Surgery Day – Administration of Anesthesia

Administration of the anesthetic varies based on the type of anesthetic. Knowing what anesthetics will be used gives you a good idea what to expect. This is all based on personal experience, so you should discuss the process with your anesthetist to understand what to expect in your case. If you are afraid, anesthetic can be applied carefully and painlessly, but it takes longer and is more expensive to give locals first or do injections in stages. You may have to ask for the extra steps, if you want them.

Local Anesthesia

Most people have experienced local anesthetic at the dentist, when having a tooth filled. A topical anesthetic is applied to the skin and a small amount of anesthetic is injected under the skin. Once that takes effect, more is injected, and within a few minutes the entire area is numb. The procedure can then be completed. You will feel pressure and tugging, but you won’t have pain.

If your procedure is simple, you may be released immediately, while the anesthetic is still working. As the anesthetic wears off, you will feel a tingly, odd sensation in the affected area, and it will be partially paralyzed. Your doctor will probably provide you a mild pain reliever for once the local has fully worn off.

Regional Anesthesia

There are many forms of regional anesthetic; the two examples that are described here are the epidural and spinal.

Often the regional anesthetic is preceded by a local anesthetic. This numbs the area before applying the regional. You will be asked to sit or lay in an almost fetal position, with your back curved. It is very important to be very still, if you are nervous, one of the nurses or anesthetic assistants will hold your hand and talk you through the process, just ask. Next you will feel a pinching and a local will be injected under the skin. Once the area is numb, the regional will be injected into the same spot; this will feel like a strong pressure on your back. Very quickly, you will start to lose feeling from the injection site down. The staff will likely help you lie down on the table.

Depending on the process you will have an intravenous line put in at this point; sometimes it will be done prior to the regional. A needle will be injected in your hand, sometimes preceded by a local. Tubing will be attached and the whole thing will be taped to your hand to keep it in place. Now the anesthesiologist can give you a variety of drugs through this primary source.

If you will be receiving a sleeping agent or a general anesthetic, it will likely be started at this point. Please see the next section for a description of the general anesthetic process. If you receive a sleeping agent, it will be administered similarly to the general. The difference is barely noticeable to the patient.

If you are to stay aware throughout the procedure, it will begin at this point. A drape will be hung, so that you will not see anything disturbing. An anesthesiologist or nurse should stay to monitor you and manage your drugs. Once the procedure starts, you may feel pressure and a tugging sensation in the area of the procedure, but there will be no pain. You may start to feel hot, dizzy and/or nauseous; this is a side effect of the medication. They can inject a drug to manage that, which helps. You need to keep them informed about how you are feeling; doing so will help them address it, and make you more comfortable.

Once the surgery is complete, they will discontinue the anesthetic, and likely remove some or all of the monitors, although they will leave the IV to deliver fluids and other drugs into your system post-operatively. At that point you should be moved into the recovery room.

General Anesthesia

The general anesthesia process is very short for the patient. You will lie on the operating table and spread your arms to the side. Monitors will be attached to monitor blood pressure, heart and oxygen among other things. The intravenous will be injected into your hand and taped into place. Next a mask may be put over your face; the air will have an odd taste. You may be asked to count backwards from 100. Usually you do not get to 90 before you are unconscious. A general anesthetic feels much like going to sleep. When you wake up you will be in the recovery room.

 

Check out my last post in this series: Surgery Day – Types of Anesthetic
Check out my next post in this series:  Surgery Day – Hospital Check-In