We know what it’s like to be a patient. Many of us have required surgery at one point in time. We’ve had spouses and loved ones go through surgeries. We’ve received epidurals as expectant mothers. Some of our children have even had surgery. We know what it’s like, because we’ve been where you are.
PAA is dedicated to providing the safest, most ethical care to meet the needs of every patient. We understand that surgery—elective or mandatory—can be scary for most. But we are here to answer your questions and provide as much information as possible about anesthesia.
The educational materials below offer a deeper look into anesthesia and what patients can expect. Please know that you also can call your surgical facility with questions any time pre- or post-surgery. Lastly, we offer a HIPAA compliant tool called Talk to My Doc, which offers patients a safe, secure means of contacting PAA physicians directly.
- What to Expect Before, During and After Surgery
- Day of Surgery Preparations
- Pre-surgical Guidelines
- Notice of Privacy Practices
- Anti-Discrimination Policy
Anesthesia and Surgery FAQs
How will I know if I need a pre-anesthesia consultation?
If your surgery requires a pre-anesthesia consultation, a Novant Health nurse will contact you with several screening questions. Based on your conditions, health history and current medications, they will determine whether a pre-anesthesia visit is required.
Can I request a pre-anesthesia consultation to talk with my anesthesiologist or physician assistant, even though I am not required to?
Yes. Simply request a meeting when the Novant Health nurse contacts you. Alternatively, you may call the pre-anesthesia clinic at the hospital where your procedure is scheduled:
- Novant Presbyterian Main: 704.384.4028
- Novant Charlotte Orthopedic: 704.316.1420
- Novant Matthews: 704.384.6810
- Novant Huntersville: 704.316.4870
What happens during a pre-anesthesia consultation?
An anesthesiologist or physician assistant will review your medical records and history and perform a physical exam. You may be asked questions related to:
- Your general health, including any recent changes
- Your medications and any drug allergies
- Long-term medical conditions, such as high blood pressure, heart disease, diabetes, asthma, acid reflux and sleep apnea
- Recent hospital admissions, including surgery or procedures
- Previous experiences with anesthesia—particularly any problems or complications
Please bring a list of your medications and health records. Your provider will discuss your anesthesia plan, and you should leave the appointment with clear instructions on when to stop eating and drinking prior to surgery; which medications you should stop taking, and when; and what type of anesthesia will be administered for the procedure. Please understand that any number of events leading up to your surgery could result in changes to your anesthesia plan; however, rest assured that any changes would be discussed with you prior to the procedure.
Why do I need to have an empty stomach prior to surgery?
When anesthesia is administered, it is common for normal reflexes to relax. This condition makes it easy for stomach contents to go back into the esophagus (food tube) and mouth and even into windpipe and lungs, causing serious complications.
What are the types of anesthesia?
- General anesthesia: This anesthesia is administered intravenously or with a mask, and it is typically maintained with oxygen, anesthetic gases and supplemental intravenous medications. General anesthesia renders patients unconscious during surgery, with no sensations. After surgery the patient gradually awakens in the recovery room.
- Regional anesthesia: The anesthesiologist may “block” or “numb” the nerves to the area of the body where the surgeon is operating, then provide sedation intravenously to produce a kind of “twilight” sleep. Examples include spinal, epidural and peripheral nerve blocks.
- Local anesthesia with sedation (also called MAC anesthesia): This anesthesia is used for less extensive operations and minor procedures. Here your anesthesiologist will “numb” the specific area of the surgical incision. The patient remains awake but with no feeling of the procedure.
What are the different types of sedation?
Sedation allows patients to be comfortable during certain surgical or medical procedures. Sedation can provide pain relief as well as relief of anxiety that may accompany some treatments or diagnostic tests. Mild or moderate sedation allows patients to remain awake and able to respond appropriately to instructions. Sleep sedation renders allows patients to sleep through a procedure and have little to no memory of the procedure as a whole. Breathing can slow, and supplemental oxygen is often given during deep sedation.
What am I permitted to eat and drink on the day of surgery?
Do not eat anything on the day of your surgery—no solid food after midnight and no chewing gum; however, depending on the time of your surgery, you may be able to have something to drink. You are allowed unlimited amounts of clear fluid up to four hours before your surgery time. For instance, if your surgery is at noon, you may have a clear liquid before 8:00 am. Clear liquids include water, black coffee (no cream), tea, Gatorade and all soft drinks. Liquids that have “substance” to them, such as orange juice and milk, are NOT clear liquids and should be avoided after midnight.
*SPECIAL DIRECTIONS FOR INFANTS: If your infant (less than one year of age) is having surgery, you may give him or her a clear liquid up to 2 hours before surgery, or breast milk up to 6 hours before surgery. Feeding with formula or solid food must be completed at least 8 hours before surgery.
Will I be nauseated after surgery?
It is possible that you may experience nausea and/or vomiting following anesthesia. Patients who are at an increased risk for developing postoperative nausea/vomiting include women, non-smokers, people who experience motion sickness, and patients who have previously experienced nausea or vomiting following anesthesia. Please share this information about your prior experience with your anesthesiologist during your pre-anesthesia consultation. We understand that nausea after surgery in not a pleasant experience, so we routinely administer oral and intravenous medication to minimize your risk.
Certain types of anesthesia can increase the risk for nausea/vomiting. Regional anesthesia, such as spinal or epidural anesthesia and nerve blocks, and light sedation lower the risk of nausea/vomiting. Your anesthesiologist will discuss anesthetic options.
Certain types of surgery also increase your risk for nausea/vomiting. For instance, ENT surgery, plastic surgery and abdominal surgery all have an increased incidence of postoperative nausea/vomiting, while orthopedic surgery often has a lower incidence.
Should I take my medications on the day of surgery?
For the most part, medications that you take at home should be continued, including your usual morning medications on the day of your procedure. There are, however, a few exceptions. The following list of medications should not be taken on the day of surgery:
- Diuretics (water pills)
- Diabetes medications (insulin or pills for diabetes)
- Coumadin (your surgeon should advise you when to discontinue this)
- NSAIDs (medications such as ibuprofen or naproxen)
Certain blood thinners such as aspirin and plavix require special consideration. If you are on aspirin and/or plavix due to a stroke or have coronary disease (particularly if you have a coronary artery stent), you MUST notify both your surgeon and your cardiologist about the need for surgery. Please talk to your doctor and your anesthesiologist about all medications you are taking PRIOR to surgery.
Will I wake up during surgery?
It’s important to first understand that not all operations are performed under general anesthesia, the deep anesthetic that eliminates consciousness and movement. Many surgeries are performed with nerve blocks such as spinal anesthesia, or even local anesthesia alone. In these cases, sedation is provided through an IV, and the patient breathes on his or her own for the duration of surgery. This sedation induces what’s known as a “twilight” state in which the patient may recall awareness, but also remain completely comfortable and free from any pain.
Under general anesthesia it is very rare for a patient to experience any awareness. There are a few conditions that will increase the risk of awareness, including:
- Emergency surgery
- Surgery for major trauma
- General anesthesia for cesarean section
- Anesthesia given exclusively through the IV
- Patients with alcoholism or other drug abuse
- Patients with chronic pain on high dose narcotics
- Patients with a history of awareness under general anesthesia
- Patients who are critically ill
Please know that our anesthesiologists are aware of patients who may be at increased risk, and we do everything possible to ensure a positive anesthetic experience.
Will I have pain after surgery?
Your anesthesiologist is a specialist in perioperative medicine, and part of that expertise is directed toward preventing and treating postoperative pain. There are several ways we address pain after surgery:
- Prophylaxis, or preventative care. Pain medications given just prior to surgery can be very effective in preventing postoperative pain. We often administer non-steroidal anti-inflammatory medications and opioids before incision to achieve this effect.
- Care during surgery. Several classes of anesthetic drugs act to relieve pain, and one or more is always administered during surgery to lessen pain upon awakening.
- Nerve blocks. “Numbing” of the surgery site is very effective in preventing postoperative pain. We may administer pain medications through a spinal or epidural block, often leaving a catheter in place to give repeat doses over hours or days. We may provide a nerve block which numbs a specific extremity, again sometimes leaving a catheter in place for continued use.
- Pain medication in recovery. We understand that every patient responds differently to pain medications, so we are always immediately available to order additional medications to control your pain.
Our recovery room nurses are all specialists in postoperative care, and they will continually assess your level of pain and administer necessary treatment, alongside your anesthesiologist.
What if I experience post-surgical complications?
Complications that arise after discharge from the surgical facility are rare; however, patients who experience troublesome post-surgical symptoms should contact the surgical facility. If you believe you are experiencing an anesthesia-related complication, please call our Anesthesia Department office coordinator at 704.384.4239. Patients may also contact our anesthesiologists directly through our HIPAA compliant Secure Connect.
How will my anesthesiologist know how much anesthesia to give me?
There is no single amount of anesthesia that is appropriate for all patients. Every anesthetic must be tailored to the individual and to the operation or procedure that the person is having. Individuals have different responses to anesthesia. Some of these responses are due to genetics, and some are due to changes in health or existing conditions. The amount of anesthesia required will differ according to age, weight, gender, medications being taken and/ or specific illnesses (such as a heart or brain condition).
Your anesthesiologist monitors your heart rate and rhythm, blood pressure, breathing rate or pattern, oxygen and carbon dioxide levels, and exhaled anesthetic concentration—all which affect your anesthesia plan. Because each patient is unique, your anesthesiologist must carefully adjust anesthetic levels to meet your individual needs.
How long will it take for me to “wake up” after surgery?
There are many factors that determine the speed of recovery, which can include age, illnesses, length & complexity of the surgery, and the type of anesthesia administered. Your anesthesiologist will provide an estimate of the entire process, from the time you arrive in pre-op to recovery.
How long will it take for the nerve block to wear off?
There are many factors that determine the duration of a nerve block, including the local anesthetic and dosage, the type of nerve block, and patient factors such as age, existing conditions, etc. Your anesthesiologist will give you a range of time to expect the nerve block to last.
My Child is Having Surgery: FAQs
PAA is committed to providing safe and gentle care for your child’s surgical procedure.
For elective surgery, the administration of a general anesthetic is similar to flying an airplane and is divided into three phases: A) take-off (induction or “going to sleep”); B) flying to a destination (the time during the actual surgical procedure); and C) landing (emerging from anesthesia in the recovery room). Each of of these three phases have specific safety concerns that are constantly monitored by the anesthesiologist and the anesthesia care team. Since most children do not have significant health conditions, their overall risk for a rare or unforeseen event from anesthesia is extremely low.
Why can’t my child eat or drink before surgery?
This is a safety concern. Liquids, solids and breast milk collect in the stomach. When your child goes to sleep, it is important that the food and liquids not regurgitate back into their lungs, which could cause complications like pneumonia. Since different foods empty from the stomach at different times, it is important to follow your surgeon’s and anesthesiologist’s instructions about both fasting times and types of foods to be avoided prior to your child’s surgery.
Will my child get an IV?
Most children are given an oral sedative about 15-20 minutes before the start of the procedure to calm them and to facilitate separation from the parents. Once your child is relaxed, your anesthesia team will transport him or her to the operating room where they “go to sleep” breathing an anesthetic gas mixture through a mask. When your child is completely asleep, an IV is started for the administration of fluids and pain medications. During surgery, most children continue to breath the anesthetic gas to keep them asleep.
Will my child have pain?
Most children receive a narcotic during surgery to reduce pain, and they may receive additional pain medications in the recovery room through their IV. All drugs are dosed according to the child’s weight and modified by specific medical conditions. Some children may receive nerve blocks (local anesthetic, like going to the dentist) or caudal anesthesia (like an epidural most mothers get while having a baby). The anesthesiologist will discuss these techniques with you prior to the surgery.
When can I see my child?
We want to reunite you with your child as soon and as safely as. As soon as your child is awakening and becoming aware, we will bring you to the bedside.
What can I expect after my child’s surgery?
Most children do not experience nausea after surgery; however, some exceptions appear to be in children having eye or ear surgery, which can temporarily affect their equilibrium. Most children continue to be sleepy after surgery, usually caused by the side effects of most pain medications and not the anesthesia.