Listen to the Cancer.Net Podcast: Anesthesia - What to Expect, adapted from this content
- Anesthesia is medication that blocks the awareness of pain during medical procedures.
- There are several types of anesthesia, including general anesthesia, which is used to make a person unconscious during a major procedure, such as surgery.
- If you need general anesthesia, a team of medical professionals led by a doctor who specializes in anesthesia and related care will give you the medication before your procedure and monitor your body’s reaction to it during and after the procedure.
- General anesthesia may cause side effects; talk with your doctor about the risks.
Anesthesia is medicine that keeps a person from feeling pain during medical procedures, such as surgery or other tests that diagnose cancer. There are several different types of anesthesia. The type you receive will depend on the procedure you are having and your overall health.
Types of anesthesia
Local anesthesia. Local anesthesia is an injection that numbs the area where a procedure is being done. It is typically used for small procedures, such as a breast biopsy or the removal of a mole, and generally lasts for a short time, such as a few hours. You will remain comfortable, awake, and alert.
Regional anesthesia. Regional anesthesia blocks pain in one part of the body. Sometimes the injection provides pain relief in the hours after surgery to allow a gradual recovery. You may also be given medication that makes you relaxed and sleepy with the anesthesia. Two common types of regional anesthesia are:
- Peripheral nerve block – blocks pain in areas such as the arms, hands, legs, or feet
- Epidural and spinal anesthesia – blocks pain in areas such as the abdomen, pelvis, rectum, or lower limbs
Conscious sedation. Also called monitored anesthesia care, conscious sedation uses medication to relax you in combination with a local or regional anesthesia. The medications may be given intravenously (through the vein) or by mouth in a liquid or pill form. Some people can still speak and respond to the medical care provider while others fall into a light sleep. You may not remember the procedure when the anesthesia wears off. Conscious sedation is typically used for minor surgeries or uncomfortable diagnostic tests, such as a colonoscopy.
General anesthesia. General anesthesia makes a person unconscious during a major procedure, such as surgery. Being unconscious is different from being asleep because the person cannot wake up without additional medications or until the anesthesia wears off. General anesthesia can be given intravenously, inhaled through a breathing tube the mouth, or through a combination of both.
The medical team
The anesthesia care team is a group of physicians, nurses, and other medical professionals who are responsible for your comfort and well-being before, during, and after a procedure. The team is led by an anesthesiologist, a doctor who specializes in giving anesthesia and related care. Other members of the anesthesia care team may include certified registered nurse anesthetists (NAs; registered nurses trained in anesthesia) and anesthesia assistants (AA; health care professionals who have undergone graduate-level training in safe, high-quality anesthesia care and advanced patient monitoring techniques).
What to expect with general anesthesia
If you know you will be receiving general anesthesia, knowing what to expect can help ease your mind about the experience and guide your preparations.
Preparing for general anesthesia
Before having general anesthesia, you will talk with an anesthesiologist, NA, or AA and provide information about your health that will help him or her select the safest anesthetic for you. You will be asked about:
- Your health history
- Any prescription and/or over-the-counter medications, vitamins, and herbal supplements you are currently taking
- Allergies, including foods, medication, and substances such as latex
- Previous experiences with anesthesia
- Drug, alcohol, and tobacco use
It is important to answer these questions as accurately and honestly as possible. In some cases, you may be asked to fill out a questionnaire before your appointment to help guide this discussion.
Before you leave, you will receive instructions about when to stop eating and drinking (fasting) before the procedure. In most cases, you will be told to begin fasting about six hours beforehand. In addition, you will be told whether you will need to temporarily stop taking any of your current medications that could interfere with the anesthesia or the procedure.
Receiving general anesthesia
The medication for general anesthesia may be given through an intravenous (IV) line into a vein in your arm, as a gas inhaled through a mask placed over your face, or through a combination of both. General anesthesia typically causes you to become unconscious in less than one minute.
In the operating room, the anesthesia care team members will attach monitoring devices to your body so they can closely watch your vital signs, such as temperature, blood pressure, and heart rate, throughout the procedure and keep them at an appropriate level. The team will also monitor your level of consciousness. The anesthesiologist may choose to give additional medication to increase the strength of the anesthesia, provide additional pain relief, further relax the muscles to help the surgeon complete the procedure, or reduce the risk of side effects after the procedure.
After general anesthesia
After the procedure ends, the anesthesiologist will gradually stop the anesthesia and give you any other medications to help you wake up. You will then likely be transferred to a recovery room or post-anesthesia care unit, where specially trained nurses will monitor your condition.
After the anesthesia wears off, you will feel groggy and sleepy, and you may feel confused. In addition, you may have nausea, vomiting, or chills. If a tube was inserted into your mouth and down the airway to help you breathe during your procedure, you may also have a dry mouth or sore throat.
Because your reaction speed and judgment may be temporarily impaired by the medication, you should not drive a car, operate heavy machinery or make any important decisions for at least 24 hours after waking from anesthesia. In addition, ask your doctor how long you need to wait before taking your regular medications again to ensure they do not interact with any anesthesia that is still in your body.
After having anesthesia, you may have trouble digesting heavy foods. With the doctor’s approval, first try to consume liquids, followed by light foods, such as broth or soup, yogurt, gelatin, toast, crackers, or plain rice.
Beyond these minor, manageable side effects, rare complications of anesthesia include serious injury and death. These risks are greater for patients who are elderly or who have severe heart or lung disease.
Another rare complication (occurring in one or two out of every 1,000 people) is anesthesia awareness. This means that a person may briefly wake up during the procedure. Patients who are undergoing emergency surgery; have a long history of anticonvulsant, opiate, or tranquilizer use; have cardiovascular problems; or consume alcohol daily are at increased risk for anesthesia awareness.
For most people, though, anesthesia causes no harm. If at any time you feel your recovery from the anesthesia or your procedure is not going well, contact your doctor immediately.
Questions to ask your doctor
Before having any type of anesthesia, you may want to ask the following questions:
- Do I have a choice about the type of anesthesia I will have?
- What are the risks and complications with each type of anesthesia?
- What can I do to prevent or minimize these risks and complications?
- Do I need to have any tests before undergoing anesthesia?
- Can my family come with me to the operating room?
- How will I be cared for before, during, and after my procedure?