My Anesthesia Experience

Presbyterian Anesthesia Associates is a group of 45 anesthesiologists providing the finest anesthesia care available anywhere. Anesthesiology is a medical specialty, and all our physicians are board certified by the American Board of Anesthesiology. Many are board certified in multiple medical specialties and subspecialties, providing expertise in medical management that extends well beyond the immediate time of surgery. Patients under our care will be provided the safest possible anesthetic experience.

The care we provide does not involve only the anesthesiologist. At Presbyterian facilities we practice as an Anesthesia Care Team, the safest method of providing anesthesia and perioperative care. A nurse anesthetist (CRNA) provides care with the medical direction of the anesthesiologist, and is in attendance with the patient throughout the case. The nurse anesthetists at Presbyterian facilities are among the finest anywhere, demonstrating unparalleled commitment to quality and safety.

The Anesthetic Plan

Our anesthesiologists are specialists in perioperative medicine; that is, the management of patients throughout the period of surgery, from the time the surgery is scheduled until the patient is released home or to his hospital bed. Our involvement begins with a preoperative evaluation. We have set up a screening tool that identifies patients with medical conditions who would benefit from an early visit with an anesthesiologist. About 40% of our patients have conditions that require a preoperative visit. An appointment is provided for a face to face assessment, where the anesthesiologist will discuss the patient's medical history, any medications and allergies, and past experiences with surgery and anesthesia. He will order tests, including laboratory and other diagnostic testing. Often he may ask for a consultation from a medical subspecialist such as a cardiologist to look conditions that may place patients at risk during surgery. In concert with the patient, we create an anesthetic plan. The anesthetic procedures on the day of surgery are described and the risks discussed.

Types of Anesthesia

An anesthetic typically takes one of three forms:

General anesthesia: The anesthetic is induced (started) with an intravenous (adults) or a mask (children), then usually maintained with oxygen, anesthetic gases and supplemental intavenous medications. These are discontinued when the surgery is finished, and the patient gradually awakens in the recovery room.

Regional anesthesia: The anesthesiologist may "block" or "numb" the nerves to the area where the surgeon is operating, then provides sedation through an intravenous to produce a sort of "twilight" sleep. Examples include spinal and epidural anesthesia.

Local anesthesia with sedation: For less extensive operations and minor procedures the surgeon may "numb" the specific area of the incision. Only light to moderate intravenous sedation is typically required.

Recovery from Anesthesia

Following surgery, patients gradually awaken in the "post-anesthesia care unit" (PACU). With our experienced and dedicated PACU nurses in attendance, and under the direction of the anesthesiologist, any needs will be met with respect to pain, anxiety, nausea and any medical problems. Once stable and comfortable, patients are transferred either to the medical floor (if spending the night) or to a secondary recovery area where they can be with family or friends until discharge.

Upon discharge, patients are given instructions and a point of contact if questions arise regarding their post-anesthetic recovery.