monitored anesthesia care (MAC)
regional anesthesia
general anesthesia

Some options may be inappropriate for a given operation or patient.

This type of anesthesia is used for short operations or those that do not go deep into the body. You will receive sedatives and painkillers through your IV to keep you relaxed and comfortable and may even lightly sleep. The surgeon frequently injects local anesthesia at the site of your operation to make it numb.

You may receive oxygen through a plastic tube under your nose. Your blood pressure, EKG and blood oxygen level will be monitored continuously by the anesthesiologist or nurse anesthetist.  Top

During regional anesthesia, your anesthesiologist or nurse anesthetist will administer oxygen and continuously monitor your vital signs just as during monitored anesthesia care.

Spinal anesthesia blocks the pain signals where they travel up the spinal cord. After numbing a small area of your lower back, local anesthesia is injected into the fluid surrounding your spinal nerves through a very small needle. Numbness usually develops from your lower rib cage down. Normally, you are unable to move your legs during spinal anesthesia since the nerves controlling the muscles are also temporally blocked. A spinal injection may also be used for post-operative pain control.

Epidural anesthesia also blocks pain signals traveling up the spinal cord, but the local anesthesia is administered into the epidural space just outside the spinal fluid. After numbing the skin, epidurals can be placed in either the upper or lower back depending on the desired area of numbness. In addition, very small plastic tubes (catheters) can also be left in place for up to three days for post-operative pain control. Local anesthesia is sometimes mixed with other painkillers to adjust the amount of numbness.

Nerve blocks are administered to block pain signals traveling through a single nerve bundle when a smaller area of the body, such as one arm or one leg, needs to be made numb. Nerve blocks may be appropriate for use during the operation or for post-operative pain control. After numbing the skin, a needle is placed near the nerve bundle and local anesthesia is injected through the needle or catheter.

A special type of nerve block called an IV block or Bier block can be used for certain operations to numb one arm. A second IV is placed in the operative arm and a tourniquet (like a small blood pressure cuff) is wrapped around the upper arm. After inflating the tourniquet, local anesthesia is injected through the IV to numb the arm below the tourniquet.  Top

Usually, you will first breathe pure oxygen through a face mask, after which IV medications will be given to produce a rapid and pleasant sleep. Then additional IV medications and gas anesthetics will be added to keep you asleep during the entire operation.

After you are asleep, we may insert a breathing device in your mouth to assure that you are breathing well or to protect your lungs from stomach acid. This may be a laryngeal mask airway that rests on top of your vocal cords or a hollow plastic endotracheal tube that is gently passed through your vocal cords. You are normally totally unaware of this breathing device, but may have a scratchy throat or hoarse voice for a couple of days.

At the end of the operation, the anesthetic medications and gases are stopped and you begin to wake up. With modern anesthetics, many patients are awake enough to talk with us on the way to the post-anesthesia care area (PACU or recovery room).  Top

Copyright 2002 - 2015 Reading Anesthesia Associates, Ltd. All Rights Reserved