Pre-Surgical
Visit
The Anesthetic
Anesthetic Preparation
Types of Anesthetics
Pre-operative Instructions
After your Surgery
Anesthesia for Children
At the
Spokane Ear, Nose, and Throat Ambulatory Surgery Center (SENT),
surgical and anesthetic care are provided in a manner so that
you don’t stay overnight and can return to your home later
in the day. For the surgeons, anesthesiologists, and nurses
at SENT, your safety is their number one priority. Their training
and experience, the use of modern medical monitoring devices
and medications, and your cooperation in adhering to all pre-operative
instructions ensure that your surgery is safe and convenient.
It is normal for
patients and their families to experience stress and anxiety
prior to surgery. We hope that the information contained in
this brochure will help put you at ease.
Pre-Surgical
Visit
Once your surgeon determines that surgery is necessary for your
care, a pre-operative visit to SENT is scheduled. This is your
opportunity to ask questions well in advance of your surgery and
to tour the surgical facility, and will include the completion
of a detailed health history, the acquisition of any necessary
laboratory tests, and written and verbal pre-operative instructions.
Oftentimes, it is during this initial visit that an anesthesiologist
will evaluate you. The pre-operative visit and pre-registration
are important steps in your preparation for surgery.
If you do not have a pre-surgical visit, a nurse will call
you at your home before your surgery to gather information and
answer your questions.
The Anesthetic
Your anesthetic at SENT will be provided by an anesthesiologist.
Anesthesiologists
are physicians who have received at least 4 additional years
of specialized training in the medical specialty of anesthesiology.
Anesthetic
Preparation
The information you
provide during your interview with the anesthesiologist and
on the Review of Systems Medical History form will help to determine
your suitability for surgery at SENT. If your pre-existing medical
conditions indicate that an overnight stay might be necessary
or if there are significant medical risks, for example with
the heart or lungs, the anesthesiologist may suggest that the
surgery be done in a hospital. The SENT surgery center is not
designed to accommodate overnight stays.
Your anesthesiologist needs to know as much about you as possible
because anesthesia and surgery affect your entire system. During
your pre-operative interview, an anesthesiologist will ask you
about your medical history, prior surgical and anesthetic experiences,
and your allergies and current medications. Frequently, people
requiring surgery have other medical conditions, such as diabetes,
asthma, high blood pressure, arthritis, or heart disease. The
preoperative evaluation will allow the anesthesiologist to be
aware of these conditions and to be well-prepared to treat them
during your surgery and immediately afterward in the Post-Anesthesia
Care Unit (PACU). From information obtained from the pre-operative
evaluation, your anesthesiologist may order laboratory tests
or determine that you would benefit from preoperative medications.
Based on all this information, plus the type of surgery you
are having, the anesthesiologist will outline to you the anesthetic
alternatives. Most times the choice of anesthetic technique
is best left to the anesthesiologist.
Types
of anesthetics
Surgeries at SENT usually require either general anesthesia or
local anesthesia with sedation.
Anesthetics are designed so that you can go home soon after
your operation. Short-acting anesthetic medications and specialized
anesthetic techniques, as well as care specifically focused
to the needs of the ambulatory patient, are used to make your
experience safe and pleasant.
General Anesthesia - patients having general
anesthetics are unconscious and do not awaken until the anesthetic
is discontinued. These anesthetics are injected into veins or
are inhaled. Frequently, a combination of intravenous and inhaled
anesthetic medications is used. In most cases of general anesthesia
the anesthesiologist will place a breathing device down your
mouth after you are unconscious, assuring the movement of anesthetic
gases and oxygen to and from the lungs. Modern anesthetic medications
have less nausea and vomiting and faster wake up times.
Local Anesthesia and Sedation- the surgeon
injects local anesthetic solution through a needle in the skin
and adjacent tissue; this is usually reserved for minor operations.
Sedatives are often given through the intravenous by the anesthesiologist
so that you can be more relaxed.
The anesthesiologist will closely monitor your vital signs throughout
your operation whether you are having a general or local anesthetic.
Pre-operative
instructions
You will receive specific instructions about what and when you
can eat and drink before surgery. The risks patients expose
themselves to when they fail to comply with the eating and drinking
guidelines are prolonged hospitalization and life-threatening
lung injury. The pre-operative instructions apply to all types
of anesthesia. Please read the instructions very carefully and
call SENT if you have any questions.
After
your Surgery
You will be taken to the Phase 1 Recovery Room and cared for
by nurses with specialized training. It is there you will awaken.
Visitors are not allowed in this area, but your escort will
be informed of your arrival.
Anesthesia
for Children
The preparation for surgery for children begins with efforts
by the parents to explain honestly to their child what the anesthetic
and surgery will be like. Words and phrases with positive connatations
should be used. The condition of unconsciousness could be described
as “a special nap”. The word “medications”
sounds better than “drugs”.
Anesthesiologists and nurses are specialists in treating pain.
Children need to know that yes, there will be some discomfort
after the surgery, but that these specialists will work very
hard to make them feel better. Also, Children should be informed
that parents will not be with them at all times, but that they
wil be in the hospital waiting for them.
We encourage the children to bring with them to the operating
room their favorite stuffed toy or blanket.
The anesthesiologist may decide to begin the anesthetic in the
operating room by having the child breath an anesthetic gas
through a mask, then placing an intravenous catheter depending
on the pre-operative evaluation, the physical exam and the type
of surgery. Parents oftentimes see this as a desirable induction
method as it eliminates the discomfort associated with the iv
in an awake patient. However, in some situations it is preferable
and safer to have an iv placed prior to beginning the anesthetic.
When this is the case, local anesthetics are placed into the
skin to reduce the pain when placing the iv.
It is normal for children to be afraid of a hospital, and it
is very common that they cry. It is difficult being a patient
when you are a child, and it is difficult being the parent of
a child having a surgery. Your operating room staff understands
this, and their experience allows them to safely care for children
and parents of all temperament.
