We have found many patients have the same questions before surgery. Often these questions only arise after you have met with your anesthesiologist. You may even have these questions the night before your surgery. Our hope is that you will find this information helpful or it will help allay most of your fears.
Please note: The information provided on this page is general information only which may not apply to you. We recommendthat you also speak to your anesthesiologist who is administering the anesthestic if you have any more questions.
Why do I need to see the anesthesiologist before my surgery?
See Pre-operative Assessment.
Will I be in pain after surgery?
Any operation can hurt, but the anesthesiologist will provide pain relief for the expected duration of severe pain. Should that be insufficient, then one only needs to ask for further therapy.
Do I have to go to sleep for my surgery?
See Types of Anesthesia.
What are the risks of anesthesia?
Dying or suffering permanent serious harm (such as brain damage) is very rare, but the possibility does exist. The risk will vary according to your health beforehand and the seriousness of your operation. In Canada, the chance of a healthy person dying as a result of anesthesia is probably between 1 in 200,000 and 1 in 400,000. This is certainly comparable with the risks of commercial airline travel and much safer than travel by car.
Side-effects and minor complications occur more often.
Will I wake up in the middle of the operation?
See Anesthesia Awareness.
Does the anesthesiologist stay with me the whole time?
Your anesthesiologist remains in the operating room to monitor your safety. He or she also makes decisions about intravenous (IV) fluids, the need for blood products, antibiotics, pain medications, and where you will recover after the surgery.
Why can't I eat or drink before surgery?
In a normal state, your body has defenses to prevent stomach content from coming up. Unfortunately when you are unconscious this mechanism does not work, so it's best that your stomach is empty when you have a general anesthetic. In emergency surgery when you may have eaten recently, your anesthesiologist will take special precautions to reduce the risk of aspiration.
Even if you are booked to have a regional anesthetic, it is important to follow the instructions about not eating and drinking, just in case it becomes necessary for you to have a general anesthetic.
Will I say things I wouldn't otherwise say?
No, this never happens.
Will I dream?
No, the anesthetic state is more profound than the usual type of sleep in which dreams occur.
Will I be sick to my stomach afterwards?
See Common side-effects after anesthesia
Will I have a sore throat after surgery ?
See Common side-effects after anesthesia
I have a loose tooth. Is that a problem?
Your anesthesiologist will want to know about any loose teeth, capped teeth, dentures, bridges or crowns.
When you are being intubated, the teeth are very close and there is always a possibility of a tooth being chipped or damaged, particularly if a tooth is capped or loose. By giving any details of loose or capped teeth, the anesthesiologist can make extra sure to prevent damaged teeth. Sometimes, if a tooth is really loose, it is wise just to take it out before your surgery.
Do I really need an intravenous line? When can the IV come out?
Almost always, one intravenous (called an ‘IV’ for short) line will be placed before you go off to ‘sleep’. Frequently, the intravenous is started with a little bit of local anesthesia in the back of the hand, although other sites can be used as well.
This is called ‘lifeline’ and is used to give the anesthetic agents such as propofol, and as a route for fluids. In case of an emergency, drugs can be given to treat complications such as very low blood pressure.
Usually the IV will come out if you can take enough to drink by mouth and there is no need for medications such as intravenous antibiotics or painkillers.
What is an epidural?
See What is an epidural?
What is a spinal?
See What is a spinal?
When can I resume normal activities?
This is more often a function of your surgical procedure, and your surgeon will advise you accordingly. The anesthetic drugs are largely gone from your body within hours of your operation, though we advise against performing fine procedures such as driving, operating machinery or signing legal papers for the first 24 hours after any anesthetic.
Will the pills I take interfere with the anesthetic drugs?
Any drugs you take, including those used for recreation, should be known by your anesthesiologist prior to your procedure, for interactions are always possible. However, modern anesthetic techniques allow you to continue to take your scheduled medications even prior to the operation, unless you are specifically advised not to do so. Please check with the surgeon or anesthesiologist if in doubt.
What is the difference between "anesthetist" and "anesthesiologist"?
See Who are anesthesiologists?
What if I'm allergic to anesthesia?
Sometimes patients may think, or be told, that they are 'allergic to anesthesia' because they have an unpleasant experience that they associate with anesthesia, for example nausea and vomiting. These are side effects of drug administration, not allergic reactions. A true allergic reaction to a drug usually produces hives or weals on the skin, wheezing in the lungs, swelling of the mouth, throat or eyes, and sometimes a drop in blood pressure. Please see Allergic Reactions and Surgery for more information.
I have sleep apnea. Will this make any difference re. my upcoming surgery ?
See OSAHS: Obstuctive sleep apnea/hypopnea syndrome
What happens in the operating room?
The operating room staff generally consists of nurses, doctors, technicians and support staff as needed. They all form part of the operating room team. In ‘teaching’ hospitals there might also be nursing students and medical students to learn and help. Before you enter the operating room many of these people prepare the instruments and drugs required for your specific surgery. Great care is taken to ensure the cleanliness of the operating room to reduce your risk of having an infection after your surgery.
Prior to going to ‘sleep’ (or being “anesthetized”) your surgeon and anesthesiologist may talk with you to confirm details about your medical history or to explain what you can expect after the surgery is complete. Once inside the operating room the staff will connect you to machines (called ‘monitors’) to check your blood pressure, heart rate, heart rhythm and make sure you breathe. These monitors stay connected till the end of the surgery. The safe surgery checklist is also performed.
Once ‘asleep’ (or sedated if regional anesthesia is the technique of choice) the operating room staff continue to prepare for your surgery. This may include inserting a catheter to drain urine and more intravenous lines, cleaning the part of your body that is to be operated on and then covering that part with sterile drapes or covers. After this the surgeon(s) will don sterile gowns and gloves and begin to operate.
During the operation there is a gowned nurse who assists the surgeon(s) with handling the various instruments such as scalpels and needles. There is also a second nurse (called the circulating nurse) who acts as a ‘runner’. Regardless of the length of your operation there will always be nurses and doctors in your operating room to care for you.
At the end of the surgery the anesthesiologist will wake you up (or stop the sedation if you were having a regional anesthesia) unless you are told otherwise (i.e. you may be transferred to an Intensive Care Unit while still asleep). He or she will transport you to a recovery area (called the recovery room or post anesthesia care unit). Here another team of nurses will care for you until you are transferred to a ward or to the day surgery unit. Back in the operating room the various staff members clean up and prepare the room for the next patient.
Dr. Nam Le MD (Resident Anesthetist)
Dr. Martin van der Vyver (Specialist Anesthetist) MBChB FRCPC
Date created: October 22, 2010