BOBBIE Freeman, M.D.

The type of anesthesia that you receive will be based on many variables.

 

The anesthesiologist will look at:

*the operation/procedure site and length of surgery

*patient medical history

*patient physical exam, including the airway exam

*labwork

*surgeon preference

*patient preference

 

There are many types and ways to administer anesthesia.  I would compare it to a chef making a recipe.  There are many ways to change or make the recipe better; adding ingredients or changing the cooking time or method.  Two chefs might cook the same recipe in completely different ways but ultimately create delicious dishes.  Anesthesiologists have been trained to administer anesthesia in a variety of ways; always with the ultimate goal of a safe and pleasant perioperative experience. 

 

I provide 5 types of anesthesia:

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1. General Anesthesia

2. Regional Anesthesia

3. Monitored Anesthesia Care (MAC)

4. Sedation

5. Local Anesthesia

 

1. General Anesthesia 

General anesthesia is the administration of anesthesia to the point of unconsciousness without awareness.  I call this "all the way asleep".  General anesthesia can be achieved with anesthesic gas that you breath through a mask, laryngeal mask airway (LMA), or endotracheal tube (breathing tube).  It can also be achieved with medications through the IV, called total IV anesthesia (TIVA).  This type of anesthesia can also be administered with a combination of gas and IV medication.  

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2. Regional Anesthesia

Regional anesthesia involves an injection of a local anesthetic around nerves.  Any part of the body covered by that nerve would then go "off to sleep" or become numb.  There are two types of regional anethesia; neuroaxial and peripheral.  Neuroaxial anesthesia involves injections around the spine; like spinals, epidurals, and caudals.  Peripheral regional anesthesia includes nerve blocks away from the spinal cord.  For example, you can get a nerve block for shoulder surgery to help with pain during and after a shoulder arthroscopy.  

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3. Monitored Anesthesia Care

Monitored anesthesia care (MAC) is the term used when IV sedation is given for patient comfort during a procedure with the patient being able to follow commands or respond if needed.  The patient may remember parts of the procedure or waking up in the operating room.  But at no time will the patient be uncomfortable.  A combination of anti-anxiety, pain, and anesthetic medications can be given while the patient breathes oxygen through a cannula or mask.  

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4. Sedation

Sedation is the term used when a small dose of medication is given to allow a patient to be more comfortable during a procedure.  At times, sedation can be given by a registered nurse.  MAC and sedation are what some people call twilight sleep.  Under sedation, the patient may remember part or all of the procedure.  It is usually reserved for minor procedures of a short duration.

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5.  Local Anesthesia

A surgeon may inject a local anesthetic at the site of operation.  That specific area would go "off to sleep" or numb.  This type of anesthesia can be combined with sedation for comfort during the injection of the local anesthetic.  Some surgeons inject local anesthesia to help with pain after the procedure is over.  

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No matter which type of anesthetic you receive, your anesthesiologist should discuss the risks, benefits, and anesthetic plan with you.  Feel free to ask questions and discuss concerns prior to the procedure.

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Now, will I get a needle stick or IV?  

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The majority of my patients need an IV.  I can give fluids through the IV to hydrate my patient after not eating or drinking for hours.  For most procedures, my patients require medications that can be given through the IV.  These medications include antibiotics, anti-anxiety medications, pain medications, and anti-nausea drugs.  I can also give emergency drugs, if necessary.  For me, it is always safer to have an IV in place until my patient is ready to go home.  Patient safety is a priority!

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Bobbie Freeman, M.D.