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Everything You Never Wanted to Know About Anesthesia
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Will I have a Breathing Tube?
    Laryngoscopes General anesthesia decreases your ability to breathe on your own. Your anesthesiologist has different ways to assist your breathing including the use of an endotracheal (breathing) tube. Click Intubation movie (Video for Windows, 1200K) to see how this is placed.

    As shown in the video, an endotracheal tube is placed in the "wind-pipe" by passing it through the vocal cords under direct vision by use of a laryngoscope like one of those shown here.

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Are there any Alternatives to the Breathing Tube?
    Laryngeal Mask Airway The Laryngeal Mask Airway (LMA) is an alternative airway that is an effective method of assisting your breathing with a decreased likelihood of a sore throat. This airway is particularly useful for quick Day Surgery cases on peripheral areas of the body. Anesthesia for patients with a high likelihood of reflux of stomach contents would probably be safer with a cuffed endotracheal tube. Some surgeries are accomplished simply by placing a mask over the patients mouth and nose to deliver anesthesia with or without an oral airway.

    Click to see LMA Video (Video for Windows, 1307K).

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How does an Anesthesia Machine Work?
    Anesthesia Machine The anesthesia machine is a tool to assist the vigilant anesthesiologist in delivering the safest of anesthetics to the patient. This machine consist of many parts that communicate with each other during the administration of a general anesthetic. Vital controls for the flow of Oxygen, Air, Nitrous Oxide and Inhalation agents that are essential to a successful general anesthetic are included in this machine. A breathing machine (ventilator), oxygen analyzer, and scavenger system are also components. Monitors that allow the anesthesiologist to follow vital signs are also mounted on this machine. These monitors include EKG, blood pressure, oxygen saturation, temperature, and end tidal gas measurements.

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I'm afraid I won't wake up. Can I Die from Anesthesia?
    Anesthesia is safer today than it has ever been before. The risk of death from the anesthetic today is estimated at 1/200,000 anesthetics. This number in 1982 was 1/10,000. Your risk of undergoing anesthesia can be affected by your age, sex, weight, habits (smoking/alcohol/drugs) and other acute or chronic diseases you may have.

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What do you give to put me to sleep? Are you going to Give me Ether?
    Ether is a drug that is not presently used in the practice of anesthesia. This was a drug that was used about 25 yrs. ago for the induction and maintenance of the anesthetized state but it has since given way to better drugs with fewer side effects. For an adult, IV medications like Sodium pentothol and Propofol are used to put them to sleep. Inhalation agents, ForaneŽ and Sevoflurane, are the inhalation drugs presently used in the manner that ether was used in the past.

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Do I have to Have an IV?
    Almost all adults will have an IV placed prior to their anesthetic for the induction of anesthesia, fluid therapy, and as an avenue for medications for pain and nausea. The same is true for children, but the majority of the IVs are placed after the child goes to sleep.

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Will I receive any Experimental Drugs?
    All medications that are used in anesthesia are approved by the FDA prior to patient use. There are a few exceptions. Some newer medications will go through trial periods in patient use in selected areas under close FDA supervision prior to general use. If you are to receive one of these medications, special permission will have to be given on your part. The other exception is in pediatrics. A lot of the anesthesia medications are safely used in everyday pediatric anesthesia and are not experimental but are not approved by the FDA. Legislation and lobbying by anesthesiologists is currently directed at correcting this situation.

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How do you know everything is alright while my Body is Sleeping?
    The anesthesiologist or nurse anesthetist will place monitors on you prior to putting you to sleep. These monitors will allow them to closely follow how your body is doing while the surgeon is working. These monitors include heart rate, blood pressure, oxygen saturation, temperature, and carbon dioxide monitors.

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What is a Cardiopulmonary Bypass Procedure?
    Cardiopulmonary Bypass Machine This is a picture of a Cardiopulmonary (heart-lung) Bypass machine. This specialized piece of medical equipment is commonly used to perform cardiopulmonary bypass during coronary artery bypass surgery and other types of surgery where the heart must be stopped. Through a series of tubes connecting this machine with the patient, one set draining blood from the body and one set returning oxygen enriched blood to the body thus taking the place of the heart and lungs during the time when the heart is stopped. A specially trained technician operates this machine under the direction of the surgeon and the anesthesiologist.

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Is there any chance I might Wake Up in the Middle of surgery?
    There is no guarantee that you will not recall events during your surgery. With the development and use of muscle relaxants that are essential to many operations, recall can happen. Patient movement is a sign of inadequate anesthesia and a key to the anesthesiologist to deepen the anesthesia. Muscle relaxants will not allow the patient to move. An increased blood pressure and heart rate are also signs of inadequate anesthesia, but they are also signs for other things. Heart bypass surgery and C-sections under general anesthesia have the highest incidence of awareness and recall. There is currently no proven monitor of anesthetic depth.

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Can I be Paralyzed if I Move when you are putting in the Epidural?
    Paralysis after epidural anesthesia is extremely rare. Movement during epidural placement is much more likely to result in a "wet tap", i.e. an inadvertant spinal tap. If a patient develops a severe headache after a wet tap, the anesthesiologist can place an "epidural blood patch" with the patient's blood to "seal" the leak. The mid-lumbar spine location for most "labor" epidurals is chosen because of it's decreased likelihood for nerve injury. In this area of the back the spinal cord has divided into a certain number of nerve roots which float in a space filled with cerebrospinal fluid. A needle entering this area is very unlikely to damage one of these nerve roots. There have been rare cases of neurologic injury from unrecognized epidural infections and hematomas which compress these nerve roots.

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    Disclaimer: Please note that the opinions expressed herein represent those of the individual authors. These observations are made for patient education and benefit. There are no guarantees either expressed or implied. The actual patient experience undergoing anesthesia may be different from those given here. Please consult your particular physicians with questions regarding your situation.


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