At El Camino Health, we perform hundreds of surgical procedures requiring anesthesia each month. During your surgery, the anesthesiologist’s job is to keep you free from pain and anxiety. Anesthesia also protects your body and brain and helps you withstand the stresses of surgery.
All anesthetics are administered by our highly trained anesthesiologists. Your anesthesiologist is a doctor who has years of extra training in inducing a safe anesthetic state — often including controlled breathing, heart action and blood pressure during surgery. When the procedure is finished, your anesthesiologist wakes you and takes you to the post-anesthesia care unit (PACU).
Anesthesia Benefits and Risks
Anesthesia has many benefits and few drawbacks. In recent years, there’ve been considerable scientific and technical advances in anesthesia. As a result of these advances, many surgical procedures that couldn’t have been performed a generation ago are now possible.
While serious anesthetic problems are extremely rare, they can occur — even with the best of medical care. You should be aware of this risk when you decide to have a procedure or test that requires anesthesia. Feel free to share any questions with your anesthesiologist.
Types of Anesthesia
- Types of Anesthesia
- Common Side Effects of Anesthesia
- Preparing for Anesthesia
- Recovering from Anesthesia
Your anesthesiologist will choose the type of anesthesia best suited and safest for you. This decision will depend upon the type and duration of procedure, your age and general health, the position your body will need to be in during surgery, the preferences of you and your surgeon, and other factors. There are a number of anesthesia options.
Sometimes the anesthesiologist will order a medication before surgery to help you feel calm and pleasantly sleepy while you await your surgery. If you’re having a minor procedure, such as outpatient surgery, the anesthesiologist may choose not to pre-medicate because it may cause you to take longer to wake up from anesthesia. Most patients under age 10 are pre-medicated to decrease anxiety prior to surgery.
For general anesthesia, the anesthesiologist puts you to sleep by injecting medication into a vein, having you breathe anesthetic from a face mask, or both.
Once you’re asleep, your anesthesiologist may insert a breathing tube through your mouth into your windpipe to control your breathing and protect your airway during surgery.
Your anesthesiologist may give you special medications to relax your abdomen and chest muscles. In such cases, your natural breathing is weakened or stopped, and your anesthesiologist maintains your breathing with an anesthetic machine or respirator.
Minor complications include nausea and vomiting; a sore lip, tongue, nose or throat; and muscle aches.
Rare complications include eye soreness; loosening or breakage of teeth, dental caps, dentures or bridges; irritation of vocal cords from a breathing tube; inhalation of stomach contents into the lungs, causing pneumonia; heart stoppage; brain damage; and liver or kidney failure.
Spinal anesthesia is an injection of anesthetic through your back into the spinal fluid, which numbs the lower part of your body. Sometimes your anesthesiologist will give you sedatives through an arm vein so you can sleep during the procedure. If a spinal anesthetic doesn’t work perfectly, general anesthesia is added to stop pain.
Minor complications include temporary drop of blood pressure; headache (less than 2 percent of cases), usually lasting from a few days to several weeks; and the accidental injection of local anesthetic into a vein, causing temporary dizziness.
A very rare complication is the abnormal spread of anesthetic in the spinal fluid, which can cause temporary breathing weakness; permanent nerve or spinal-cord damage, causing pain, numbness, weakness or paralysis of the limbs; and bladder or bowel dysfunction.
Epidural Anesthesia (Caudal or Lumbar)
Epidural anesthesia is similar to spinal anesthesia, except that the injection is made outside the spinal fluid. Sometimes a small catheter (flexible tube) is left in your back. Through the catheter, the anesthesiologist can inject booster doses as necessary. The effect of epidural anesthesia can last longer than spinal anesthesia.
In other cases, your anesthesiologist injects small amounts of sedatives into one of your arms so that you can doze during your procedure. If epidural anesthesia doesn’t work perfectly, the anesthesiologist will add general anesthesia to stop pain.
Complications of epidural anesthesia are the same as for spinal anesthesia. There’s also the risk of rapid absorption of anesthetic into the bloodstream, causing unconsciousness, convulsions or heart stoppage.
For regional anesthesia, a limited part of your body (usually an arm, leg or foot) is numbed by injecting anesthetic around the main nerve or into the veins. Sometimes sedatives are also given so that you can doze during your procedure. If a regional anesthetic doesn’t work perfectly, general anesthesia is added to stop pain.
Minor complications include temporary dizziness from slight absorption of local anesthetic into the bloodstream.
Rare complications include rapid absorption of anesthetic into the bloodstream, causing unconsciousness, convulsions or heart stoppage.
Monitored Anesthesia Care
In some cases, your anesthesiologist or surgeon will suggest monitored anesthesia care for your surgery. This usually consists of local anesthesia injected in the area of the procedure, along with sedatives given through an IV. The anesthesiologist controls your level of sedation, ensures that pain control is adequate, and monitors your safety and medical well-being in the operating room. The anesthesiologist is always ready to add general anesthesia to stop pain, although it’s not often necessary.
Possible Complications of Anesthesia
Complications may occur during any type of anesthesia, and may or may not be related to the anesthesia. Minor complications include skin irritation or injury from adhesive tape or antiseptic liquids; backache from lying in the same position for a long time; and soreness, bruising or a clotted vein at the place of injection.
Rare complications include pressure damage to the body due to the position of the body on the operating table; breakage of a plastic tube in a vein or in the back, possibly requiring surgery for removal; infection or bleeding at the place of an injection; nerve damage resulting in numbness or paralysis, which is caused by injections or from limbs being in one position for a long time; injury to arteries or veins from needles or tubes; high fever from a reaction to anesthetics or fluids given through a vein; reaction to blood transfusions, possibly causing harm to the kidneys or other important organs; and burns or electric shock caused by abnormal function of an electrical apparatus.
Almost all minor and many major surgical procedures are performed without need for a blood transfusion. Your anesthesiologist is familiar with techniques for blood conservation that may further decrease the need for transfusion. However, sometimes the medical benefit of transfusion clearly outweighs the small associated risks, and your anesthesiologist and surgeon will decide to administer blood products. If there’s even a small possibility that you may require a transfusion, your surgeon will discuss this with you in advance of surgery, and your signature will be required on a transfusion consent form.