Depending on the type of procedure, you may have a general anesthetic, neuraxial anesthetic, regional anesthetic, or intravenous sedation with local anesthesia. Often times, combinations of these types are used to optimize your care. Your anesthesiologist will discuss the various anesthetic and post-operative pain control options available to you during your pre-operative assessment.
General anesthesia involves placing you in a state of controlled unconsciousness for the period of the operation. This is typically achieved by a combination of both intravenous and inhalation agents.
Neuraxial anesthesia includes spinal and epidural anesthesia. These techniques involve the use of combinations of local anesthetics and often times narcotic medicines to block the nerves coming from the spinal cord. They can be used as the sole anesthetic for many procedures on the lower extremities and lower abdomen. In addition, they can be used to help provide post-operative pain relief for many procedures.
Regional anesthesia refers to numbing an area by injecting local anesthetic near major nerves. Also referred to as peripheral nerve blockade, these techniques are used to make the surgical area insensate for a limited period of time. These blocks can be performed as a single, one-time injection, or may be dosed continuously by placement of a small hollow catheter which may remain in place for several days. Depending on the type and concentration of the local anesthetic used, this may be used as the sole anesthetic along with intravenous sedation. It may also be used in combination with general anesthesia to minimize the depth of anesthesia. Regional anesthesia techniques are often very helpful in controlling post-operative pain.
Finally, for some procedures, intravenous sedation can be used in combination with local anesthesia injected near the operative site by the surgeon.
Regardless of the anesthetic type decided upon, your vital signs will be closely monitored at all times. This includes your heart rate, blood pressure, respirations, and oxygenation (referrred to as oxygen saturation or pulse-oximetry). Other types of monitors may be needed, depending on your procedure and co-existing medical problems, and these will be discussed with you prior to your anesthetic.