- A responsible adult must accompany you to the Westmount Square Surgical Center and be available to drive you home as well as stay to assist you overnight the day of your surgery.
- A light meal before 20:00 (8:00PM) the day prior to your surgery is permitted. Food and drink should NOT be ingested after midnight up until the scheduled surgery.
- Do not take medication containing aspirin (Fiorinal) or ibuprophen for one week prior to your scheduled surgery unless otherwise directed by your physician.
- Take prescribed medications, as directed in your pre-assessment at 18:00 (6:00PM) the evening prior to your surgery.
- If you have asthma or any other respiratory condition, please bring your inhaler(s).
- If you have type I Diabetes (Juvenile), please bring your prescribed insulin with you.
- Shower and wash your hair the day of surgery.
- Wear loose, comfortable clothing on the day of your surgery; a patient gown, robe and footwear will be provided for you at the Center.
- Jewelry and other valuables should be left at home. We cannot be responsible for their safety.
- Cosmetics should be minimal or not at all.
- CONSENT TO SURGERY, CONSENT TO ANESTHESIA; your signature will be required indicating that you give your surgeon and anesthetist permission to perform a procedure(s) You must read this form carefully and be sure to clarify any concerns that you may have prior to signing.
- Illness – please contact the Center if you have an obvious respiratory infection (cold) or other acute illness one week prior to your surgery.
Your choices in anesthesia
There are three main categories of anesthesia:
- Local anesthesia.
- Regional anesthesia.
- General anesthesia.
The following information provides a brief overview of each type of anesthesia:
- The patient receives a shot to numb the immediate treatment area.
- Blocks nerve impulses and reduces or eliminates local sensation.
- A region of the body is anesthetized without rendering the patient unconscious.
- Referred to as nerve blocks.
- An anesthetic is injected into a nerve cluster and it affects sensation in all areas which this cluster controls.
- Given by an inhaled gas and/or intravenously.
- The gas is an odorless, rapid-acting opioid, which depresses the central nervous system and respiratory function.
- Intravenous sedative agents are used for the induction and maintenance of general anesthesia.
Gas or liquid? Inhaled, injected or swallowed?
What are the differences between gas and liquid anesthetics? What does it mean to inhale, inject or swallow an anesthetic gas or drug? Finally, what does it feel like? You’d be surprised just how many people want to know the answers to those questions before they sign up for a potentially life-altering surgery. The following information provides a brief overview of what gas and liquid sedatives are, and what you can expect to feel as you go under its effects:
- Gas anesthesia is inhaled into the lungs.
- Your blood is saturated with the anesthetic gas, and carried to your central nervous system.
- Effects of the gas are dependent on:
- Gas concentration.
- Rate of gas flow (from the machine).
- Rate and depth of breathing.
- Amount of blood the heart pumps per minute.
- Dissolvability of the gas in the blood (some are more soluble than others).
The type of inhalant we use at the WSSC for surgical procedures is Sevofluorane.
- There are several types of liquid sedatives. Amongst the ones we use are:
- Propofol – suitable for monitored sedation and maintenance of general anesthesia.
- Ketamine – primarily used for the induction and maintenance of general anesthesia, usually in conjunction with a sedative drug.
Like gas anesthetics, the effects and duration of liquid sedatives are dependent on a few factors:
- The amount injected.
- Weight of the patient.
- Fat solubility of the drug.
- Fat percentage of the patient’s body.
Used in small doses, most liquid anesthetics can be used for light sleep sedation.
What does it feel like?
- Regardless if you have a liquid or gas anesthetic, you will more than likely have an IV inserted to keep you hydrated and have a ‘vascular doorway’ should the need arise.
- What does an IV feel like?
- Having an IV inserted feels sort of like blood being drawn, but for a shorter period of time.
- The initial placement of the IV catheter may sting a bit.
What does anesthesia feel like?
- The effects of the anesthesia are felt soon after injection (a few seconds).
- It feels like heat going into your veins then creeping up your arm;
- Then it jumps from your shoulder to a metallic-like taste under your tongue, and then you are blissfully anesthetized.
- Entails breathing through a mask, depending on what type.
- In older machines, a little balloon the size of your two thumbs holds your tongue out of the way so it does not obstruct your breathing.
- In newer machines, you have the pleasure of having a tube down your throat but you don’t usually remember it going in.
- You may wake up with a sore, dry throat because cylinder air is dry.
- Regardless of the type, you are basically told to count up to 10. After the gas hits your lungs, your blood becomes saturated with the gases and carried to your central nervous system where you are in all actuality, knocked out.
Your anesthesiologist must know for your weight and body fat percentage what will work best for you and in what amounts. On top of that, they will monitor your heart rate, breathing rate, your blood pressure, and much more.
If you are going under light sleep (IV), an anesthesiologist may not be present in the operating room with you. Some use nurses, and in others, the surgeon may be in charge of inducing light sleep anesthesia.
A successful recovery is vital for your safety and long-term health. However, many things can go wrong during the initial recovery period. Shivering and feeling cold is the least of your worries. Please read the information below and discuss the anesthesia protocol with your anesthesiologist:
- Patients must be monitored during recovery to ensure adverse events are rapidly recognized and treated.
- Vital signs should be recorded at regular intervals and blood oxygen levels should continue to be monitored until the patient is no longer at risk.
- Monitoring should include observation by a person trained in recognition of post-procedure/post-sedation complications.
Appropriate discharge criteria should be met prior to discharge. Criteria include:
- The patient should be alert and oriented.
- Vital signs should be stable and within acceptable limits.
- Sufficient time (up to two hours) should have elapsed after last administration of reversal agents (naloxone, flumazenil) to ensure that patients do not become re-sedated after reversal effects have abated.
- Outpatients should be discharged in the presence of a responsible adult who will accompany them home and be able to report any post-procedure complications.
- Outpatients should be provided with written instructions regarding post-procedure diet, medications, and activities, and a phone number to use in case of emergency.
Post-operative instructions following general anesthesia
- Never remove the original bandage unless otherwise instructed by your doctor.
- A small amount of bleeding is normal. If your bandage becomes soaked with blood, place another bandage over it and apply a small amount of pressure until it stops.
- You may receive a prescription for medication which should be filled at your local pharmacy.
- Limit your activities for the next 24 hours: no heavy work, do not drive or operate hazardous machinery, etc.
- Nausea is often felt after a general anesthesia so limit your food intake. Start by drinking water or clear fluids (ginger ale, bouillon, tea). Progress to light foods such as jello and soups. You should feel able to resume your normal diet within a 24 hour period.
- Do not drink alcoholic beverages for 24 hours.
- Please make an appointment with your doctor for a follow-up visit.
- In case of an emergency or questions regarding your surgery, please call your doctor’s office. If you are unable to reach your doctor – in case of emergency only – you should contact your local hospital.
- After your surgery, your surgeon will prescribe a set of specific post-operative instructions that you must follow until your follow-up appointment.
Symptoms to report to your doctor immediately:
- Excessive or persistent bleeding.
- Excessive swelling or redness of wound or surrounding area.
- Fever of 38℃ (99℉) or more.
- Excessive pain.
- Persistent nausea or vomiting.