At AAPA, we recognize that people with an upcoming surgery commonly have questions and concerns about their anesthesia plan. Please see below for information that may answer your questions and provide you with a better understanding of what to expect on the day of your procedure.
Rest assured, you will talk with an anesthesiologist before your procedure. The anesthesiologist will address your questions and concerns about your anesthesia plan.
If you would like to talk to us before you arrive, please call our nurse line at (612) 452-0858.
Do I need a physical or any special tests?
You will need a history and physical (H&P) completed by your primary care team within 30 days of your procedure. As part of this physical exam, some blood tests, an electrocardiogram (EKG), or a chest x-ray may be necessary. Your doctor's clinic will either send this directly to the facility or give you a copy to bring with you.
When should I stop eating?
Carefully follow the directions provided by the facility where you are having your procedure. In general, you should not eat food for eight hours prior to your scheduled procedure. You may drink water up to two hours prior to your scheduled procedure. If you have any questions about when you should stop eating or drinking, please contact the facility where you are having your procedure or your surgeon's office.
What if I have nail polish or body piercings?
Please remove all nail polish and jewelry or body piercings prior to arriving to the facility.
What if I can't get my wedding ring off?
In some cases, we can put tape around your wedding ring to keep it safe. If you are unable to remove your ring, please notify the nursing team upon arrival to the facility.
Do I need someone with me on the day of surgery?
If you are planning to go home on the day of surgery, you will need someone to drive you home or accompany you on public transportation. You will need a responsible person (age 16 or older) to stay with you overnight to ensure you are safe during your early recovery period.
Can I brush my teeth the morning of surgery?
Yes, you may brush your teeth and swish with a small amount of water to rinse.
Can I smoke before I come in?
You should refrain from smoking for at least 24 hours before your procedure. In general, smokers have a higher incidence of airway complications than non-smokers. AAPA strongly encourages you to work with your primary care team to quit smoking.
Should I take my medications the morning of surgery?
Please discuss this with your primary care team during your preoperative visit. It may be important to hold or continue your home medications based on your medical history or the scheduled procedure. If your doctor wants you to take your medications, you may take them the morning of surgery with a small amount of water.
What if I'm taking diet medications that contain phentermine?
Phentermine should be discontinued seven days prior to surgery. Please tell your anesthesiologist if you are taking this medication.
What if I'm on blood thinners or medications to prevent a blood clot?
During your preoperative visit, please ask your primary care team when to take your blood thinners before and after surgery.
What if I don't feel well or there are new symptoms that have developed since I saw my primary care team or surgeon?
If you are feeling unwell or develop new symptoms, please contact your primary care team to discuss whether it is safe to proceed with surgery as planned.
Will I get a chance to speak with an anesthesiologist?
Yes! A board-certified anesthesiologist will review your medical history, perform a physical exam, and discuss the anesthesia plan with you before your procedure. You and your family will have an opportunity to ask questions and discuss concerns with your anesthesiologist before your procedure.
What type of anesthetic will I have?
Your anesthesiologist will select a type of anesthetic based on your health history, type of procedure, and the preferences of you and your surgeon.
What if I don't want the type of anesthesia that is recommended?
Please share your concerns with your anesthesiologist. The anesthesiologist will work with you to develop an appropriate plan.
What will I see and experience when I go into the Operating Room?
Even though most patients receive medication to help them relax in the pre-operative area, entering the operating room can be an anxious experience for some patients. Rest assured that you will be treated respectfully and watched carefully by the AAPA anesthesiologists and CRNAs during your entire procedure. Below are some additional notes to answer your questions about the operating room environment:
- You will notice that the room temperature is quite cool. The OR nurses will provide you with some warm blankets.
- There are many different pieces of equipment in the operating room including specialized overhead lights, the anesthesia machine, monitors, several carts that are used to store medications and supplies, and other equipment needed for your specific type of procedure. If you are curious about the function or purpose of any item-just ask!
- There are usually at least 5-7 people present during an operation. These include the scrub nurse/tech, surgeon, CRNA, circulating nurse, and anesthesiologist. Others are present as needed to assist with your procedure or to provide special monitoring during your procedure.
- The operating room table is narrow, so much care will be taken to transfer you safely and to fasten straps similar to seat belts to prevent you from falling.
- Special care will be taken to pad and secure your arms, legs, and head so skin/nerve injury does not occur. Your anesthesiologist and CRNA are experts at keeping you safe!
Will I see an anesthesiologist?
An anesthesiologist will manage your care in the recovery room to ensure you are recovering safely. If you stay in the hospital, an anesthesiologist will be available 24/7 to address any questions or clinical needs pertaining to your anesthetic.
How long will I be in the recovery room?
Patients are usually in the recovery room for about an hour. On occasion, a person may need additional time in the recovery room to address blood pressure, pain, or other needs. If your family or significant other want an update on your care, please have them ask the waiting room staff or call the facility.
Why is my throat sore?
During a general anesthetic, your breathing is supported with airway devices. These devices and/or the procedure may irritate tender throat tissue causing a sore throat. Cool beverages, popsicles, or sore throat sprays are helpful in reducing sore throat discomfort. These symptoms usually resolve in a few days. Please contact us or your surgeon’s office if you have questions.
How long will the effects of anesthesia last?
Modern anesthesia medications are generally very short acting. While some patients may feel groggy for the remainder of the day, most patients feel the effects have largely dissipated by about six hours following the procedure. This can be affected by several factors including anesthetic type, length of procedure, and specific patient characteristics. Anesthesia can slow reflexes, slow your thought processes, and cause amnesia. Do not drive, operate power machinery, or make any important decisions until the effects of anesthesia have worn off, which may be as long as 24-48 hours. These restrictions are prolonged while taking your opioid (narcotic) pain medications. Discuss your return to activities of daily living with your surgeon.
Will the anesthesia medications affect or interfere with other meds that I take?
You may safely resume your home medications as prescribed following your anesthetic. However, you should make sure your medications are reviewed with your surgeon's team as they may have a surgical reason to alter your schedule or prescribe pain medications which could interact with your daily medications. Additionally, hormonal birth control may not be as effective after some medications given during your procedure. Please talk to your anesthesiologist to discuss if you need to use non-hormonal contraceptives for seven days after your procedure.
I had a regional block for my procedure and went home while the block was still in place (area was numb and pain-free), when should I start taking my pain medications?
Once a regional block begins to wear off, the ability to move your arm or leg and the return of feeling (including pain) occurs rather quickly. It is important to not get behind in your pain control measures. We recommend that you begin taking the pain medications prescribed by your surgeon as soon as you begin having any feeling in the area that was numb. Take your pain medications as directed by your surgeon.
I have sleep apnea. Is there anything special that I should do?
The medications used during anesthesia and to control your pain after your surgical procedure cause you to not breathe as deep or as often. They may cause an increase in the frequency and severity of apnea spells in the early recovery period after your procedure. If your primary care team recommended that you use a CPAP mask, it is very important that you use it both at night and during any naps.
When can I resume breast-feeding after an anesthetic?
In general, the amount of anesthetic medication secreted in breast milk is very small so there is no restriction from the medications you would receive for your anesthetic. However, if you feel more comfortable pumping and discarding for the first 12 hours after surgery, you may choose to do so.
What should I do if my pain meds aren't managing my pain?
The surgical team will be managing your pain after you leave the recovery room or go home. Please contact your surgeon’s office if you have any questions or concerns about your pain level or prescriptions.
What if I have more questions about my anesthetic?
If you have additional questions or concerns, please call our nurse line at (612) 452-0858.
What is an epidural catheter?
An epidural is a small, flexible catheter (tube) that an anesthesiologist carefully places in the lower area of your back and advances into the epidural space near your spinal cord. A small dose of local anesthetic and narcotic are infused continuously into the catheter. By combining a low dose of the local anesthetic with a low dose of narcotic, we can control labor pain while avoiding systemic side effects of pain medications including itching, nausea, and most importantly, transmission of medications to your baby via the umbilical cord. The infusion may be increased or decreased if more or less pain control is needed.
Will an epidural relieve all my labor pain?
An epidural infusion will greatly reduce the amount of pain associated with labor but rarely relieves 100% of the pain or pressure that you may experience. Each mother's labor is different. Please let your nurse know if you are experiencing pain after an epidural catheter has been inserted. Your nurse will work with the anesthesiologist to optimize your pain relief.
If you want more information about anesthesia, please visit the links below. However, please contact us if you have a specific question or concern.
From the Agency for Healthcare, Research and Quality:
From the National Patient Safety Foundation:
For information about pain control options during labor and delivery: https://www.mayoclinic.org/healthy-lifestyle/labor-and-delivery/in-depth/labor-and-delivery/art-20049326
Anesthesia Techniques Overview
During a general anesthetic, you are completely asleep and unaware of your surroundings. A medication is injected into your IV which quickly takes effect. It is often necessary to place a breathing device to support your breathing during your procedure. This is required with most general anesthetics and is expertly managed by the anesthesia care team.
Please alert your anesthesia team if you have a history of a “difficult airway.” Please tell your anesthesia team about any loose or damaged teeth, plates, bridges, or other dental issues.
Your heart rate and rhythm, blood pressure, oxygen status, temperature, and breathing are all carefully monitored during your general anesthetic. Medications to keep you unaware (asleep) and to treat your pain are given during your procedure. The anesthesiologist and CRNA take care to keep you safe during the procedure.
After your procedure is over, you will gradually become more alert and aware of your environment. The anesthesiologist and CRNA will explain what is happening and care for you as you wake up.
During a MAC anesthetic, you are given medication to make you drowsy and to control your pain. However, you are awake enough to breathe on your own. Depending on the procedure and your preferences, a MAC anesthetic may mean that you are only slightly drowsy to almost fully asleep. The anesthesia team will give medications as needed to keep you relaxed and comfortable.
Regional anesthesia refers to an anesthetic in which a specific part of your body is numbed for your procedure. Regional anesthesia reduces the risk of nausea and vomiting after your procedure and it significantly reduces the medication needed for your procedure. If needed, additional medications may be administered during your procedure to relax you and keep you comfortable. There are three types of regional anesthesia.
1. Spinal: A local anesthetic is injected into the space surrounding the spinal cord, in the area of your lower back. You will lose all feeling from your waist down and will not be able to move your legs or feet. A spinal anesthetic is commonly done for c-sections, orthopedic procedures (such as hip replacements or total knee replacements), and some procedures of the colon, bladder, and reproductive systems.
2. Epidural: A local anesthetic is injected into the epidural space to decrease pain sensation from the xiphoid (upper chest) to the hips. Epidural analgesia is most commonly used to help manage pain during labor. It can also be used to control pain after large abdominal procedures. If an epidural is in place for labor pain management, additional medication may be added to provide anesthesia if a c-section is necessary.
3. Nerve Blocks: A local anesthetic is injected around a selected nerve, or group of nerves, to numb the area and block sensation of pain. Medications are often given to relax you prior to the nerve block procedure. The anesthesiologist uses the ultrasound machine to guide the placement of the medication. Shortly after the block is performed, your arm or leg will begin to feel numb and heavy. You may lose the ability to move your arm or leg. The block will gradually wear off and feeling and movement will return to your extremity.
Nerve blocks may be administered for the purpose of postoperative pain control. They decrease the need for narcotics in the early recovery period. Please review Instructions Following Your Nerve Block for safety information and when and how to contact us.