1. How will I receive pain relief after the surgery?

2. What are the pre-surgical testing requirements?

3. What are the pre-surgical fasting requirements?

4. Should I take my usual medications?

5. What types of anesthesia are available?

6. Should I stop smoking before surgery?

7. What if I need a blood transfusion?

8. What is outpatient surgery?

9. When do I meet my anesthesiologist?

10. What are the risks of anesthesia?

11. What does an anesthesiologist do during the surgery?

12. Ask the doctor

1. How will I receive pain relief after the surgery?
There are several ways to treat pain after a surgical procedure. The method most suitable for you depends on your medical conditions and your scheduled procedure. Postoperative pain can be treated with intravenous pain medications, injection of local anesthetic around the surgical incision, or an epidural infusion (epidural infusions are managed by the Acute Pain Service). Young children may receive Tylenol suppositories (you can discuss this method with your anesthesiologist before the surgery). Just remember—your well being is our primary concern, and we will take all necessary steps to assure your comfort and safety! 
 

2. What are the pre-surgical testing requirements? 
Generally, for healthy patients, no pre-operative testing is necessary. For some medical conditions, your surgeon and medical doctors determine your pre-surgical tests. For example, if you will be having an operation that may result in significant blood loss, we would probably need a preoperative hemogram, or blood count.

Many pre-surgical patients wonder whether they need preoperative electrocardiograms (ECGs). For most surgeries, preoperative ECGs are unnecessary. However, patients with medical conditions or symptoms associated with heart disease are required to have pre-operative ECGs. Interpretation of the pre-operative ECG by a physician will clarify whether further pre-operative cardiac testing is needed. Currently, the medical conditions that often require a pre-operative ECG are:

3. What are the pre-surgical fasting requirements?
 - No solids after midnight
 - No candy or gum after midnight the night before surgery
 - Water only until 4 hours before surgery

 Exceptions:
 Infants
 - Breast milk until 4 hours before surgery
 - Infant formula
    - <6m: until 4 hours before surgery
    - >6m: until 6 hours before surgery

Children
- Water or apple juice until 4 hours before surgery

Insulin-dependent diabetics
A. Surgery scheduled before 12 noon:
     - no solids after midnight
     - water until 4 hours before surgery
     - hold morning insulin dose

B. Surgery scheduled after 12 noon:
     - light meal (clear tea and plain toast only) 7 hours before surgery
     - water until 4 hours before surgery
     - take 1/2 long acting insulin dose (lente, ultralente, NPH) with meal
     - Do not take any regular insulin  
 

4. Should I take my usual medications?
Do not stop taking your usual medications unless your surgeon or anesthesiologist recommends that you stop taking them. Always take medication used to treat high blood pressure or any heart condition. Most medications should be taken, but some should not. You need to discuss this question with your surgeon or check with appropriate preoperative staff available at 847-723-7400 for Advocate Lutheran General Hospital or 847-299-2273 for Golf Surgical Center.
 

5. What types of anesthesia are available?
Anesthesiologists apply many techniques in the course of their duties. Broadly, these techniques are: general anesthesia, regional anesthesia, and monitored anesthesia care.

Your wishes, your planned surgery, and our medical evaluation are all important in the final choice of anesthetics that we administer. The final anesthetic plan will be discussed with you prior to your surgery.

General anesthesia is the application of medicine to render a person unconscious for surgery. Patients are anesthetized by two methods. In adults, injection of medicine through an intravenous catheter (started before surgery) begins the general anesthetic. Children are usually anesthetized by delivering an inhalation anesthetic through a pleasant-smelling mask. The intravenous catheter is generally started in children after they are asleep.

After the initiation of general anesthesia, anesthesia is usually maintained with a combination of inhaled anesthetic gases and intravenous medications. Anesthetic drugs used today have a shorter duration of effect than in previous years, allowing faster recovery and low rates of nausea and vomiting.

At the end of your operation, you will awaken and your conscious reflexes will return. As you emerge from general anesthesia, your anesthesiologist will be with you and will continually assess your state of consciousness. Once he or she judges you to be awake enough, he or she will personally transport you to the post-anesthesia care unit.

Anesthesiologists administer regional anesthesia when an arm, leg, or body region can be isolated and anesthetized by injecting a local anesthetic near a regional nerve complex. Regional anesthetic techniques do not directly suppress brain function, although almost all patients do prefer supplemental intravenous sedation to help them rest calmly during their surgery. A small minority of patients desire to be awake during surgery with regional anesthesia, and their preference is easily accommodated. Examples of common regional anesthetic techniques include spinal and epidural anesthesia.

Monitored anesthesia care is used for brief superficial operations such as removing skin lesions or breast biopsies. After intravenous sedation is given, local anesthesia is infiltrated into the area of surgery. You will be relaxed and comfortable throughout the procedure. Your anesthesiologist will manage your care and safety as vigilantly as when he or she administers general and regional anesthesia.

The type of anesthesia you receive depends on your type of surgical procedure and your general health condition. Your anesthesiologist will make this decision based on information from your record and from a physical exam. He or she will discuss with you all available options and explain the risks and benefits associated with different anesthetic techniques.

Regardless of the type of anesthesia that you receive, remember that your safety and comfort are our primary concern. Remember, too, that the best way to make an informed and educated decision regarding your anesthesia is to speak directly with your anesthesiologist about your needs and concerns.
 

6. Should I stop smoking before surgery?
People who smoke have an increased risk for some complications after anesthesia and during surgery. These risks include coughing, wheezing, and pneumonia. In addition, diseases such as high blood pressure and coronary artery disease are associated with smoking. Any of these conditions may complicate the outcome. To decrease the chance of these complications you should stop smoking at least several months before surgery, although some benefits may be obtained even if you stop smoking within 48 hours of surgery.
 

7. What if I need a blood transfusion?
Some surgical procedures may require blood transfusions—for example, heart surgery and scoliosis surgery. If you will require a blood transfusion, your anesthesiologist will be responsible for giving you the right blood type and treating any complications that may occur during or just after the transfusion. Although blood transfusion is a relatively safe procedure, complications such as fever and allergic reaction may occur. On the other hand, transmission of HIV or hepatitis virus is extremely rare. If you have any objections to receiving a blood transfusion or if you desire to donate your own blood in advance of your surgery, please discuss this with your anesthesiologist and surgeon. 
 

8. What is outpatient surgery?
If you are scheduled for an outpatient surgical procedure, you should expect to return home on the day of the procedure. After surgery, you will be taken to a post-anesthesia recovery room. Your anesthesiologist will direct all your needs during your stay there, and you will be watched closely by a nurse for 30 to 60 minutes. During this period you will receive some oxygen and pain medications, and your vital signs (blood pressure, heart rate, breathing) will be monitored closely. After this initial recovery period, you will be moved to the second-phase recovery area where some family members will be allowed to stay with you. At this point, you will be offered something to drink and your IV line will be discontinued. You should make prior arrangements for a responsible adult to take you home. Furthermore, it is recommended that you have someone stay with you during the first 24 hours after surgery.
 

9. When do I meet my anesthesiologist?
Your anesthesiologist will interview and examine you in the pre-operative area before your procedure. He or she will review your medical history, laboratory tests, and medical records. The decision regarding the type of anesthesia you receive will be based on this interview. If you have any questions prior to your surgery, please either contact us at 847-723-5524 or direct your concerns to your surgeon.
 

10. What are the risks of anesthesia?
Adverse reactions to any type of anesthesia may occur. Some reactions are specific to your surgical procedure, to your associated medical problems, or to the type of anesthesia you receive. Death and other serious complications such as stoke and heart attack are rare but possible. Studies show that the safest anesthetic intervention is provided by board-certified anesthesiologists. Anesthesia services at Advocate Lutheran Hospital are provided by medical doctors only, as your safety is our primary concern!

Minor complications usually include sore throat, headaches, nausea, dental trauma, and allergic reactions. Should any of these complications occur, your anesthesiologist would be responsible for treating it and discussing any measures that should be taken to prevent a recurrence of the complication.
 

11. What does an anesthesiologist do during the surgery?
Your anesthesiologist is personally responsible for your well-being during surgery and in the recovery room. We manage all "non-surgical aspects your care in the operation room. These include administration of anesthetics or other medication, monitoring and regulation of your circulation, respiration, and temperature and ordering and interpreting laboratory tests when appropriate. We provide optimal conditions for the surgeon and constantly monitor your vital signs. Your  anesthesiologist will be with you throughout your procedure and will personally transport you to the recovery room.
 

If you have questions, inquiries, or comments, please, let us know: