Types of Anesthesia

Sedation / Monitored Anesthesia Care (MAC)

Sedation is the administration of medication in oral (by mouth) or intravenous (by vein through an IV or into a muscle with a needle) form to allow for you to relax and to decrease the amount of anxiety produced by undergoing surgery.

Generally, the minimally and moderately sedated patient is able to respond to verbal (spoken) stimuli and will follow commands. It is common for sedated patients to “fall asleep” while continuing to breathe on their own.

Occasionally, deeper sedation is required and you may require assistance in breathing. Regardless of the level of sedation, you are monitored closely by the anesthesiologist (doctor), who will care for your level of sedation before, during, and after the surgical procedure.

Local Anesthetics

Local anesthesia uses medications that may be injected (using a needle) or applied topically (sprays, creams, or ointments applied to the skin) to prevent the sensation of pain in a small and specific area of the body. An example of this type of medication is Lidocaine.

This form of anesthesia is used for smaller or “minor” procedures and you remain awake during the procedure.

Local anesthetic is often injected into the surgical area of patients undergoing procedures requiring general anesthesia (see below) to provide for longer lasting pain control once awakened from surgery. Pain relief can last up to several hours following the operation.

Sedation (see above) is often used in conjunction with local anesthesia to make you more comfortable and to reduce your anxiety during the procedure.

Regional Anesthetics

Regional Anesthesia or “Block” is local anesthetic medication injected with a needle to cause numbness in a specific area of the body. In hand surgery it is common to use regional anesthesia to put the “entire arm or hand” to sleep. Blocks commonly last several hours and can provide effective pain relief for over a day depending upon your metabolism and the specific medication chosen.

Again, sedation (see above) may be used along with your block to provide comfort and to reduce your nervousness during surgery.

General Anesthesia

General anesthesia is what patients commonly refer to as going “to sleep”. This form of anesthesia is administered by a combination of intravenous (by vein) and inhalational gas (breathed in by the patient) to produce unconsciousness. The difference between the regular sleep that you experience every night and general anesthesia is that the “anesthetized brain” does not react to pain or surgical intervention.

General anesthesia or “general” is used for larger or “major” surgery. It is also utilized when the operative procedure may be lengthy (several hours) and too much local anesthetic would be required to complete an “awake” surgery. General anesthesia is also often employed when you DO NOT want to hear, feel, or remember ANYTHING from your surgical experience.

This type of anesthesia is administered by your anesthesiologist (doctor) who will monitor your vital signs and directly assist in breathing for you. As the “machine breathes for you” it requires that a “tube” be placed into the airway, which may cause a “sore throat” type of sensation in the hours following surgery. This is normal, expected, and will pass.

General anesthesia is safe and effective, however it does pose additional risk not seen with the above methods of anesthesia. Therefore, depending upon your age and co-existing medical conditions, you may be required to obtain “medical clearance” from your primary care physician or another specialist. Certain pre-operative (before surgery) exams are often performed for your safety, they include:
Chest X-rays
EKG
Blood Work (including pregnancy tests if indicated)