During the Surgery
We provide anesthesia services for a wide variety of operations, including orthopedic surgery, heart surgery, lung surgery, endoscopy, neurosurgery, and multispecialty procedures. You can find specific information about the type of anesthesia for your procedure below. Also, you will find answers to common medical concerns and the risks of anesthesia.
If you have questions about your procedure, please feel free to contact us at (904) 387-4030 or discuss it with your surgeon.
Orthopedic Surgery
You will discuss the options for anesthesia and pain control with your anesthesiologist in the holding area. Some of the decisions will be determined by the preferences of your surgeon.
If a nerve block is selected, you will receive IV sedation in our holding area. The anesthesiologist will use an ultrasound machine and a small needle to numb your leg. There are two main nerves in your leg: the femoral nerve on the front and sciatic nerve on the back. Sometimes we just numb the femoral nerve as it supplies most of the sensation to the knee.
After the block, you will be taken to the operating room and put under general anesthesia. You will wake up after your surgery and spend about an hour in the recovery room before going to your hospital room.
Your block will last about 12-24 hours. The surgical team will prescribe oral and IV medications to control your pain as the block wears off. It is important to remember not to try walking on your own, as your leg will be very numb.
For simple knee arthroscopy, we commonly give a general anesthetic. If the surgeon is planning a more extensive procedure (such as an ACL repair), we will administer a femoral nerve block along with a general anesthetic.
After the surgery, we will wake you up and take you to the recovery room. Once you are awake and comfortable, usually in an hour or two, you will be sent home. If you have had a block, it will last about 12-24 hours. Your surgeon will provide a prescription for pain medicine for when your block wears off.
After meeting your anesthesiologist, you will be given some sedation in the holding area. The anesthesiologist will use a small needle to inject numbing medicine around the nerves of the brachial plexus, which controls sensation to the arm. You will then be taken to the operating room and given general anesthesia.
Once the surgery is complete, we will wake you up and take you to the recovery area. Your arm will be heavy and numb. The block will last 12-24 hours. Side effects of the block that are fairly common and well-tolerated include hoarseness of the voice, feeling a bit short of breath, and a droopy eye on the side of the block. Some people get numb tingly patches (paresthesia) on the arm that may last a few weeks after surgery and go away with time.
After meeting your anesthesiologist, we will discuss your anesthetic based on your desires, as well as your surgeon's preferences. A general anesthetic is most commonly used for hip replacement, but sometimes a spinal anesthetic is the best option.
Cardiac Surgery
On the day of your heart surgery, you will meet with one of our anesthesiologists in the holding area. There, they will review your medical history and discuss any concerns with you. Following a brief discussion, they will administer a sedative through an IV.
Once sedated and asleep, a breathing tube and one or two central lines will be placed. These central lines allow your anesthesiologist to measure pressure within the heart and administer medications directly into your body’s major veins. At this time, your anesthesiologist may also place a TEE probe – or transesophageal echocardiography probe. This probe allows us to view the heart’s function both before and after the surgery.
After your surgery, the TEE probe is used to make sure your heart is functioning properly and that your new valve is working well. Once we know your surgery has been successful, we will escort you to the open-heart recovery unit. Here, you will be sedated and put on a breathing machine for several hours. At this time, your family will be able to visit you during your stay and throughout your recovery.
After we ensure your heart and breathing function look good, we will slowly wean you off the ventilator and reduce your sedation. This process may take several days or weeks, however, our goal is to wean you off the ventilator as quickly and efficiently as possible.
You will meet your anesthesiologist in the holding area and they will extensively review your medical history and discuss any concerns with you. Next, you will be given some sedation in the IV and brought to the operating room. You will then be given more medicine in the IV and go to sleep.
Once asleep, your anesthesiologist will place a breathing tube, as well as one or two central lines. A central line is basically a big IV that can be used to measure pressures and give medicine directly into the major veins of the body.
Your anesthesiologist will also place a TEE probe. This probe will allow the anesthesiologist to view the heart muscle function, valve function, and any other abnormalities before and after surgery. We use it to help guide the surgeon, especially for minimally invasive procedures, in placing various catheters.
After the surgery, we use TEE to check the heart function, ensure the new valve is working well, and to assist with the placement of devices meant to help the heart pump blood if the heart muscle is weakened.
After the surgery is complete, your anesthesiologist will either wake you up in the operating room or leave you sedated and on the breathing machine for a while. This will depend on the surgical approach and your heart and respiratory function. Either way, you will be taken to the open-heart recovery unit after the procedure. Your family will be allowed to see you once you are stabilized – usually in about an hour.
After meeting your anesthesiologist in the holding area, you will be taken back to the procedure room and hooked up to monitors. You will be given medicine by IV and put under general anesthesia. Once the procedure is finished, you will be brought to the recovery area for about an hour. Once you are awake and comfortable, you will be taken to your room.
Lung Surgery
First, you will meet your anesthesiologist in the holding area. They will discuss your medical history with you as well as the options for pain control after anesthesia. If you receive an epidural for pain control, you will sit up on your stretcher and IV sedation will be given. The anesthesiologist will clean your back with a sterile solution and use a small needle to numb the skin on the back. Another needle will be advanced into the epidural space and a small catheter about the size of a fishing line will be threaded into the epidural space.
After the procedure, a pump will be hooked up to the epidural catheter and numbing medicine will run continually until the epidural is removed (usually 3-6 days). After the epidural is inserted, you will be wheeled back to the operating room where the anesthesiologist will give you more medicine in the IV to induce general anesthesia.
After you are asleep, the anesthesiologist will insert a breathing tube to help you breathe during the surgery. The breathing tube allows the anesthesiologist to selectively ventilate one or both lungs at a time.
Once the surgery is complete, you will wake up and the anesthesiologist will typically remove the breathing tube and take you to the recovery area for about an hour or two. If you are not breathing well on your own, you may be sedated and taken to the intensive care unit (ICU), where you will stay on the breathing machine until you are ready to breathe on your own.
Common Medical Concerns
Most of our patients have medical issues beyond their planned surgery. Whether you are on medication for diabetes or have congestive heart failure, we will be happy to answer any questions or concerns you have.
During your pre-admission testing (PAT) appointment, you will receive instruction on what medications to take. If necessary, we may also contact your primary care doctor or specialist to make sure you are healthy enough for surgery.
A number of our patients are on long-term pain medication to treat back pain, cancer, or a variety of other ailments. Many patients have concerns about pain control after their surgery. We generally recommend continuing your chronic pain medications as prescribed, except for NSAID-type medications. Some medications like Suboxone need to be discontinued before surgery. This is best done by coordinating the transition with your pain doctor.
Anticoagulants are excellent drugs for preventing blood clots in blood vessels and strokes. However, most anticoagulants increase the risk of bleeding during an operation. If you are taking an anticoagulant, please let us know during your pre-admission appointment. We feel it is best to manage these medications with the help of your primary doctor or specialist, and we will often discuss with them the best way to manage these medications during your operation.
Many of our patients have a history of heart attack and have stents or heart failure. Because having any surgery is a stress on the body, we are always very concerned about making sure your heart is healthy enough for an operation. This is best done by contacting your cardiologist before surgery to make sure your medications are appropriate and no additional testing needs to be performed.
Usually, we will have you stop any blood thinners before surgery (with your cardiologist’s permission) and have you continue your other medication. If you have had any recent heart studies performed, please let our pre-admission nurses know so that we can have these records available for your operation.
If you have asthma, COPD, or another lung issue, it is best to continue taking your inhaled medications as prescribed. If you are on oxygen, you should continue to use it normally. Please let your anesthesiologist know if you have been having any recent difficulties breathing.
Normally, we will ask how often you are using your rescue inhaler. After surgery, we will monitor your breathing closely as you recover. It is not uncommon for patients to need oxygen or an extra breathing treatment following an anesthetic.
If you are on dialysis, it is best to continue your dialysis as scheduled. When you meet your anesthesiologist, we will ask about your last dialysis session. We will also conduct a blood draw for potassium levels prior to surgery. Please let us know if and where you have an AV fistula or shunt so that we can place a blood pressure cuff and IV appropriately.
Risks of Anesthesia
With the advent of new anesthetic drugs and high-tech monitors, anesthesia has become very safe. However, just like driving a car around town, there are some risks.
Fairly common yet minor complaints include:
- Sore throat
- Nausea and vomiting
- Prolonged sedation
More serious, yet rare complications include:
- Heart attacks
- Breathing difficulties
- Nerve damage
- Dental damage
Often, the risks are influenced by the operation you undergo and any medical conditions you may have. We will be happy to discuss any concerns you have in the preoperative holding area when you meet your anesthetist.
High-Quality Anesthesia Services in Jacksonville, FL
At North Florida Anesthesia Consultants, a subsidiary of Envision Physician Services, we are proud to offer you comprehensive care you can rely on. For more information regarding your upcoming surgery with us, call North Florida Anesthesia Consultants in Jacksonville, Florida, at (904) 387-4030.
