Anesthesia at Middlesex Hospital
Long before you come to the hospital for your surgery or procedure your medical record will be organized by our pre-operative nurses. They will gather all needed laboratory and test results, which will be reviewed by the anesthesiologists. You may be asked to see your own primary care doctor or a specialist for additional information.
You will be called the day before your procedure and given eating,drinking and medication instructions. Most people will be told to not eat or drink anything after midnight.
Some patients will be asked to come to the hospital days or weeks before their surgery to visit our PEAC (Pre-operative Evaluation and Assessment Clinic). These patients include all total knee and total hip replacement patients, many spine surgery patients and any other person who's surgeon wants them seen for an evaluation.
On the day of your surgery you will meet the anesthesia team. Either an anesthesiologist alone or an anesthesiologist working with a CRNA, (Certified Registered Nurse Anesthetist). We will review your medical history and examine you. We will discuss your anesthesia options specific to your procedure. We will ask you to sign permission for the anesthesia you agreed to.
Immediately prior to going to the operating room, we conduct a safety check. Your surgeon, the Operating Room nurse and the anesthesia team all gather with you and review the plan each of us has for you to keep you safe.
During your procedure your vital functions of breathing and circulation will be closely monitored. We are constantly evaluating the need for more or less anesthesia, and planning for the end of your procedure when we wake you up. Pain medicine and anti-nausea medicine is always given when needed, prior to you waking.
Most people will not remember waking from anesthesia, but may be talking when they arrive in the recovery room.
Some people will be offered or recommended to have a nerve block before or after the surgery. This will be included in the permission form. Frequently a sedative will be given to make the nerve block more comfortable.
Types of Anesthesia
There are three types of anesthesia:
- General anesthesia means you are unconscious and have no awareness or sensations. This can be done with medicines we deliver through a breathing mask, or intravenous medicines.
- Regional anesthesia is when we make a part or region of your body numb, such as spinal or epidural anesthesia.
- In local anesthesia medicines are injected close to or around the area to be operated on, making you not feel the surgery.
Sedation is frequently added to regional or local anesthesia. Sedation can be light, moderate or deep. Light and moderate sedation allow you to still respond appropriately to instructions. During deep sedation you sleep through the operation and extra oxygen is needed to keep you safe. You are monitored closely with all sedation.