General anesthesia, which renders the patient unconscious during surgery, is the most common anesthetic method. After careful review of pertinent medical history, a Northeastern Anesthesiology (NEA) nurse will insert an intravenous line in the holding area, also known as the surgery prep room. An NEA staff member will then administer a light dose of medicine to relax the patient and allay any pre-surgery anxiety. At this point the patient is transported to the operating room.
What to expect in the operating room
Once in the operating room, NEA staff members connect monitors and place an oxygen mask over the patient's face. The NEA anesthesiologist then constantly monitors heart rate and rhythm with an electrocardiogram, oxygen levels using a pulse oximeter, the patient's temperature and the patient's blood pressure. NEA may use other more sophisticated monitoring for more complex surgical procedures.
Typically, for adults, medicine passed through the intravenous line is how the anesthesia is administered. Children requiring general anesthesia usually breathe an anesthetic gas through a mask. The anesthetic medicines delivered for general anesthesia also inhibit normal breathing. NEA anesthesiologists often assist or mechanically take over breathing for the patient.
Laryngeal mask airway to manage breathing
A device called a laryngeal mask airway is often inserted into the back of the throat to manage the airway and breathing. For longer, more complex procedures it may be necessary to place a breathing tube in the wind pipe. NEA doctors insert the laryngeal masks after patients are asleep and remove them before patients awaken. Usually, the only post-operative reminder of having had the airway is a mild sore throat that lasts a day or two and resolves on its own.
Gases administered through breathing device to keep patient asleep
A patient is kept asleep by the administration of gases through the breathing device. These gases are supplemented with intravenous drugs designed to ensure amnesia (forgetfulness) and provide analgesia (pain control) after surgery. Many procedures require muscle relaxation to provide ideal surgical conditions. The NEA anesthesiologist will administer the muscle relaxant and make sure their effects are reversed by the end of the operation. When muscle relaxants are required by the surgeon, an endotracheal tube (breathing tube) is typically part of the anesthetic plan.
NEA staff member in constant attendance
During surgery, the NEA anesthesiologist monitors the depth of anesthesia to make sure that a patient doesn't wake up or remember anything that happened while the surgery was underway. While in the operating room, a member of the NEA anesthesia care team is in constant attendance with the patient and will escort him or her to the recovery room at the end of the surgery.
As the operation nears the end, the NEA anesthesiologist lightens the level of anesthesia so the patient regains consciousness. Most patients are awake in the operating room but don't remember anything until later in the post-anesthesia care unit. NEA staff continue to monitor the patient's vital signs in the recovery room.
Anti-nausea drugs administered during surgery to fight most common side effect of general anesthesia
The most common side effect from general anesthesia is nausea. NEA anesthesiologists give patients anti-nausea drugs during surgery to prevent stomach upset, but sometimes it's necessary to treat nausea in the recovery room. Further pain medicines are administered in the recovery room to help minimize post-operative pain.
AwarenessThe media has certainly done its part to get people thinking about intraoperative awareness. From multiple late night news reports, to the movie, "Awake", patients' preoperative anxiety levels have risen noticeably. This issue is without doubt, one of the more common concerns expressed to us by patients before their operations and as such deserves a thorough explanation.