South Coast Orthopaedic Associates, P.C.

South Coast Surgery Center: Patient Education

Anesthesia Services

How Will I Meet My Anesthesia Provider?
Your anesthesia provider, a CRNA, will interview you before your procedure to gather the information needed to evaluate your general health. This interview may be a telephone call, visit to the facility or a visit in the surgery center. Laboratory tests may be ordered, and other medical, surgical and anesthetic records will be reviewed. You will be asked to fill out a questionnaire about your previous anesthetic experiences and medical conditions, medications and allergies you have. If you have particular concerns, you should discuss them with the CRNA before your procedure.

What Types of Anesthesia are Available?
Your anesthesia is tailored specifically for you. The type of anesthesia you receive depends on your general health and the type of surgical procedure as well as your preferences, when possible. Based on the information your CRNA has gathered from your records and pre-anesthesia visit, potential choices for your anesthetic care will be discussed with you.

There are four main types of anesthesia from which to choose:

• General Anesthesia provides loss of consciousness and loss of sensation.
• Regional Anesthesia involves the injection of a local anesthetic to provide numbness, loss of pain or loss of sensation to a large region of the body. Regional anesthetic techniques include spinal blocks, epidural blocks and arm and leg blocks. Medications can be given that will make you comfortable, drowsy and blur your memory.
• Monitored Anesthesia Care consists of medications to make you drowsy and to relieve pain. These medications supplement local anesthetic injections, which are often given by your surgeon. While you are sedated, your CRNA will monitor your vital body functions.
• Local Anesthesia, which provides numbness to a small area, is often injected by your surgeon. In this case, there may be no anesthesia provider with you.

Your CRNA will discuss the risks and benefits associated with the different anesthetic options. Occasionally it is not possible to keep you comfortable with regional monitored or local anesthesia, and general anesthesia may be needed. Although uncommon, complications or side effects can occur with each anesthetic option even though you are monitored carefully and your CRNA takes special precautions to avoid them. With this information, you will together determine the type of anesthesia best suited for you.

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Preoperative Reminders

What about eating or drinking before my anesthesia?
As a general rule, you should not eat or drink anything after midnight before your surgery. Under some circumstances, you may be given permission by your CRNA to drink clear liquids up to a few hours before your anesthesia. If you smoke, please refrain from smoking on the day of surgery.

Will I need someone to take me home?
Yes, you must make arrangements for a responsible adult to take you home after your anesthetic or sedation. You will not be allowed to leave alone or drive yourself home. It is strongly suggested that you have someone stay with you during the first 24 hours. If you have a local anesthesia only, with no sedation, it may be possible to go home without someone to accompany you. Check with your doctor first.

Should I take my usual medicines?
Some medications should be taken and others should not. During your preoperative visit, pre-op medications will be discussed. Do not interrupt medications unless you are instructed to not take them.

What should I wear?
If at all possible, wear loose-fitting clothes that are easy to put on and will fit over bulky bandages or surgical dressings. Leave your valuables at home.

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Preoperative Education

• DO NOT eat anything after midnight the evening prior to surgery. Three hours before surgery you may have one glass of clear liquid with the medication prescribed by the CRNA. Clear liquids include water, black coffee (no cream or milk products), or juice with no pulp. This surgical precaution must be observed or your procedure may be cancelled.
  REASON: Under stress, such as the thought of an operational procedure, the stomach often does not empty. Therefore, if nausea and vomiting occur during or after the anesthesia, the contents of the stomach may enter the lungs and result in pneumonia. You may be given medications to take before surgery. Occasionally, in the case of a small child, your surgeon may give you specific instructions to give the child fluids, and in this case, of course, you should do so.


• DO NOT bring valuables; such as money, jewelry or credit cards.


• Please dress simply (i.e. sweat suit).


• Day surgery candidates are expected to be in general good health. If you should develop a cold, sore throat, cough or fever, please notify your surgeon before reporting to our Day Surgery Department. He may wish to reschedule your surgery for a later date.


• Arrange for someone to drive you home and escort you all the way to you residence. You must have a responsible adult accompany you. REASON: Even though you think your reactions are normal, all drugs, including anesthetic agents, may slow down your physical reactions.


• Before surgery you will be seen by a CRNA, who will explain the type of anesthesia you will have. He/she will answer any questions related to the anesthesia that you may have and will order any necessary pre-medications.


• If your surgeon or CRNA determines that you need further medical observation, you will be transferred to an in-patient hospital room at the Bay Area Hospital.


• If your physician orders pre-surgical tests (i.e. lab, x-ray, EKG) please have them done as soon as possible to assure the results in a timely manner.


• If you have any problems or questions after you are home, consult your physician immediately.

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Day of Surgery

What happens before my surgery?
Most commonly, you will meet the Certified Registered Nurse Anesthetist (CRNA) who will care for you on the day of your surgery before you go into the operating room. Your CRNA will then review your medical and anesthesia history and the results of any laboratory tests, and answer any further questions you may have. Nurses will record your vital signs, and your CRNA and surgeon will visit with you, completing any evaluations and laboratory tests. Intravenous fluids will be started and preoperative medications given, if needed. Once in the operating room, monitoring devices will be attached such as a blood pressure cuff, EKG and other devices for your safety. At this point, you will be ready for anesthesia.

What happens during my surgery?
Your CRNA is personally responsible for your comfort and well-being. Your CRNA will monitor as well as manage your vital body functions during your surgery. Your CRNA is also responsible for managing medical problems that might arise related to surgery as well as any chronic medical conditions you may have, such as asthma, diabetes, high blood pressure or heart problems. Your anesthesia provider (CRNA) will be with you throughout your procedure.

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Recovery in the Surgical Facility

What can I expect after the operation until I go home?
After surgery, you will be taken to the post-anesthesia care unit, often called the recovery room. Your CRNA will direct the monitoring and medications needed for your safe recovery. Initially you will be watched closely by specially trained nurses. During this period, you may be given extra oxygen and your breathing and heart functions will be observed closely. You will then be moved to another area where you will continue to recover and family or friends may be allowed to be with you. Here you will be offered something to drink and you will be assisted in getting up.

Will I have any side effects?
The amount of discomfort you experience will depend on a number of factors, especially the type of surgery. Your doctors and nurses can relieve pain after your surgery with medicines by mouth or injection or by numbing the area around the incision. Your discomfort should be tolerable, but do not expect to be totally pain-free. Medications to minimize postoperative pain, nausea and vomiting are often given during the surgical procedure and in recovery. Nausea or vomiting may be related to anesthesia, the type of surgical procedure or postoperative pain medications. Although less of a problem today because of improved anesthetic agents and techniques, these side effects continue to occur for some patients.

Will I be able to go home?
This will depend on the type of surgery and the anesthesia used. Most patients are ready to go home between 1-4 hours after surgery. Your CRNA will be able to give you a more specific time estimate. Occasionally, it is necessary to stay overnight. All ambulatory surgical facilities have arrangements with a hospital if this is medically necessary. SCSC has an arrangement with Bay Area Hospital if this is medically necessary.

What instructions will I receive?
Both written and verbal instructions will be given. Most facilities have both general instructions and instructions that apply specifically to your surgery. In general, for 24 hours after your anesthesia:

• Do not drink alcohol or use nonprescription medications.
• Do not drive a car or operate dangerous machinery.
• Do not make important decisions.

You will be given telephone numbers to call if you have any concerns or if you need emergency help after you go home.

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Patient Responsibilities

• All patients are responsible for behavior that shows respect and consideration for other patients, family, visitors and personnel of the Facility.


• All patients are responsible for assuring that financial obligations for health care rendered are paid in a timely manner.


• All patients are responsible for accepting consequences of their actions if they should refuse a treatment or procedure or if the do not follow or understand the instructions given to them by the doctor or their health care team member.


• All patients have the responsibility of providing the Facility, to the best of the knowledge, with an accurate and complete medical history about present complaints, past illness, hospitalization, surgeries, existence of advance directives, medications and other pertinent data.


• All patients are responsible for following the plan of treatment recommended by the doctor primarily responsible for the patient's care and/or other personnel authorized by the Facility to so instruct the patients.


• All patients are responsible for notifying the Facility of any change in their condition.


• All patients are responsible for keeping their appointment for scheduled procedure. If they anticipate a delay or must cancel the scheduled procedure, it is their responsibility to notify the Facility as soon as possible.


• All patients are responsible for carrying out their preoperative orders as supplied by the Facility.


• All patients are responsible for the disposition of their valuables as the Facility does not assume this responsibility.

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