Updated 2/1/06

In many cases, there are different anesthesia options available to you for your surgery.  The decision as to which to use is a decision made jointly between your surgeon, anesthesiologist, and the patient.  One type of anesthesia is not necessarily the safest method for all patients.  We will always recommend safest method first.

Local

This is the simplest type of anesthesia, not all that different that what you get from a dentist’s office.  A local anesthetic (Xylocaine, Marcaine, Novacaine etc) is injected near a specific nerve or area, which causes that nerve/area to go numb.  Depending on the anesthetic used, this numbness may last for a few hours to up to 24 hours.  There is little to no systemic effect from this type of anesthesia, so that you should not have any changes in your mental status.  This means that you will have the least amount of drowsiness or nausea, but it also means that you’ll be complete awake and aware during the surgery as well.

Local with Sedation

This is the same as the “Local” section above, however, in addition, an intravenous (IV) is given through which sedatives and anti-anxiety medications can be given.  This can make the surgical experience much more calming and tolerable.  Often patients simply end up falling into a natural type sleep and do not remember much if at all of the surgery.  However, the sedative effect can last for a variable amount of time after the surgery is performed.

Regional Anesthesia

This is not that much different from the local section above, however, it entails an entire region or larger area to be numbed, such as an entire upper or lower extremity.  Included in this category is spinal or epidural anesthesia.  This also can be combined with sedation.

In both the local and regional methods of anesthesia, there is a small possibility that for various reasons you may experience an incomplete anesthesia.  If you are having discomfort, please notify your physicians.  In some cases, more anesthesia or sedation can be administered.  In others, your anesthesiologists may have to resort to general anesthesia.

Local and Regional anesthesia can be associated with some risks, and is not necessarily safer than general anesthesia.  For example, the needle used to introduce the numbing agent may be inadvertently placed into the nerve instead of around the nerve.  This rare complication can lead to prolonged or even permanent nerve damage. 

General Anesthesia

This form of anesthesia entails going to sleep.  Your breathing is monitored and controlled by one of several methods:  Face mask, LMA, or Endotracheal tube.  A face mask is an external mask similar to a breathing mask used in dentistry or in CPR.  An LMA is a tube that goes only part way into your throat, while and endotracheal tube goes fully into your trachea (breathing tube).  The tubes are placed after you have already gone to sleep and therefore you will not be aware of this part of the anesthesia.  Most people feel as if they have merely blinked, and will find themselves already in the recovery room. 

This anesthesia can be associated with a variable amount of nausea and possibly a slightly sore throat for several days.