Anesthesia and Perioperative Medicine
Dedicated anesthesiologists and nurse anesthetists, who have received specialized training and board certification in anesthesia, work together as a team to ensure your comfort and safety during surgery at Emerson Hospital. Their primary roles in the operating room are to ensure that you are comfortable and not aware during surgery, to monitor vital functions of the body, and to make informed decisions to protect you from harm. Typically, this includes monitoring critical life functions such as breathing, heart rate and rhythm, blood pressure and oxygen level, as well as treating changes in these functions that may occur as a result of surgery and anesthesia.
Over the past few years, the risks associated with anesthesia have been greatly reduced by improvements in training, advances in monitoring techniques and the development of safer drugs with fewer side effects. You can help the anesthesia team to keep you safe by ensuring that we are aware of your health history and medications, including non-prescription medications and supplements, before the administration of anesthesia.
Prior to surgery
Surgery and anesthesia affect your entire body. It is important for your anesthesia team to know as much as possible about your health history including a complete list of your prescription and over-the-counter medications, diet pills, herbs and other dietary supplements. These may alter your body chemistry or impair the normal functioning of major organ systems. For generally healthy patients undergoing minor procedures, a preliminary interview is conducted over the telephone, and an anesthesiologist will perform a final preoperative assessment on the day of your surgery. However, if you have serious medical issues, are having major surgery or have had significant problems with anesthesia in the past, it will usually be necessary for you to come to the pre-surgical testing clinic several days in advance of your procedure for an interview with a member of the anesthesia department. At this time, your health history and medications will be reviewed, a brief examination may be performed and you will have an opportunity to discuss your options for anesthesia.
You will be given instructions concerning the intake of food, drink and medications before surgery. It is important that these instructions be followed carefully. Failure to do so may result in delay or cancellation of your surgery, or may jeopardize your safety during the procedure.
Types of Anesthesia
Below is a brief description of the different types of anesthesia. The anesthesia team and your surgeon will work with you to determine the best type of anesthesia for you.
General Anesthesia – With general anesthesia, you are unconscious and have no awareness of events occurring during surgery. There are a number of general anesthetic drugs. Most frequently, inhalational and intravenous agents are used in a balanced combination. After you are asleep, a breathing tube or airway may be inserted through your mouth into the throat or windpipe to maintain proper breathing during this period. The level of anesthesia is monitored and adjusted continuously, based on your vital signs and other measures. At the conclusion of surgery, you emerge from anesthesia and subsequently regain awareness in the recovery room.
Regional Anesthesia – With regional anesthesia, a member of the anesthesia team makes an injection near the spine, or near a cluster of nerves, to numb the region of your body that requires surgery. You may remain awake, or you may be given an intravenous sedative. You do not see or feel the actual surgery take place. There are several kinds of regional anesthesia. Two of the most frequently used are spinal anesthesia and epidural anesthesia, which are produced by injections made with great precision in the appropriate areas of the back. Another commonly-used regional anesthetic technique is peripheral nerve block, where an injection is made, or a catheter is placed, adjacent to a cluster of nerves, primarily for post-operative pain control, for example in shoulder surgery.
Local Anesthesia with Intravenous Sedation – With this type of anesthesia, a combination of local anesthesia and intravenous sedation is used. The surgeon injects a local anesthetic drug, such as lidocaine or marcaine, into the tissue around the surgical site to numb the area and keep you pain-free during the procedure. Additionally, an intravenous sedative agent is administered. The amount of sedation can be adjusted to achieve a level of mild sedation, deep sedation or total sleep, depending upon the procedure, your preference or other factors. In most instances, a light sleep is induced, from which the recovery is rapid. At the conclusion of surgery, you will most likely bypass the main Post-Anesthesia Care Unit and be transported to a recovery area in the Clough Surgical Center for a brief recovery period prior to discharge home.
Straight Local Anesthesia – Minor surgeries are often performed with straight local anesthesia, without IV sedation and without anesthesia personnel in attendance. The surgeon injects a local anesthetic drug, such as lidocaine or marcaine, into the tissue around the surgical site to numb the area and keep you pain-free during the procedure. You may be able to take Valium or other anxiety-relieving medications by mouth prior to the procedure. You need to arrange this with your surgeon before the procedure.
The American Society of Anesthesiologists have set up this website for patients to obtain more detailed information about anesthesiology.
Today’s new, safe, ultra short-acting anesthetic medications and sophisticated monitoring devices enable our highly-skilled anesthesia providers to provide you with the most up-to-date and best medical care possible. As a result, an increasing number of surgical procedures are performed safely on an outpatient basis; you come to the hospital, have surgery and go home—all on the same day. You may continue your recuperation the same day in the comfort of your own home and often avoid costs that insurance might not cover.
Same-day surgery usually is elective and can range in duration from a few minutes to a few hours. Modern anesthetic techniques and drugs are used to enable you to continue your recovery safely at home, whether you have received general anesthesia, regional nerve blocks or local anesthesia with intravenous sedation.
How to contact the Department of Anesthesia and Perioperative Medicine
If you have questions or concerns, an anesthesiologist is available on a 24-hour basis 7 days/week. On weekdays from 7:00 am – 3:30 pm, please call the Department of Anesthesia at 978-287-3162. Outside of these hours, or in the event of an emergency situation, please call the main Emerson Hospital switchboard at 978-369-1400 and ask the operator to page the anesthesiologist on call.