What to Expect When Going Under General Anesthesia

Anesthesiologist, Dr. Troy Ockerman demystifies anesthesia, explaining what to expect from beginning to end and sharing the simple steps you can take to help ensure it all goes smoothly.From the clothes you threw on this morning and what you ate for lunch to your children’s hectic after-school schedules and that pressing deadline at work—you’re in control of a lot from day to day. And while packed calendars and overflowing inboxes can be overwhelming, for many people, the opposite end of that spectrum—letting go of any and all control of a situation, like what happens when you “go under” for surgery—can be even more daunting of a thought.

General anesthesia—which renders a person completely unconscious and prevents the brain from responding to pain signals or reflexes—can intimidate, and even scare, people facing surgery, says Roper St. Francis affiliated anesthesiologist Troy Ockerman. “However, it’s incredibly safe,” he assures. You also have more control over the situation than you may think. Here, Dr. Ockerman demystifies anesthesia, explaining what to expect from beginning to end and sharing the simple steps you can take to help ensure it all goes smoothly.

Understanding Anesthesia

By definition, anesthesia is the use of medicine to reduce or prevent pain during surgery. General anesthesia is used for a variety of procedures; in some cases, such as heart and brain surgery, it’s the only option for keeping a patient safe and comfortable. In others, like joint replacement, a doctor may allow a person to choose between general anesthesia and regional anesthesia. The latter uses a numbing agent to block pain to a certain part of the body—the leg, for example. Patients are conscious during surgery with regional anesthesia, but often sedated. When the numbing agent is administered to an even smaller area of the body—say a patch of skin or area of the gums—it’s known as local anesthesia.

General anesthesia uses several medicines, which are administered either through a breathing mask or tube or an IV. A sedative relaxes the patient before he or she is moved into the operating room. There, a sedative-hypnotic is given to bring on deep sleep. A paralytic drug relaxes the muscles, and a narcotic, such as morphine, prevents pain. Just as you might find a dozen different cold medicines on a drug store’s shelves, multiple varieties of sedatives, narcotics, and on are available to anesthesiologists, who write a customized “anesthetic plan” for each patient.

Preparing for Surgery

Roughly two weeks before surgery, the patient will have a preoperative interview either over the phone or in a pre-op clinic. “During the interview, a nurse asks questions about your medical history, your lifestyle, any medicines you take, and more,” Dr. Ockerman explains. Health conditions like high blood pressure, heart disease, diabetes, obesity, and obstructive sleep apnea as well as lifestyle factors like heavy alcohol consumption and smoking can increase a person’s risks during surgery and the potential for complications from anesthesia. Using information gathered from the interview, the anesthesiologist considers any risk factors the patient may have and creates an anesthetic plan accordingly.

Patients also receive vital information of their own during the pre-op interview, including when they can take their last bites and sips prior to surgery (the general rule is no food or drink after midnight the night before). The nurse may instruct them to stop taking certain medications and herbal supplements that can interfere with anesthesia or increase the risk for other complications. “Listen to these instructions carefully and follow them to the letter,” says Dr. Ockerman. “Doing so will help ensure your surgery goes off without a hitch.”

The Day of Your Surgery

After checking in to the hospital or surgical center, patients meet their anesthesiologist—the doctor who will administer anesthesia medications and vigilantly monitor their vital bodily functions during surgery. The doctor will do a final review of the patient’s medical history, examine his or her heart and lungs, and explain the anesthesia plan. “Ask any and all questions you may have,” Dr. Ockerman says. “That’s what we’re there for.” He notes that patients should also inform their doctor of any health-related problems they’ve experienced in recent days, be it a cold, fever, or infection. “The body requires a lot of energy to heal itself after surgery, and we want for you to come into the operating room in the best condition possible,” Dr. Ockerman says.

While the patient is asleep in the operating room, “An anesthesiologist monitors your levels of sedation, as well as your blood pressure, heart rate, breathing, and more,” explains Dr. Ockerman. “We take special care to ensure that patients arrive in the post-op period not just safe, but also comfortable.” The effects of the anesthesia medications are reversed once the surgeon has finished. In many cases, patients are awake and talking within five to 10 minutes.

What’s Up Post-Op

Following surgery, patients are transported to a recovery room, where they’re closely monitored as the anesthesia wears off completely. From there, they head to an inpatient room or—in some cases—are cleared to go home under the care of a friend or family member. The anesthesiologist will do everything possible to ensure the patient isn’t hurting. There’s a good chance they even administered a regional anesthetic before the surgery. “These decrease a patient’s need for IV pain medicines, which are more likely to cause side effects like nausea,” explains Dr. Ockerman.

As for the side effects of general anesthesia? “It’s common today for patients not to have any at all,” says Dr. Ockerman, though nausea and vomiting are possible, as are a sore throat, muscle aches, itching, chills, and shivering. While it’s normal to feel a little groggy and confused immediately after a procedure, most adults aren’t going to be loopy enough to earn a starring role in one of those post-anesthesia videos flying around YouTube. “That’s more common in patients who are very young or old,” says Dr. Ockerman. Though it’s rare, those who are elderly or who have heart, lung, Alzheimer’s, or Parkinson’s diseases may be at higher risk for more serious complications, such as postoperative delirium, in which confusion, disorientation, and memory troubles can come and go for up to a week.

The chief thing to remember if you or a loved one is anxious about undergoing anesthesia? “If you’re having surgery in a Roper St. Francis facility, you’ll have an anesthesiologist at the head of your bed the entire time,” Dr. Ockerman stresses, “and our one mission is to get you safely and comfortably on the road to recovery.”