Do not eat or drink ANYTHING (not even mints or gum) after midnight the night before your procedure -- except medicines with sips of water -- unless otherwise instructed by your surgeon about exceptions to this rule.  This policy reduces the hazards associated with stomach contents during surgery.

It may be extremely important for you to continue some of your medicines, such as those for heart, blood pressure, and breathing problems.  These drugs should be taken with sips of water.

Other medicines, such as insulin, blood thinners, or aspirin-like drugs might need to be stopped or the dose adjusted to prevent unwanted reactions; ask your surgeon about these medicines.

Please bring a list of your current or recently taken drugs (and their doses) with you for your anesthesiologist to review.

You will have a chance to meet and talk with our anesthesiologist and CRNA during the pre-anesthesia assessment, which will occur the day prior to your surgery (if you are an in-patient) or the day of your admission (if you are scheduled through out-patient surgery).

Bring these medical problems to the attention of your surgeon well before the day of your operation.  If needed, their office can contact our anesthesiologists in advance of your procedure, or make arrangements for other medical consultations.  Your usual doctor (internist, family practitioner, cardiologist, etc.) can also contact us directly, if there are special concerns.

Your surgeon will give you those instructions, and the hospital will contact you as well.  Usually your arrival time will be at least one hour before the procedure is planned to begin to allow for preparation.

If you are to be discharged after your procedure, a responsible adult must drive you home, and they need to be available to stay with you overnight.

In the pre-op area, you will have an intravenous line (IV) inserted (almost always with local anesthetic injected before the IV needle is placed).  Then, immediately before going into the operating room, in most cases, we give a rapidly acting sedative through the IV, not to put you to sleep, but to help you relax.

If you are having a regional anesthetic, we often administer the block in the pre-op area, following sedation.  For major operations requiring invasive monitoring, we will likely begin some of the preparatory work.

We discontinue the anesthetic, which returns you to consciousness.  You will then be transported to the Post Anesthesia Care Unit (PACU), where you will recover from the anesthetic.  In most cases, you would have already been given pain medicines before you arrive in the PACU.

Because every person is different, every anesthetic is unique.  This is the science and art of the practice of anesthesia.  Again, our anesthesia team continually monitors and carefully makes any necessary adjustments during your procedure.

Our anesthetists will continue to care for you in the PACU.  If an admission to the hospital was planned after your procedure, you will remain in that area until you are ready to go to your room.  If your procedure was on an outpatient basis, you will be released once your condition meets discharge guidelines.

The medications given during anesthesia will affect your judgment and coordination.  Therefore, you will be required to have a responsible adult to escort you out of the surgical facility, drive you home, and stay with you the night after your surgery.  You must also avoid activities such as driving, drinking alcoholic beverages, making big decisions, and so forth, for at least 24 hours after the operation.

Additionally, the staff visits inpatients (and attempts to call outpatients) on the day after surgery.  We want to know how well you are recovering, and we will answer any questions you may have.

General anesthesia renders you unconscious, making memory -- let alone speech -- highly unlikely.   Bear in mind that our anesthesia staff remains with you for the duration of the procedure, adjusting the anesthetic on an ongoing basis, making any degree of awareness an exceedingly rare event.

No, unless you desire.   Sedatives are almost always administered along with the regional anesthetic.   While we make no guarantees of complete amnesia, these sedative medications result in a relaxed patient.  Experience shows that the vast majority of patients who have previously had a regional anesthetic request another if they return for subsequent surgery.

Statistically, the risk of nausea is about 20 per cent.  The highest incidence of nausea is in abdominal operations (especially laparoscopic GYN procedures).   We frequently administer additional anti-nausea medications to those at risk.   Scientifically, the cause of nausea with anesthesia and surgery has never been clearly identified.

Unscientifically, we are also concerned about people with a history of nausea after procedures or who have sensitivity to narcotics (such as codeine), and we will additionally treat these patients.   As with most drugs, including anti-nausea medications, side effects are possible.  Therefore, each patient is considered individually.

Many procedures need more airway protection than that provided by a mask.  For those cases, after the general anesthetic has been administered, a breathing tube is placed into the windpipe to secure the airway.   Except in special circumstances, this tube is removed before the patient has fully regained consciousness.   The breathing tube often causes a bit of a sore throat that almost always passes in a day or two.

Swelling, difficulty breathing, and/or low blood pressure are serious allergic reactions.   Some reactions are labeled allergies but may be predictable side effects of medications.

For example, an "allergy" to a local anesthetic manifesting itself as rapid heart rate may have been from epinephrine (adrenaline) contained in some solutions.  As another example, some itching with narcotics is not unusual.

Please discuss your reactions with your anesthesiologist.

Prior to your surgical procedure, we can request your old medical records; or, you can personally request medical records (if they are from other non-Novant facilities where we do not practice).  If your previous procedure was with us, and we knew of a problem, be advised that our anesthesia staff makes every effort to talk to you or to your family about those problems that may impact any future anesthetic.