible given the type and location of the planned surgical procedure. If a patient is uncomfortable during a surgical procedure in which the MAC technique is being utilized, then the anesthesiologist will convert to a general anesthetic.
General Anesthesia (GA)
General anesthesia is an anesthetic used to induce unconsciousness during surgery. The medication is either inhaled through a breathing mask and/or administered through an intravenous line (a thin plastic tube inserted into a vein, usually in the hand or forearm). A breathing tube may be inserted into the windpipe or in the back of the throat to maintain proper breathing during surgery. Once the surgery is complete, the anesthesiologist ceases administering the anesthetic, the breathing tube is removed, and the patient is transported to the Recovery Room to wake up and for further monitoring.