5 questions about anesthesia

Anesthesia is used to make you emotionally and physically comfortable during surgery. It can relieve anxiety, block pain and, in some cases, put you in an unconscious state so that you aren’t aware of and don’t remember your surgery.

Anesthesia can also help achieve better results for patients undergoing non-surgical procedures. For example, if you need to hold your breath to ensure a clear, accurate image, your doctor may recommend anesthesia to help relax your muscles. 

We talked with Elizabeth Rebello, M.D., about types of anesthesia, potential side effects and how best to prepare. Here’s what she shared.

What are the types of anesthesia?

There are four types of anesthesia:

• Local anesthesia — You’ll receive an injection that is isolated to the area of the procedure. The drug will numb only that area, and you’ll remain conscious.
• Monitored anesthesia (a.k.a. twilight anesthesia) — Medications for sedation and pain relief are given to make you feel calm and relaxed, but you may hear what’s going on around you. An anesthesia provider is present throughout the procedure.
• Regional anesthesia — By combining local anesthetics with other medications, we can provide nerve blocks to a larger area of the body. This type of anesthesia is frequently used during a procedure and for postoperative pain relief. We commonly use this technique with surgeries performed on the breasts, abdominal area and brain.
• General anesthesia —We render you fully unconscious so you’re in a sleep-like state. You’ll be unable to recall the procedure when you wake.

The type of anesthesia you receive will depend on the procedure you undergo.

How is anesthesia administered?

It depends on the type of anesthesia. To start, you can expect a trained nurse or nurse anesthetist to insert a line into one of your veins with a needle, called an intravenous line or an IV. This allows the medication to flow directly into your blood stream for quicker action. The needle is removed and only a tube known as a catheter remains secured in your vein. Next, you’ll likely receive sedation to help calm your nerves. When you’re taken into the operating room, we’ll connect monitors that help us assess your heart and lung function. Then, after receiving oxygen through a face mask, you’re ready to receive more powerful anesthetic medications through the IV.

If you’re receiving general anesthesia, we’ll first give you medications to put you asleep. We’ll then place a tube in your airway or a device above your vocal cords to ensure you can breathe comfortably throughout the procedure. To ensure you stay in a sleep-like state, you’ll inhale anesthesia in a gas form.

How should I prepare for anesthesia?

Prior to surgery, we’ll meet with you to assess your overall health. If you’ve had previous medical concerns, such as heart and lung issues, bring them up during this meeting because you may be at higher risk for complications. We also want to know if you’ve had any dental work, such as dental implants.  In addition, alert your anesthesiologist if you have a family history of a condition known as malignant hyperthermia, a severe increase in body temperature that can be triggered by certain medications used during general anesthesia.

Also, don’t eat eight hours before surgery because there’s a risk of aspiration. This means food in your stomach could enter your lungs while you’re under anesthesia. You may drink clear liquids such as water, apple juice and sports drinks up to two hours before the surgery.

In addition, at your pre-operative evaluation, it’s important you share an accurate list of medications you’re currently taking. We may ask you to take new medications prior to anesthesia, or we may ask you to stop taking certain medications that may cause complication when receiving anesthesia. It is important to bring your home medications with you on the day of surgery.

Lastly, if you’re a smoker, it’s best not to smoke prior to surgery. In fact, it’s a great time to quit smoking and start a new, healthy chapter in your life.

What are side effects of anesthesia?

Nausea and vomiting are the most common anesthesia side effects, and patients who receive general anesthesia may experience grogginess when they wake up. But there are medications that we can give to help relieve your discomfort.

Is there anything else that you want patients preparing for anesthesia to know?

Anesthetics are powerful drugs shouldn’t be administered by anyone other than an anesthesiologist. We have extensive training, so we can address complications if they arise. Unfortunately, the best drug in the wrong hands can cause death. You’re in the right hands at MD Anderson.

If you have concerns about how your body will handle anesthesia, don’t hesitate to speak up. We have different ways to tailor your care to your needs and goals. And it’s OK to be nervous. We’re here to tell you what to expect and help you get back to living your life.

Request an appointment at MD Anderson online or by calling 1-877-632-6789.