During surgery, you will be given some form of anesthesia -- medicine for the relief of pain. The type and dosage of anesthesia is administered by the anesthesiologist. When a patient faces surgery, he or she will meet with the anesthesiologist before the procedure. The anesthesiologist will review the patient's medical condition and history to plan the appropriate anesthetic for surgery.

There are various forms of anesthesia. The type of anesthesia you will receive will depend on the type of surgery and your medical condition. Usually, an anesthesiologist will administer a sedative in addition to the anesthetic. The different types of anesthesia are as follows:

Cost. Anesthetic drugs and gases are costly and the latter often difficult to transport. The costs associated with spinal anesthesia are minimal.

Patient satisfaction. If a spinal anesthetic and the ensuing surgery are performed skillfully, the majority of patients are very happy with the technique and appreciate the rapid recovery and absence of side effects.

Respiratory disease. Spinal anesthesia produces few adverse effects on the respiratory system as long as unduly high blocks are avoided.

Patent airway. As control of the airway is not compromised, there is a reduced risk of airway obstruction or the aspiration of gastric contents. This advantage may be lost if too much sedation is given.

Diabetic patients. There is little risk of unrecognized hypoglycemia in an awake patient. Diabetic patients can usually return to their normal food and insulin regime soon after surgery as they experience less sedation, nausea and vomiting.

Muscle relaxation. Spinal anesthesia provides excellent muscle relaxation for lower abdominal and lower limb surgery.

Bleeding. Blood loss during operation is less than when the same operation is done under general anesthesia. This is because of a fall in blood pressure and heart rate and improved venous drainage with a resultant decrease in oozing.

Visceral tone. The bowel is contracted during spinal anesthesia and sphincters are relaxed although peristalsis continues. Normal gut function rapidly returns following surgery.

Coagulation. Post-operative deep vein thromboses and pulmonary emboli are less common following spinal anesthesia.

Q: Who will administer anesthesia to me?
A: An anesthesiologist will direct or administer your anesthesia during surgery. An anesthesia provider will be present in the operating room the entire time to monitor and adjust the anesthesia you are receiving.

Q: What training does an anesthesiologist receive?
A: An anesthesiologist has training of similar length as a surgeon. He is a college graduate who has also completed four years of medical school and four years of anesthesia residency training.

Q: When will I meet my anesthesiologist?
A: You will meet the anesthesiologist on the day of surgery. Many patients also will visit the pre-operative clinic where a nurse will review your medical history, obtain any necessary lab tests, X-rays, or electrocardiogram and answer any questions about the anesthesia.

Q: What type of anesthesia will I receive?
A: There are three main categories of anesthesia commonly used, general, regional and local anesthesia. General anesthesia involves giving medications into the vein to induce sleep, and then having you breath an anesthetic gas to maintain the anesthesia. Often a breathing tube is placed to assist inhaling the gas. Regional anesthesia involves giving a spinal, epidural, or nerve block to numb part of the body, and is usually accompanied by sedative drugs to relax you and limit your memory of having the surgery. Local anesthesia is limited to small procedures of skin or subcutaneous tissues and can be combined with sedation. Some surgeries require or are best done under one type of anesthesia, but many procedures allow for a choice. Talk to your anesthesiologist about these choices prior to surgery.

Q: What are the chances of awaking during a general anesthetic?
A: With an anesthetic gas based general the chance is extremely remote. Talk to your anesthesiologist about your risk if you are seriously ill, or in very poor general health.

Q: What is the risk of anesthesia?
A: The risk of anesthesia is based on your previous health in general, and particularly prior cardiac and pulmonary disease. The vast majority of patients have an extremely low chance of serious anesthesia related complications.

Q: What are the side affects of anesthesia?
A: The most common side affects are nausea, muscle soreness and sore throat from general anesthesia. Regional and local anesthesia may have soreness at the site of injections, and spinal anesthesia can rarely cause a postoperative headache. The spinal headache incidence is much lower than even ten years ago due to the use of smaller and less traumatic needles. There is no need to lay flat after a spinal anymore. Some patients will feel cold and shiver in the recovery room.

Q: How can postoperative pain be minimized?
A: Some operations are known to be associated with higher degrees of postoperative pain, and this pain can be minimized by utilizing additional anesthetic procedures. Examples include adding a narcotic to the spinal anesthetic to give prolonged pain relief, and using an epidural pain catheter for chest or major abdominal surgery. These procedures can dramatically improve the postoperative experience and speed recovery in some cases.

Q: How soon before surgery can I eat or drink, and should I take my usual medicines on the day of surgery?
A: The usual requirement is to have no food or drink after midnight. If your surgery is in the afternoon this may be modified. Most medicines are to be taken on the day of surgery, except coumadin and some other blood thinners may need to be stopped a few days in advance.

Q: How soon will I wake up after surgery?
A: The usual time to awakening is about five to ten minutes. Most people will feel groggy after surgery, depending on how long they were asleep and how much narcotic was given intravenously. Most people will be in the recovery room one to two hours