Anesthesia Frequently Asked Questions

Before Surgery

What is an anesthesiologist?
Your anesthesiologist makes sure your vital signs – blood pressure, heart rate, temperature and oxygen levels – are stable throughout the surgery. He or she also manages your level of consciousness and sleep during the procedure.

If you encounter a problem during surgery (blood loss, changes in blood pressure, heart arrhythmias, and many others), your anesthesiologist will work to correct the problem. Anesthesiologists at HSS are experts on developing the best way to approach anesthesia for your specific operation.

Learn more about what your anesthesiologist does.

What are the risks associated with anesthesia?

The Department of Anesthesiology, Critical Care & Pain Management has made great strides in advancing anesthesia safety for orthopedic surgery patients. Based on your specific needs, your anesthesiologist will develop a comprehensive anesthetic plan before, during, and after surgery. Before surgery, please speak with your anesthesiologist about any concerns you have about anesthesia and pain management.

Common side effects include headache, pain at the injection site, and nausea and vomiting. Many of these risks are mitigated through our anesthetic approaches, more specifically regional anesthesia.

Can I talk with my anesthesiologist before surgery?
You will meet your anesthesiologist the day of the operation before surgery. If you have any questions or concerns related to your anesthesia, you are welcome to contact the Department to arrange for a pre-anesthetic consultation. We always have an anesthesiologist on call to answer your pressing questions.

If you have any questions about your operation, you should contact your surgeon's office.

Can I request a specific anesthesiologist?
Although we cannot promise a specific anesthesiologist to you before surgery, we do consider patients’ preferences. If you have been to HSS in the past and liked your anesthesiologist, we will try to arrange for the same physician for your next surgery at HSS. To request the same anesthesiologist, please contact your surgeon's office or the Department in the days leading up to your surgery.

Your anesthesiologist will be assigned to you the day before surgery. Many factors go into determining an anesthesiologist for each patient or procedure, but the most important consideration is matching our anesthesiologist’s specific clinical expertise with your medical history and procedure type.

While our expert staff is highly trained and an expert in his/her field, some have developed particular areas of interest and clinical expertise. For example, several anesthesiologists specialize in pediatric anesthesia and these physicians care for the vast majority of pediatric patients.

Can I eat before surgery?
You will be given specific instructions about eating and drinking by the nurse who contacts you the day before your surgery. You should refrain from eating at least eight hours before your scheduled procedure to reduce side effects related to an aspiration. An aspiration is when stomach contents are expelled into the lungs and can cause significant damage. You can protect yourself from an aspiration by carefully following preoperative instructions regarding food and drink.

What medications should I take on the day of surgery?
You should discuss your medications with your physician at your preoperative medical clearance appointment or with your surgeon before surgery. All patients scheduled for ambulatory surgery will be contacted by an HSS nurse on the afternoon or evening before surgery – you should ask about your medications then. If your medication questions are not answered by the day of surgery, you should bring your medications with you.

Can my allergies interfere with anesthesia?

It is vital to inform your anesthesiologist of any allergies you may have. Your providers need to know what you are allergic to and how you react to those allergens. At the time of your admission, a color-coded wristband will be given to you to indicate to your caregivers that you have an allergy.

Some people have allergies specifically to anesthetic agents. Allergic reactions range from skin rashes, hives, breathing problems, and anaphylaxis to a very rare condition called malignant hyperthermia. If you do have an allergic reaction in the hospital, it can be treated. However, the safest way to avoid these types of problems is by avoiding exposure.

Your anesthesiologist can often find safe, alternative ways of providing anesthesia without using medications that may have caused problems in the past. For your safety, your anesthesiologist may recommend preoperative testing by an allergist to confirm drug allergies.

Will my sleep apnea impact anesthesia?
If you know that you have sleep apnea, please alert your surgeon, anesthesiologist, and the hospital staff before surgery. If you have special home equipment for sleep apnea, such as nasal continuous positive airway pressure (CPAP) mask, please bring it with you to the hospital on the day of surgery.

If you have sleep apnea, as a precautionary measure, you may be admitted overnight to be observed by one of our Critical Care Team to ensure that the medications prescribed to control pain after surgery do not interfere with your breathing.

Will my pain medications cause problems for anesthesia?
The Department manages a dedicated Acute Pain Service to address postoperative pain issues. Our goal is to keep you safe and comfortable regardless of the medications you are taking for pain preoperatively.

You should contact the Department for a preoperative consultation with a pain specialist if:

• You are taking large doses of opioid pain medication before your surgery
• Have any implanted pain devices such as a spinal cord stimulator or implanted opiate pump
• Have reflex sympathetic dystrophy (RSD) or complex regional pain syndrome (CRPS)

Addressing these pain management issues will allow your anesthesiologist to develop a specialized plan of care for your postoperative pain treatment.

What is an anesthesia technician?
An anesthesia technician, often called an anesthesia tech, is a key member of the perioperative team. An anesthesia tech oversees and masters all of the anesthetic equipment the perioperative team uses – from ultrasound machines to monitors that display critical information about the progress of the procedure – and manages the safekeeping, maintenance, and troubleshooting of these technologies. An anesthesia tech is vital in improving anesthesia care by ensuring all of our cutting-edge technology, equipment, and instruments are up-to-date and working soundly.

During Surgery

Am I going to be asleep during my surgery?
While general anesthesia requires complete unconsciousness and the assistance of a machine for breathing, regional anesthesia techniques have several levels of sedation. Your surgeon and anesthesiologist determine the type of anesthesia and your level of sedation. In many cases, your anesthetic can be customized to meet your expectations. Many of the sedatives your anesthesiologist will use can cause amnesia, and although you may be awake and conversant during the procedure, you may have no recollection of these events later.

Am I going to wake up during surgery?

It is extremely rare to wake up during surgery under general anesthesia. Depending on the anesthetic technique and the amount and type of drugs that are administered by your anesthesiologists, you may be able to choose from being wide awake to fully asleep during your procedure.

After Surgery

Will I be in pain after my surgery?

Your anesthesiologist will do everything he or she can to keep you comfortable following surgery. You will be closely monitored by physicians, nurses, and other medical staff throughout your time in the recovery room to help ensure a safe and comfortable recovery.

If you are staying in the hospital after your surgery, our Perioperative Pain Service (POPS) may coordinate your pain control. POPS is available 24 hours a day, seven days a week.

Will anesthesia make me throw up?
Your anesthesiologist will review your case to see if you are a candidate for regional anesthesia. Patients who undergo regional anesthesia are less likely to report feelings of nausea or vomiting following surgery. In fact, only five percent of patients at HSS report throwing up after undergoing surgery with a regional anesthetic compared with 40 percent to 50 percent of patients that receive a general anesthetic. HSS anesthesiologists routinely combine anti-nausea medications into your regional anesthetic to lower your risk of postoperative nausea and vomiting.

If you have a history of nausea and vomiting following surgery or a history of motion sickness, please talk to your anesthesiologist before surgery. He or she will make necessary adjustments to the anesthetic plan to ensure the best approach to keep you comfortable and safe throughout your stay at HSS.

When can I see my family after surgery?
After your procedure, you will be moved to the Post-Anesthesia Care Unit (PACU). Once you are stable and/or awake, family visits may be allowed to visit for a short time. Your family will have to check with nursing staff about the exact time frames allowed. Pediatric patients are permitted to see up to two parents or guardians upon arrival in the PACU. Ultimately, visitation is decided by the nursing staff in the PACU.

Will my insurance cover anesthesia care?
Like charges from your surgeon, your anesthesiologist's fees are not included in your hospital bill. Many insurance plans cover our charges in full but some do not. While all of our physicians participate with Medicare and Medicaid, they may not participate with your specific insurance plan. To obtain information about your particular insurance plan, we recommend that you contact your insurer.

The Department is contracted with over 96% of HSS patients’ insurances. Regardless of your insurance coverage, you will receive a bill for anesthesia services. Our billing company, Billing Services Inc. (BSI), will also file this claim directly with your carrier. In many cases, you may be required to intervene with your insurance company to ensure that they cover all the charges they should. BSI will assist you in this process.

If you have an outstanding balance after your insurance payment, you will be responsible for that amount. In the case of financial hardship or other extenuating circumstances, you should contact BSI to resolve the matter. If you have further questions about our billing practices, contact BSI at 888.877.3850.

Learn more about paying for your care.

 

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