Anesthesia is a treatment used to block pain and awareness during medical procedures. Anesthesia care is delivered by specially trained physicians, called anesthesiologists, and by certified registered nurse anesthetists (CRNAs). Our anesthesiologists and CRNAs typically use propofol-based sedation.
Propofol-based sedation causes complete or near-complete amnesia for the procedure. Individuals who are sedated with our propofol-based sedation often report a pleasant restful sleep. Memory and most cognitive functions typically return to normal within hours after discharge.
Patients receiving moderate sedation with fentanyl-midazolam usually have some awareness during the procedure, but some patients may have some degree of amnesia for their procedure. In addition, patients receiving moderate sedation may report varying degrees of discomfort during the procedure. It is not unusual for individuals to complain that they felt “drugged” for hours after their procedure.
Patients sedated with propofol rarely complain of feeling “drugged” and more often remark that they feel as if they had a great nap. While fentanyl and other opioid-type drugs may cause nausea, particularly at higher doses, this is rare with propofol.
Our anesthesia care providers will meet you and walk you through your anesthesia care plan prior to your procedure. Please do not hesitate to ask any questions or express any concerns you may have about your anesthesia experience prior to your procedure.
Most of our patients prefer not to remember their procedures. Sedation with propofol is more likely than conventional moderate sedation (using fentanyl-midazolam) to succeed in providing a pain-free examination. It is very unusual for patients to report the recall of any significant discomfort. It is important for you to discuss your preferences regarding your sedation with your doctor, who will work with you to incorporate your wishes into your sedation plan.
Sedation may not be required for every medical procedure. We encourage you to discuss your sedation plan and options with your physician prior to your procedure.
The ability to tolerate a medical procedure without sedation or with moderate sedation depends on the nature of the procedure, the amount of manipulation required to complete the procedure or exam, and your sensitivity. Sensitivity is quite variable from patient-to-patient and difficult to predict before the procedure.
Our goal is to provide the patients we care for with a safe and comfortable experience. Our sedation by Propofol treatment provides much more flexibility in meeting sedation needs than sedation with fentanyl-midazolam because of its very rapid onset, the range of sedation depth that can be safely achieved, and the short duration of effect. Our anesthesia care providers will walk you through your anesthesia care plan prior to your procedure. Please do not hesitate to ask any questions or express any concerns you may have about your anesthesia experience prior to your procedure.
Surgery and anesthesia both have some risks, and these are dependent upon many factors including the type of procedure/surgery and the medical condition(s) of the patient. Fortunately, adverse events are rare. Your anesthesia care provider takes precautions to decrease the risk of adverse events. You should ask your anesthesiologist about any risks that may be associated with your anesthesia.
As a general rule, it is very important that you DO NOT drink any liquid (including water) within 4 hours of your scheduled procedure. CLEAR liquids such as water, apple or cranberry juice may be consumed in modest amounts up to 4 hours of your scheduled procedure. NOTE, milk products, creamer, O.J. with pulp are NOT clear liquids. Also, DO NOT drink any other liquid or eat anything (including chewing gum, candy or cough drops) for a MINIMUM of 8 hours prior to your procedure. If you violate this, then your procedure may be delayed or cancelled. The ONLY exceptions will be for medications and/or for the bowel prep as instructed by your Gastroenterologist. If you are instructed to take any of your routine medications by mouth use only enough water to allow the pills to be swallowed – sips – not any extra water or liquid.
All patients receiving anesthesia MUST have a responsible person accompany them from the office or center following the procedure. This escort MUST physically enter the office or center before you will be allowed to leave. If you attempt to drive yourself or you do not have an escort then you will not receive anesthesia for your procedure. For 24 hours following your procedure, you will not be allowed to DRIVE a vehicle, use public transportation or a taxi without an escort, operate any machinery or power tools or sharp knives, and drink ANY alcohol. You are also advised not to make any important decisions for 24 hours following your procedure.
Patients with significant medical problems or over the age of 65 and living alone are advised to arrange for a responsible person to stay with them for at least 8 hours following their procedure.
All patients that are taking diabetic medications (Insulin and/or pills) and live alone are advised to arrange for a responsible person to check in on them several times during the first 24 hours following their procedure.
Patients that take blood thinners, seizure, heart, asthma/emphysema or diabetic medications should contact their physician regarding which medications should be stopped and which can safely be taken the morning of their procedure with a sip of water. Inhalers should be brought to the office/center the day of your procedure.
Some medications should be taken and others should not. It is important to discuss this with your doctor and anesthesia care provider. Do not interrupt medications unless your anesthesiologist or surgeon recommends it. Please only take your medication(s) with a small sip of water.
Herbal medicines could prolong the effects of anesthesia or interact with certain anesthetics. Tell your doctor and anesthesia provider about everything you take before surgery. Ideally, one should stop all herbal medicines, vitamins, and dietary supplements one week before their scheduled procedure or surgery.
Aisthesis will not administer any anesthesia to a female patient if they are pregnant or if they suspect that they are pregnant. The scientific literature is inadequate to inform patients or physicians on whether anesthesia causes harmful effects on early pregnancy. Aisthesis recommends that all females of childbearing age that are late for their period or have irregular periods and are sexually active have a pregnancy test. This includes irregular periods due to medications (such as Seasonale or a birth control patch), medical conditions, and pre-menopausal state, patients that are breast feeding, and patients that have had tubal ligation or that are on birth control medications and are past 30 days from their last period. If you are 100% certain that you cannot be pregnant, in some instances you may be asked to sign a pregnancy waiver form prior to your procedure.
All patients receiving anesthesia care must make arrangements for an escort to take them home after their procedure. This escort should be a responsible adult. We recommend that patients wait at least 24 hours after the end of their procedure before driving or operating potentially dangerous machinery, signing any legal documents, returning to work, or drinking alcohol.
Depending on the type of anesthesia you are given, a sore throat or nausea may occur. Nausea is uncommon after propofol-based sedation.
A sore throat after general anesthesia is not uncommon if a breathing device has to be placed. In most cases it is mild, and gets better without treatment over a couple of days. It is unusual for the soreness to last longer than a week. If this does occur, please contact your physician.>
Your anesthesia care provider may give you prophylactic anti-nausea medicine before or during your procedure to reduce the risk of nausea. In some instances, anti-nausea medicine might be given to a patient in recovery. During your pre-anesthetic evaluation your anesthesia care provider can answer any questions you have regarding side effects.