Q  What
is an anesthesiologist?
A The anesthesiologist is a doctor who
does more than just ensure a patient's comfort. His most important
role is to make informed medical decisions regarding the patient's
vital body functions during surgery, and to immediately diagnose and
treat any medical problems that occur during an operation or during
the recovery period. The anesthesiologist is responsible for easing
discomfort as well as managing breathing, blood pressure, heart beat,
and brain and kidney function. The anesthesiologist must have at least
four years of premedical college, followed by four years of medical
school, and then one year of in-hospital internship, and finally three
years of specialized anesthesiology residency training. Many of the
Fairbanks Anesthesia Group anesthesiologists have additional training
such as specific fellowship training in pediatrics, critical care medicine,
pain management, and education degrees such as MBA and PhD.
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Q What is
a nurse anesthetist?
 A The
nurse anesthetist is a specialized anesthesia nurse who works together
with the anesthesiologist on certain cases. The anesthetist is trained
to handle the majority of the tasks and problems encountered in administering
an anesthetic. This provides the advantage of a team approach to patient
care. The anesthetist must have completed an associate, diploma or
degree Registered Nurse program, acquired additional nursing experience
in a critical care area for at least one year, followed by at least
two years of specialized nurse anesthesia training. All of the Fairbanks
Anesthesia anesthetists have passed the rigorous national certification
examination, being certified by the American
Association of Nurse Anesthetists, and most have many years of
experience. All of the Fairbanks Anesthesia Group anesthetists have
additional training in specialized areas such as cardiac care units,
intensive care units, critical care nursing, and/or cardiac surgery.
Many of our anesthetists also have a Bachelor of Science Degree as
part of their undergraduate degree or a Masters Degree along with their
anesthesia training.
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Q What is
general anesthesia?
A General Anesthesia involves administering
intravenous and inhalational agents that cause loss of consciousness.
This is used for many major operations. A general anesthetic usually
begins with "Induction" when an intravenous drug is given
and a patient drifts off to sleep. Sleep is then maintained with a
combination of inhaled anesthetics and intravenous drugs. Amounts of
medication given are based on the body's weight, age, general medical
condition and response to surgery. After surgery, the patient is allowed
to "emerge" from anesthesia by discontinuing the medications
and, in some cases, by administering reversal agents.
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Q What is
regional anesthesia?
A Regional Anesthesia is useful in operations
on extremeties or the lower abdomen by numbing regions of the body.
Examples include: epidurals, saddle block, spinal block, axillary block,
and intravenous (Bier) block. Intravenous sedatives are included in
a regional anesthetic so that the patient is relaxed, sleepy, or even
napping throughout the procedure.
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Q What is
monitored anesthesia care (MAC)?
A Monitored Anesthesia Care (MAC) involves
the numbing of a small area of the body with local anesthesia for simple
surgeries and also can include sedatives for additional comfort.
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Q Should
I have anesthesia for childbirth?
 A Having
a baby will be one of the high points of your life. Today your obstetrician,
anesthesiologist, and nurses can make your childbirth more safe and
free of pain then ever before.
Discomfort during labor is related to your baby's size and the size
of your pelvis, and to the baby's position, the power of your contractions
and, of course, to your pain tolerance. A twenty year old having her
first baby may be expected to have more noticeable discomfort than
a thirty five year old having her third baby.
Breathing and relaxation methods may be all some patients need, but
you may desire additional comfort measures for your birthing. Your
obstetrician or family doctor will help you decide the best technique
for pain control which may include intravenous medications, local anesthetics
or an epidural. An epidural refers to an anesthetic which is placed
low down in your back. The epidural is a very popular method because
of the comfort it provides.
 An
epidural is performed with you sitting or lying on your side. The area
is cleansed and numbed with a local anesthetic. Then a very tiny tube
or catheter is placed in the small of your back through the numb spot
and then taped in place. There is no needle that stays in your back,
and since the epirdural catheter is soft and flexible you may lay on
your back without any problem. Should you decide to have an epidural,
your doctor and the anesthesiologist will evaluate you and your baby's
progress. Your anesthesiologist will then talk with you about your situation,
including your health and past anesthetic experiences and he will answer
any questions you may have. Analgesic medication is then injected into
the catheter which numbs the nerves from your uterus and cervix.
The medicine may be pumped continuously until your baby is born. Some
numbness of the legs may be noticeable. Throughout your labor your
comfort level will be monitered and the epidural medications may be
adjusted from time to time corresponding with your progress.
In addition to vaginal births, Cesarean births can also be safely
accomplished using epidural or spinal anesthesia.
Your Fairbanks Anesthesia doctor will use his specialized skills and
precautions to see to it that epidural anesthesia can be safe for you
and your baby.
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Q Is anesthesia
safe for senior citizens?
A As Alaskans age, medical and surgical
problems inevitably become more common. Your anesthesiologist is responsible
for seeing you safely through a surgical procedure, and will meet with
you prior to surgery to address your concerns. He will study your medical
history and evaluate your diagnostic tests like X-rays, blood tests,
and EKGs. He will give special attention to any existing problems you
may have, like heart trouble, high blood pressure, lung disease and
diabetes. Together, you and he will form the plan for your anesthesia.
 Some
surgery can be accomplished with local anesthesia and a small amount
of intravenous sedation. Regional anesthesia, where an area of your body
is numbed, can be used for certain surgeries on the extremities or lower
abdomen. Examples of regional anesthesia include axillary, interscalene,
epidural and spinal block. General anesthesia is commonly used for larger
operations and uses a combination of intravenous and inhaled medications.
SAFETY - To some extent anesthesia risk increases with age. However,
more important than your years is your overall medical condition. There
are plenty of octogenarians who are at lower risk than some patients
in their fifties. Thanks to modern advances in medicine and technology,
anesthetic outcomes are better than ever before.
BEFORE SURGERY - Do not eat or drink anything after midnight prior
to having anesthesia, unless otherwise instructed. The presence of
stomach contents greatly increases the risk during an anesthetic. Even
chewing gum or a lifesaver can increase stomach acid production. Part
of your anesthesiologist's responsibility is reducing the risk of stomach
contents being regurgitated into the lungs while the patient is either
sedated or fully anesthetized.
If you are taking prescription medication, you may have questions
about whether or not to take them prior to surgery and anesthesia.
Some medicines should be continued up to and including the day of surgery.
These include medicines for your heart, blood pressure, and breathing.
Other medicines such as insulin should be adjusted or stopped prior
to surgery.
INSTRUCTIONS and ASSISTANCE - You will be given written and verbal
instruction and information before you leave the hospital including
an appointment to return to your surgeon and probably a prescription
for pain medication. All patients need at least some assistance around
the time of any operation. You will likely require a friend or family
member to drive you home, help with decisions, and perhaps stay with
you when you are released from the hospital. Things should return to
normal for you in a day or two.
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Q Is anesthesia
safe for children?
A All of the Fairbanks Anesthesia Providers
have had specific training in the anesthetic care of children and infants.
Our primary concerns with your child are safety and comfort. Even if
your child is having a small operation, the anesthesia is still a full
general anesthetic. You should begin to prepare your child for a trip
to the hospital ahead of time. Knowing what to expect greatly reduces
their fears as well as your own.
First of all, modern advances in techniques and vital sign monitoring
have made anesthesia very safe for children. Secondly, methods for
anesthetizing children are quite comfortable. It is rare that a child
would need a shot or an IV while awake. Often a flavored liquid medicine
is offered by mouth ahead of time to calm your child. Most kids can
go off to sleep simply by breathing anesthesia air mixed with oxygen
through a small face mask.
The anesthesiologist will evaluate your child's condition prior to
surgery. It is imperative that you give him information regarding medical
problems, recent colds and coughs, prior anesthesia experiences, drug
allergies, and family problems with anesthesia.
It is critical that you know if your child has had anything to eat
or drink prior to anesthesia. If a child must have emergency surgery,
but has food or drink in their stomach, then an IV will probably be
placed ahead of time in order to use specific intravenous anesthetics
to go to sleep safely.
(Pictured above, Elle is assisting us in demonstrating the process
and sequence of children entering the operating room, breathing into
the mask and drifting off into a peaceful temporary sleep while the
surgeon performs the surgery. Children awaken in recovery room, a
different room from where they went to sleep.)
Your child will do best if calm and that is easier to accomplish if
you, as a parent, appear confident and relaxed. Knowing that your child
will be okay will help you to achieve this, although it is certainly
normal for you to have some anxieties. You can reassure your child
that they will be safe, that the doctors and nurses will be very nice
to them and that you will be waiting for them nearby.
It is unusual for a parent to accompany a child into the surgical
operating room as this can distract the anesthesia team. Occassionally
however, the anesthesiologist will permit the parent to accompany a
child in the three to four year old range, if the parent is calm and
if there is clear benefit to the child. A parent may not accompany
a child under the age of two as this group requires the fullest concentration
of the anesthesia provider.
After surgery, some children wake up and are fully alert very quickly.
Others will be groggy for several hours afterward. Yet others, will
wake up grumpy and irritable. Nausea and vomiting can occur after any
stressful operation, but newer medicines are far more successful in
controlling this.
For a crossword puzzle activity that may familiarize your child with
the operating room, click here. You can print
the crossword puzzle and check the answers online.
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Q What should
I do to prepare for anesthesia?
A Do not eat or drink anything after
midnight prior to having anesthesia, unless otherwise instructed. The
presence of stomach contents greatly increases the risk during an anesthetic.
Even chewing gum or a lifesaver can increase stomach acid production.
Part of your anesthesiologist's responsibility is reducing the risk
of stomach contents being regurgitated into the lungs while the patient
is either sedated or fully anesthetized.
If you are taking prescription medication, you may have questions
about whether or not to take them prior to surgery and anesthesia.
Some medicines should be continued up to and including the day of surgery.
These include medicines for your heart, blood pressure, and breathing.
Other medicines such as insulin should be adjusted or stopped prior
to surgery.
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Q What
happens during my anesthesia?
A Your anesthesiologist will manage any
medical problems that arise. A member of the anesthesia team will be
with you continuously throughout your operation. During a regional
anesthetic or monitored anesthesia care, your anesthesia provider will
talk with you, keeping you relaxed, comfortable and safe. During a
general anesthetic, you will be deeply asleep and your critical body
functions will be continuously monitored and closely controlled. Particular
attention will be given to special pre-existing conditions like asthma,
heart problems, high blood pressure and diabetes.
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Q Will
I be safe during my anesthesia?
 A More
than 40 million anesthetics are performed in the United States each
year. Anesthesiology is now one of the most technologically complex
medical specialties. Most of that technology revolves around keeping
patients safe by the use of a wide variety of sophisticated electronic
monitoring devices that accurately measure the function of virtually
every major organ system. In addition, modern pharmacology has produced
advanced drugs that are very specific and safer than ever before.
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Q What
about anesthesia for outpatient surgery?
A Ambulatory surgery, also known as outpatient
surgery, is very common today. You do not need to stay overrnight in
the hospital, but rather return home the same day. The anesthetic is
designed to be short acting with few aftereffects. Your anesthesiologist
will interview you prior to surgery and review your medical history,
past anesthetic experiences, and evaluate any medical tests. You and
he will discuss your concerns and choices, formulate the anesthetic
plan, and he will counsel you to the individual benefits and risks
of different anesthesia techniques.
Our fantastic outpatient nurses.
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Q Am I
going to have pain?
A The members of Fairbanks Anesthesia
will certainly provide pain relief while you are in surgery. Outside
the operating room, your anesthesiologist will still be involved in
continuing pain control. In the Recovery Room or Postanesthesia Care
Unit, specific pain medications will be ordered for individual patients.
Additionally, you may benefit from specialized forms of pain relief
such as long acting regional anesthetics. Regional anestetics are designed
to shut down nerve impulses traveling from the site of injury or surgery
to the brain. Examples include interscalene blocks for shoulder surgery,
axillary blocks forearm, wrist or hand surgery, lumbar epidurals for
lower abdominal and lower extremity surgery, and thoracic epidurals
for chest or upper abdominal injury or surgery. Anesthesiologists have
specialty training in the administration of chronic pain therapies.
Fairbanks Anesthesia doctors accept referrals from the medical community
at large for a wide variety of patients with persistent pain conditions,
most notably for neck and back problems as well as nerve related pain.
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Q What
about the anesthesia charges?
A Surgical procedures are always associated
with risks. Your consulting anesthesiologist is the physician that
plans for and provides safe conduct through the dangers of your surgical
operation, without pain or anxiety. He also is a specialist in protecting
your vital functions during your procedure. Like other highly trained
doctors, he will charge a fee for the professional services provided
and this fee will be separate from the surgeon's fee and the hospital
charges.
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