One thing we’ve learned from our patients over the years at Southern Surgical Arts is just how much curiosity surrounds anesthesia. We often see some anxiety as well. We want our patients to feel comfortable with every aspect of their relationship with us, from their first phone encounter to their last follow-up visit. So we’ve asked SSA’s own Albert Romero, CRNA, to participate in this Q & A to address some of our patient’s most common questions—and dispel some of their biggest concerns.
Q: What are some common misconceptions about anesthesia?
A: I think the most common thing is that people don’t fully understand the process. We tend to see three common concerns. First, they are worried they won’t be completely asleep when the procedure starts. They may also be scared they will wake up during the procedure. Finally, they are concerned about the risk of not waking up.
Because these are such common concerns, we are very open with our communication before the procedure. We reassure them that we have monitors to ensure that they are fully under and that their heart rate and blood pressure, etc., are strictly observed. We take a full medical history before all procedures to ensure we have a clear picture of the patient’s health and any prior history with anesthesia. We are very thorough because patient safety is our primary concern.
Q: What if someone has had issues with anesthesia in the past?
A: If you’ve had issues with anesthesia in the past, you need to share that information every time you are considering a procedure that involves anesthesia. This is very important information for the medical team to know. Sometimes we hear from patients that they are “lightweights” when it comes to anesthesia, or that they took a long time to come fully out after a past procedure. We tailor every treatment plan, including anesthesia, specifically for each patient based on their general health and medical history, including allergies, heart and lung health, and past experiences with anesthesia. Based on an individual patient’s needs, we may choose to use IV sedation instead of general anesthesia (if the procedure allows for that substitution), or less narcotics, for example.
Q: Do any health conditions preclude a patient from going under anesthesia?
A: It’s best for patients to be in as optimal health as possible. Anesthesia stresses the body. If you have a heart or lung condition—if you get out of breath going up the stairs, if you experience chest pain—you may have trouble with anesthesia because it will put stress on those systems. Patients with some chronic heart or lung disorders are not good candidates for anesthesia in an outpatient setting for that reason. If we have any concerns, we sometimes recommend patients get a full workup by a cardiologist before we move forward. This is an important step to help the patient have as safe an experience as possible.
Q: Why can't patients eat before their procedures?
A: We don’t want patients to have anything by mouth for at least 8 hours before their procedure. We want their stomachs empty, and we will ask them to take an H2 blocker like Pepcid to help reduce gastric acid. The reason for this is that anesthesia relaxes everything, including the esophageal sphincter, which keeps stomach contents in the stomach. If food and gastric juices are present in the stomach a patient can regurgitate. There is a very real danger the patient could then aspirate this material into his airway. Acid can destroy lung tissue like tissue paper, and then you have the possibility of developing aspiration pneumonia, which is life-threatening. This is a case where a very dangerous outcome has a simple solution: follow your doctor’s orders regarding food before anesthesia to the letter.
Q: Do you have any advice for patients to have the safest, most comfortable experience with anesthesia.
A: Communication is key! Communicate openly and clearly with your medical team. Let them know about any health conditions you have, tell them about your allergies, and share your medical history with them. If you know about your procedure several months in advance, get as fit as you can before your procedure. If you are considerably overweight, consider losing some weight. The heavier you are, the more at risk you are of developing complications like infections. Ask questions until you feel comfortable and assured that you have chosen the right surgeon. And, of course, no eating for at least 8 hours!
If you are considering cosmetic surgery and would like to learn more about the anesthesia that will be used during your procedure—or any other questions—please do not hesitate to call our office at 423-266-3331. Our team is always happy to answer all of your questions to help you have the safest, most satisfying experience possible.
Another article from our Southern Surgical Art's blog that might interest you is on preparing for cosmetic surgery.