Going under: What you should know about general anesthesia

General anesthesia involves using many medications to render you unconscious during a surgery. This makes you unaware of things that are happening and removes the pain during surgery.

While many fear general anesthesia, Dr. Jeffrey Anderegg, anesthesiologist with Marshfield Clinic Health System, says there is no need for concern as long as your medical conditions are controlled.

“They are under the care of an anesthesiologist who is specially trained in taking care of people while under general anesthesia with many different medical problems,” said Anderegg. “As long as their medical conditions are well-controlled, the risk is minimal.”

Uncontrolled medical conditions that could cause an issue include smoking or having a recent heart attack. Talk to your surgeon for more information about your risks.

Before your surgery

When you come in for your surgery, you first meet your anesthesiologist during a pre-operation meeting.

Your anesthesiologist may talk about what they monitor and if they’ll monitor anything special. They also may talk about pain relieving procedures they may do in addition to the general anesthetic.

You also should meet with your surgeon and other members of your care team before they bring you to the operating room.

Your anesthesiologist attaches different monitors including those that measure:

• Heart rate
• Oxygen-saturation level
• Blood pressure

Going under

Once you are ready, your anesthesiologist begins the process for putting you under anesthesia.

First your anesthesiologist gives you oxygen by putting a mask over your mouth and nose. Then they give you a sedative, pain medication and antibiotics as needed.

Once your lungs fill up with oxygen, your anesthesiologist gives you general anesthesia so you go under.

It is generally described as melting back into the bed and falling asleep,” Anderegg said. While dreams are possible, most people experience a dreamless sleep.

During surgery

Your anesthesiologist constantly monitors you during surgery and communicates with your care team about your condition.

If your anesthesiologist has any concerns, they let your care team in the room know. Depending on the situation, your care team may take steps to fix the issue causing the concern.

It is very uncommon for patients to wake up while under general anesthesia. In some rare cases, patients are able to recall parts of their surgery. This is most common in trauma situations or when the anesthesiologist cannot give enough anesthesia because of the type of procedure.

Recall is common, however, when undergoing sedation, which is commonly used for procedures such as colonoscopies, minor surgeries or dental work. Recall is typically painless, but if you have experienced it before, you should let your anesthesiologist know.

Waking up from general anesthesia

After your surgery, your anesthesiologist stops giving you anesthesia.

You then begin to pass into a semi-conscious stage. During this stage you are able to breathe, swallow and maintain your airway. You also may have conversations with the staff, but typically do not remember these conversations. It usually takes 10-15 minutes to become aware of what is going on.

After the surgery, you also may have a dry or scratchy throat because of the equipment that controlled your breathing while you were under general anesthesia.

“When someone is asleep, we become the caretaker of all of their vital functions. We are making sure they are breathing, that their blood is circulating well, that they have good blood pressure and oxygenation, and that they maintain their temperature,” Anderegg said.

Talk to your surgeon or anesthesiologist if you have any concerns or questions about using general anesthesia when undergoing a surgery.