Before My Surgery

What is the difference between Hospital and Ambulatory Surgery?

Ambulatory surgery, commonly referred to as out-patient or same day surgery, allows a patient to immediately return home to recover from their procedure. Avoiding the overnight stay in the hospital is beneficial to the patient and the healthcare system as a whole. Patients return to a comfortable and familiar environment where they can focus on healing. Quite often, the activity and unfamiliar surroundings of a hospital make it difficult to get the proper amount of rest that you need to insure a quick and speedy recovery. Ambulatory surgery is also quite beneficial to the nation’s healthcare system, as it allows surgical procedures to be performed more efficiently and with lower costs to insurance companies and patients. The most common surgical procedures are routinely performed in ambulatory surgery centers, and as technology improves the list of available surgeries continues to grow.

Is there a difference in anesthesia for ambulatory surgery?

Similar to surgery performed in a hospital operating room, ambulatory surgery requires anesthesia to make the patient comfortable during their procedure. Ambulatory anesthesia is identical to the types available in a hospital setting, is just as advanced, and is just as safe. General anesthesia involves making a patient unconscious through the use of medicines and anesthesia gases. MAC, or “twilight anesthesia involves sedative agents. Regional anesthesia allows a certain part of the body to be made numb, reducing the need for pain medicines both during and after the procedure. Ambulatory anesthesia focuses on a quick and pain-free recovery so that the patient can return home as quickly and safely as possible.

What are common risks of anesthesia?

First, let us say that anesthesia is very safe. In fact, the field of anesthesiology has grown to be one of the most reliable parts of any operation. However, that does not mean that there aren’t any risks. Here are some common risks of anesthesia:

• Postoperative delirium – The confusion and temporary memory loss that sometimes follows the administration of general anesthesia.
• Nausea – After coming back to consciousness after general anesthesia, patients may feel nauseous.
• Sore throat and harshness of voice – This is likely to occur after undergoing general anesthesia, where a patient needs the assistance of a breathing tube to breathe.
• Death or serious injury are very rare, and are usually related to complications from the surgery rather than solely anesthesia.

What if I am pregnant?

The anesthesia administered during a procedure for a patient who is pregnant is different than for a regular patient. There are a number of different factors and concerns that the anesthesia provider must be aware of that affect the patient and her unborn child. Some of these factors include, but are not limited to, preventing unwanted drugs effects on the fetus, optimizing and maintaining regular maternal physiological functions, and avoiding awareness if general anesthesia is used. In order to help assure the procedure will not have any negative side effects on the mother or the fetus, it may be beneficial to have an an anesthesia provider with a specialty in pediatric anesthesiology or consultation with a neonatologist (high risk pediatrician).

What is informed consent?

Informed consent is the process where the anesthesia provider discloses information regarding the procedure to a patient so that they may make a voluntary choice whether to accept or refuse treatment.

Can I request the specific type of anesthesia that I want?

In certain situations, it is possible for the patient to request a specific type of anesthesia. In many procedures, there are a number of different anesthesia paths that the anesthesia provider can choose to take. A discussion between your surgeon and the anesthesia provider about the type of anesthesia needed for your specific surgery to ensure the safest anesthesia delivery method all the while keeping your request in mind.

When should I stop eating/drinking and why?

Typically for adults, you will need to stop eating/drinking eight hours prior to the administration of anesthesia. There may be exceptions to this rule, and your surgeon will give you detailed information prior to surgery about these guidelines. In addition, you may be asked to stop taking certain vitamins or herbal remedies for a certain amount of time before the procedure, as they may interfere with the anesthesia.

While this may be a hassle, doing so may save you from injury or complications during the surgery and anesthesia. This ‘no eating no drinking’ order mainly serves as a precautionary measure in order to prevent pulmonary aspiration. Pulmonary aspiration is where the stomach contents enter the lungs. This can potentially block airflow to the lungs and can put the patient at risk for pneumonia and other serious infections.

Do I have to have a breathing tube?

You will only need to have a breathing tube if you are undergoing a general anesthetic. This is because general anesthesia decreases your ability to breath on your own. If you are undergoing local, regional, or MAC anesthesia, you will not need a breathing tube. However, you will be given an oxygen mask to ensure you are getting enough oxygen.

What medications will I have to take?

You may continue to take your blood pressure, seizure, and reflux medications the morning of surgery with just a sip of water to wash it down. Many medications interfere with the anesthesia medications given during your surgery or procedure. It is imperative that you bring the names of all of your medicines with you to surgery. Anti-anxiety and pain medications must be discussed with your anesthesia provider. Diabetes medication should not be taken prior to surgery. These medications works in conjunction with your food intake to keep your blood sugars normal. Taking your diabetes medicine with no food may have drastic consequences for you during the day. Your surgeon may require you to take some medicine prior to or the morning of surgery, detailed information about these medicines will be provided by your surgeon.

Day of Surgery

What exactly does the anesthesia professional do?

A CRNA helps take care of the patient’s anesthesia needs before, during, and after a procedure. A CRNA may help by doing any of the following during the procedure:

• Preparing for anesthetic management
• Administering anesthesia
• Maintaining anesthesia during the operation
• To learn more about CRNAs and what they do, visit our What is a CRNA? page.

Ultracare offers the assurance that we will remain inches away from the patient during the entirety of the anesthetic, ensuring the most comfortable, complete and relaxed anesthetic experience possible.

What kind of anesthesia will I have?

There are three main types of anesthesia- general, regional, and local. In general anesthesia, the patient is made unconscious, while in regional and local anesthesia the patient may fall asleep, but will not be unconscious. To learn more about these three types of anesthesia, visit our Patient Education page.

Certain procedures may require a specific type of anesthesia, such as open heart surgery which requires general anesthesia. Other procedures may give you the option to use multiple kinds of anesthesia. If you feel strongly about what type of anesthesia you should have, it is best to talk with your anesthesia provider to see what can be done.

Will I need to receive blood for the surgery/procedure?

Typically, you will not need to receive blood for a surgery/procedure, especially if it is less serious or dangerous. However, it is entirely possible that you may need to receive blood during the surgery, whether it be planned or unplanned. For example, a surgery may require a blood transfusion, in which case you could donate your own blood for your surgery weeks in advance. Another potential scenario is if you were to unexpectedly lose too much blood during a surgery. If this were to happen you would likely need to receive a blood transfusion.

After My Surgery

When will I be able to go home?

There are two different types of surgery- outpatient surgery and inpatient surgery. With outpatient surgery, you are able to go home the same day as your surgery and can recover at home. However, not all procedures can be done as an outpatient surgery. Procedures that are more complicated may require inpatient surgery, in which you will have to stay at the hospital for at least a day after your surgery so that the medical team can check up on you and ensure that everything is going well.

When can I eat?

For most procedures, you are allowed to eat and drink shortly after the procedure is finished and when you feel well enough to do so. After undergoing general anesthesia, you will want to begin by just drinking small amounts of clear liquids and avoiding any sweet, spicy, or hard to digest foods. After a day, you should be able to return to your normal diet. After undergoing regional or local anesthesia, you should be able to resume your normal diet the same day as the procedure.

Will I need to have someone drive me home?

Yes, you will need to have someone drive you home. It is best to avoid driving for 24-48 hours after a procedure where you have received any kind of anesthesia. Although you may feel totally fine and like you are yourself, your judgment and thought processes will be slowed by the anesthesia. You may be required to avoid driving for a longer period of time if you are given additional medications that may impair your driving abilities.

Will I feel sick after my surgery/procedure? What are the other side effects?

Not everyone will feel sick after a surgery or operation, although it is a common problem. About 1 in 3 people (33%) will experience a feeling of sickness after surgery. Whether you will feel sick or not depends on what kind of operation you are having, what anesthesia you receive, and how susceptible you are to feeling sick after a surgery. Typically women, children, and those who often have travel sickness are more likely to feel sick.You may also have a sore throat if you used general anesthesia (from the breathing tube) and may just feel sore in general. This is normal and should go away in a few days.

Does someone need to stay with me at home?

This depends almost entirely on the type of procedure and how self-sufficient the patient is after the procedure. For most surgeries and procedures, someone should be with you for 24 hours to help take care of you. Sometimes, it is necessary to have help for greater than 24 hours, depending on how independent the patient is feeling.