Intraoperative Care
Beginning Phase
A great deal besides surgery takes place between the beginning of your anesthesia and your return to consciousness in the Post Anesthesia Care Unit. After meeting your anesthesia team and having any questions you have answered, you will be taken back to the operating room. Your anesthesia may start with an induction agent. A common one you may be familiar with is called Propofol. This is used during the first step (induction) of your anesthesia when you “drift off to sleep” and it lasts only a few minutes. For some procedures, such as joint replacements, a spinal anesthetic may be used. This involves injecting local anesthetic "numbing" medication into your back to take away feeling below your waist. You will then receive medication to make you sleepy for the rest of the procedure.
To keep you anesthetized, your anesthesia provider administers and regulates additional medications to maintain your anesthesia for the rest of the procedure. Some of these medications are injected into your veins and others, such as nitrous oxide, are inhaled through your lungs because they are gases. Inhaled gases are administered to patients who receive general anesthesia. These gases are administered either through a mask or a special breathing tube which is inserted into your windpipe (trachea) depending on your surgical procedure and physical condition.
Middle Phase
Exactly which medications will be administered to you during anesthesia will be determined by your physical responses and how they will be affected by the type of surgery you are having as well as by your medical status. Therefore, your anesthesia provider will carefully tailor your anesthetic just for you. Some of these medications will be your actual anesthetic agents that help you to remain unconscious and experience no sensations, while others are administered to regulate your vital functions such as heart rate and rhythm, blood pressure, breathing, and brain and kidney function.
Your anesthesia provider constantly is monitoring, evaluating, and regulating your critical body processes. Your anesthesia care team is responsible for and will treat any medical problem you may develop during surgery such as a blood pressure problem, for example.
Recovery Phase
When surgery is completed, the recovery phase is carefully timed and controlled. Anesthetic agents are discontinued and you will start to wake up. Before and during the wake up period, you will receive some medications to decrease postoperative discomfort. All of this is calculated precisely under the supervision of your anesthesiologist to permit you to return to consciousness in the recovery room unaware of what has occurred during the operation.