Anesthesia

Approved by the Cancer.Net Editorial Board, 03/2016

Listen to the Cancer.Net Podcast: Anesthesia - €What to Expect, adapted from this content

Anesthesia is medicine that blocks the awareness of pain during certain medical procedures. The type of anesthesia you receive will depend on the procedure and your overall health.

Types of anesthesia

There are 4 main types of anesthesia:

  • Local anesthesia. Local anesthesia is an injection that numbs the procedure site. It is typically used for small procedures. These include a breast biopsy or the removal of a mole. The numbing lasts for a short time, potentially a few hours. You will remain 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. This makes the recovery easier. There are two common types of regional anesthesia.

    • A peripheral nerve block blocks pain in areas such as the arms, hands, legs, or feet.

    • An epidural and spinal anesthesia blocks pain in areas such as the abdomen, pelvis, rectum, or lower limbs.

  • Sedation. Sedation uses medicine to make you relaxed and sleepy. You may receive these medicines by mouth in a liquid or pill form. Or, it may be given into a vein. This is called intravenous (IV) medication. Sedation may be used with a local or regional anesthesia to reduce pain. There are different levels of sedation, based on how aware and awake you are during the procedure:

    • During minimal sedation, patients receive drugs that make them less anxious and relaxed. They are awake and can speak during the procedure. This type is generally used only for uncomfortable tests or procedures.

    • In moderate sedation, also called conscious sedation, patients receive medicine to reduce pain and lower their awareness. Some people under conscious sedation can still speak and respond to the health care provider. Others fall into a light sleep. It is often used for minor surgeries. You may not remember the procedure when the anesthesia wears off.

    • In deep sedation, patients receive drugs that make them unaware of the procedure. They usually cannot speak or answer questions. They can respond to pain, but pain medicines are usually used to reduce pain. Patients may also receive drugs that affect their memory, meaning they will not remember the procedure afterward. During this type of sedation, the health care team may need to help a patient breathe.

  • General anesthesia. General anesthesia makes a person unconscious during a major procedure, such as surgery. Being unconscious is different from being asleep. You cannot wake up without additional medications or waiting until the anesthesia wears off. General anesthesia uses a combination of drugs. It can be given through an IV, a breathing tube, or a combination of both.

Who gives anesthesia?

The anesthesia care team is a group of physicians, nurses, and other medical professionals. These individuals care for you before, during, and after a procedure. Your team will mostly likely include:

  • An anesthesiologist. This is a doctor who specializes in giving anesthesia and related care. He or she will lead your anesthesia care team.

  • Certified registered nurse anesthetists, also called CRNAs. These are registered nurses trained in anesthesia.

  • Anesthesia assistants, also called AAs. These are health care professionals who have undergone graduate-level training in anesthesia care and advanced patient monitoring techniques.

Getting ready for anesthesia

Before receiving general anesthesia, you may need to meet with the anesthesiologist and fill out a questionnaire. This discussion may include the following topics:

  • Your health history

  • Prescription and/or over-the-counter medicines, vitamins, and herbal supplements you take

  • Allergies, including foods, medicines, and substances such as latex

  • Previous experiences with anesthesia

  • Drug, alcohol, and tobacco use

It is important to answer these questions accurately. You may also need to have blood tests or other examinations beforehand so your health care team can fully evaluate your health. All of this information will help the team choose the safest type of anesthesia for you.

Additionally, you will learn about food, drink, and medicine restrictions. In most cases, you will be told to fast for about 6 hours before the procedure. This means you should not eat or drink anything other than clear liquids. And you may need to temporarily stop taking current medications that could interfere with the anesthesia or the procedure.

What happens during general anesthesia?

You may receive general anesthesia in one of these ways:

  • Through an IV line inserted in a vein in your arm

  • Through a face mask that helps you inhale the medicine

  • Through a combination of both

Most likely, you will become unconscious in less than one minute.

In the operating room, the anesthesia care team members will attach monitoring devices to your body. These devices track your vital signs. Vital signs include temperature, blood pressure, and heart rate.

During the procedure, team members will ensure that vital signs stay at an appropriate level. They will also monitor your level of consciousness.

The anesthesiologist may choose to give additional medicine for these reasons:

  • To increase the strength of the anesthesia

  • To provide additional pain relief

  • To further relax the muscles to help the surgeon complete the procedure

  • To reduce the risk of side effects after the procedure

After the procedure ends, the anesthesiologist will gradually stop the anesthesia and may give you  other medications to help you wake up.

Specially trained nurses will monitor you as you regain consciousness. Typically, this happens in a recovery room or a post-anesthesia care unit

Potential side effects of anesthesia

  • Grogginess, sleepiness, or confusion

  • Nausea, vomiting, or chills

  • Dry mouth or sore throat. This may occur if you had a tube inserted through your mouth and airway to help you breathe during your procedure.

These side effects are temporary and can be managed by the care team.

Rare complications of anesthesia include serious injury and death. These risks are greater for elderly patients or those who have severe heart or lung disease.

Another rare complication is anesthesia awareness. This means that a person may briefly wake up during the procedure. It occurs in 1 or 2 out of every 1,000 people.

Risk factors for anesthesia awareness:

  • Undergoing emergency surgery

  • Having a long history of anticonvulsant, opiate, or tranquilizer use

  • Having cardiovascular problems

  • Drinking alcohol daily

For most people, anesthesia causes no harm. If you feel your recovery from the anesthesia or your procedure is not going well, contact your doctor immediately.

Recovering from anesthesia

  • Do not drive a car, operate heavy machinery, or make important decisions for at least 24 hours after waking. Your reaction speed and judgment may be temporarily impaired by the anesthesia.

  • Ask your doctor how long you need to wait before taking your regular medicines again.

  • Ask about temporary restrictions on eating and drinking after having anesthesia. Initially, you may have trouble digesting heavy foods. The doctor may recommend starting with liquids, followed by light foods. These may include broth or soup, yogurt, gelatin, toast, crackers, or plain rice.

Questions to ask your health care team

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?

  • May my family come with me to the operating room?

  • How will I be cared for before, during, and after my procedure?

More Information

What is Cancer Surgery?

What to Expect When Having Surgery

Side Effects of Surgery

Additional Resources

MedlinePlus: Anesthesia

American Society of Anesthesiologists: Anesthesia 101