Surgery

Before, During and After

Patients are rarely admitted the night before surgery and generally arrive only several hours before their scheduled operation. After your arrival at the hospital, you will have the opportunity to meet an anesthesia provider in person, discuss the anesthetic procedure in detail, and ask questions. Your medical history will be reviewed with you by your anesthesia provider. Other surgical experiences you have had are an important part of your medical history. If you have high blood pressure, heart disease, asthma, diabetes, lung, liver, kidney, or other serious conditions, be sure the doctor is aware of it! After carefully considering the nature of your surgery, your overall health, medical history, lab tests, and your own concerns and preferences, you and your anesthesia provider will make the final decision about the type of anesthesia that is safest and best for you.

Through vigilance by the anesthesia provider and your monitored response to the medications given, your anesthetic is adjusted during the procedure for your safety and comfort. A number of sophisticated monitoring devices are used to assure your well being.

Yes. Anesthesia administration is safer than it has ever been in the history of medicine. Yet these powerful medications, designed to protect you during surgery, are not benign. The likelihood of any side effects or complications depends upon a variety of factors. These include, but are not limited to, your preoperative medical condition, the nature of the operation, and the anesthesia technique used. Problems can arise in the operating room,in the recovery room, while recuperating in the hospital,or at home. The most common (unwanted) side effect is postoperative nausea and vomiting (PONV). Fortunately, the medications used in anesthesia today have reduced the incidence of PONV. However, it remains a significant problem, particularly in those patients prone to PONV and for those surgeries where the incidence is high. We can be helpful in preventing or treating this problem. Additionally, sore throat, headache, hoarseness, drowsiness, muscle aches and fatigue may occur for the first several days following surgery. Do not hesitate to discuss these concerns with your anesthesia provider. Aspiration pneumonia (inhaling stomach contents into the lungs) is a serious complication of anesthesia. Several precautions can minimize your risk. First, we ask that you not eat or drink anything for a certain time period before your surgery. Please follow these suggestions carefully. Secondly, medication may be administered prior to your surgery to reduce the amount and type of acid in the stomach. Finally, we may use an endotracheal tube (breathing tube) during surgery to protect your lungs. Other complications that can occur during your anesthetic include nerve damage, low blood pressure (hypotension), high blood pressure (hypertension), irregular heartbeat, heart attack, allergic reactions, airway blockage, physical injury, chipped teeth, muscle cramps and even death. Fortunately, serious debilitating complications are very rare.

Some surgical procedures can be accomplished readily with regional or local anesthesia. Regional anesthesia involves numbing a limited area of a person’s body to prevent pain during surgery. Other procedures may require general anesthesia. Be sure to discuss these options with your anesthesia provider. Regional anesthesia, like general anesthesia, is safe. While complications and side effects with regional anesthesia are rare, they can include the following:
Infections at the site of injection can range from inconsequential to life-threatening (meningitis).
Rarely is permanent nerve damage a result of these techniques.
Epidural, spinal, and caudal anesthetics are associated with a small but real risk of headaches. These may last several days after the procedure and may require special treatment.
One can also experience temporary difficulty emptying the bladder, which may require catheterization of the bladder. This problem resolves as the anesthetics wear off.
Heart, breathing, and blood pressure problems can occur.

Adults and Children over 2: STOP solids at midnight or at least 8 hours prior to surgery. You may have clear liquids up to 4 hours before surgery.
Children 2 Years and Younger: STOP solids (including formula) 8 hours before surgery, breast milk 4 hours before surgery, and clear liquids 3 hours before surgery.

ANESTHESIA PREOPERATIVE RECOMMENDATIONS FOR PATIENTS ON MEDICATIONS On the day of surgery you may continue to take oral medication pills as usual, except those listed below, with a small sip of water.
Oral hypoglycemic agents (oral diabetic medicines): Do NOT take on the day of surgery.
Glucophage: You may take Glucophage the evening before but do NOT take the morning of surgery. Do NOT take Glucophage after surgery until kidney function is determined by your physician to be acceptable.
Insulin: Your dose for the day of surgery must be determined by your anesthesia provider, primary physician, or surgeon. If you have not received specific instructions regarding your insulin by the morning of your surgery then take one half your usual dose and monitor your blood sugars closely.
Phentermine/Fenfluramine should be stopped for at least one week prior to surgery. Both of these when used in combination, or Fenfluramine alone are not FDA approved.
Diuretics (water pills) should be held the morning of surgery except when given for hypertension.
Anticoagulants (such as Coumadin, aspirin, Triclid), and other Non-Steroidal Anti-Inflammatory agents (such as Motrin, Advil, Ibuprofen) should be stopped as directed by your surgeon. Call your surgeon’s office if you usually take any of these medicines and have received no specific instructions.
Inhalers for asthma and emphysema: Use as scheduled and bring your inhaler with you to the hospital for continued use during your hospitalization.

If you have questions or concerns about your care, contact our office at: (314) 485-1101.

As a private group, our services are billed separate from the hospital. You will however be billed by the hospital for your anesthesia drugs and supplies. We do participate with most of the same insurance plans as your hospital and surgeon. Depending on your insurance, you may have some out-of-pocket expense for our professional services. If you have questions about your bill or need assistance in filing an insurance claim, contact our billing office by phone at (314) 775-2811 or by email at the info@mwanesthesia.com.