Types of Anesthesia Care: Monitored Anesthesia Care or Sedation Monitored Anesthesia Care means that an anesthesia provider will be with you throughout your procedures to provide you with sedative and pain medication. The amount of medication will be carefully measured, and depending on your needs, will result in anywhere from moderate to deep sedation. The end result is that your procedure can be performed without anxiety or discomfort. During moderate sedation, you will usually be able to speak and respond to verbal cues throughout the procedure, communicating any discomfort you might experience to your anesthesia provider. During deep sedation, you will be completely unaware of your surroundings. Regardless of the depth of sedation required, your anesthesia provider will monitor your heart rate, heart rhythm, blood pressure, breathing, oxygen level and level of alertness closely throughout and after the procedure. Regional Anesthesia: Regional anesthesia involves injection of anesthetic medications near a cluster of nerves such that only the area of your body requiring surgery is numb. For example, spinals blocks are methods of regional anesthesia which effectively block sensation in the lower half of your body. Peripheral nerve blocks are often used to numb individual limbs, such as one arm or leg. This type of anesthesia is used for many different types of procedures, including orthopedic, urological, abdominal, gynecologic, and obstetric. When receiving regional anesthesia, you will be given intravenous (IV) sedation so that you will be relaxed and sleepy during the surgery. Regional anesthesia tends to result in less nausea and vomiting than general anesthesia. Even if you have general anesthesia for your procedure, a regional technique such as a nerve block can be very effective after surgery to prevent or treat pain. General Anesthesia: Many operations are performed under general anesthesia. This means that you will be unconscious and have no awareness of the surgical procedure. Your anesthesia provider will carefully measure a combination of intravenous and inhaled drugs which will allow you to undergo your procedure safely and comfortably.

A nerve block is the injection of numbing medication (local anesthetic) near specific nerves to decrease your pain in a certain part of your body during and after surgery. Why should I have a nerve block? A nerve block decreases your pain during and after surgery. It is more effective than pain medications through the IV. Because you have less pain, you will need less oral and/or IV pain medications, even though you will have the medications available to you. You will have fewer side effects of pain medications, such as respiratory depression, itching, nausea, and somnolence. In addition, you may be able to avoid a deeper anesthesia. Frequently a nerve block is done in addition to a general anesthesia for pain relief after the surgery. Is a nerve block safe? Like general anesthesia, nerve blocks involve some side effects and risks. Most common side effects include unpleasant numbness and weakness of the effected area. It is also normal to experience some pain after surgery despite the block. As the block wears off, pain usually increases and it is important to take oral medications early to help control it. Serious complications are very rare (<0.1%) but include infection at the block sight, persistent nerve symptoms or damage, seizures and cardiac arrythmias.

Please do not smoke, chew, eat, or drink anything, including water, candy, gum, mints and lozenges after midnight on the night before surgery. Failure to follow this guideline may lead to a delay or the cancelation of your procedure. A nurse from the facility at which you are scheduled will contact you a day or two ahead of time with instructions specific to your procedure and your place in the schedule. Please follow those instructions closely. Feel free to ask the nurse any questions that come to mind.