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Anesthesia services are provided to patients at United Hospital District by Certified Registered Nurse Anesthetists (CRNAs). CRNAs are the primary providers of anesthesia care in rural America. Some of the services that are provided at United Hospital District include:

  • • Anesthesia during surgical procedures and some emergency room procedures
    • Analgesia, or pain control, for labor patients if requested
    • Assistance with acute or chronic pain management
    • Assistance with emergency management and trauma stabilization

Interview and Communication

As a patient, communication and cooperation between you and your anesthesia professional are essential to the anesthesia process and your safety. Before surgery, a confidential, pre-operative interview with one of our anesthesia professionals helps determine your personalized care. The type of anesthesia that can be administered to you will be based on your current health.

After your surgery, it is equally important to inform your anesthesia professional about any complications or issues you feel are related to the anesthesia. Anesthesia medications can remain in your body for several hours or more after they have been administered, and you won’t be back to your old self until the anesthetic has been totally eliminated. Never hesitate to ask your anesthesia provider any questions you might have, before or after your anesthesia is administered.

After the pre-operative interview and careful review of any tests, such as blood work, electrocardiogram or X-rays, the anesthesia provider will discuss with you the available option(s) with regard to your anesthetic choices. These anesthesia options are based on factors such as your physical condition, the nature of the surgery, and your reactions to medications. Be sure to communicate any concerns or fears with your anesthesia provider, as this is quite common. Open, honest communication is key in the selection of the best and safest anesthetic for you.

There are four basic types of anesthesia:

  • • General anesthesia produces a loss of sensation throughout the entire body.
    • Regional anesthesia produces a loss of sensation to a specific region of the body.
    • Local anesthesia produces a loss of sensation to a small, specific area of the body.
    • Sedation reduces anxiety and often creates temporary amnesia, light or deep sleep, which may be added to regional anesthesia or local anesthesia.

The anesthesia provider will discuss the options available to you for the surgery and any options for relief of pain after surgery.

Before surgery instructions:

  • • Do not eat or drink anything after midnight (Note: For small children, see Additional information for children section below.)
    • Get a full night’s sleep
    • You will be instructed which medications to take the morning of surgery (do NOT take diabetic medications, or “water” pills)
    • Notify your surgeon if you come down with the flu, a cold or a previously undiagnosed problem
    • Notify your surgeon if you suffer an additional injury in the area of the planned surgery, including cuts, scrapes, bites or bruising
    • Stop taking herbal medications at least two weeks before having surgery
    • Do not take illegal substances such as cocaine, methamphetamine or marijuana at least one week before having surgery

Day of surgery instructions:

  • • Arrive accompanied by a responsible adult who can transport you safely home
    • You may brush your teeth
    • You may be asked to provide a urine sample, please do not void just prior to coming in for your surgery
    • You will be asked to remove any dentures, glasses, contact lenses and jewelry before coming to the operating room
    • You do not have to remove make up, nail polish or artificial nails

Additional information for children:

CRNAs at United Hospital District administer anesthesia to patients of all age groups. The age and maturity of your child will aid in the decision about how he/she will go to sleep.

With younger children, the most frequent type of induction (putting one to sleep) is inhalation. Inhalation induction allows the child to breathe themselves to sleep with oxygen, nitrous oxide (laughing gas) and anesthesia gas. An IV for the administration of medications may be inserted once the child is asleep.

Insertion of an IV is uncomfortable and anxiety-provoking for adults and children, but is often the best way to get patients to sleep at higher age/weight groups. If the older child is afraid of the IV sleep, or needles, an inhalation induction may be possible.

In certain circumstances, medications are available that will sedate your child prior to the start of the anesthetic. These medications can be given either by mouth or through an IV. The anesthesia provider will discuss with you what is best for your child.

NOTE: Your child should have nothing to eat or drink after midnight the night before their procedure. For infants and toddlers, clear liquids like water, Gatorade or apple juice can be ingested up to 2 hours before the procedure.

Post surgical pain control:

The CRNAs at United Hospital District are proficient at post-surgery pain relief. They may be able to provide a range of pain management services to keep you comfortable after the surgery.

While surgeons routinely order medications for the treatment of post-surgical pain, some patients have the opportunity to take advantage of or require additional or different methods other than those used routinely by the surgeon. Patients with multiple allergies, a history of chronic pain, or other major medical conditions are examples of patients that may benefit from post-surgical pain management by an anesthesia professional. The surgeon and CRNA will collaborate with you on a treatment plan prior to your procedure.

A variety of single injections and continuous (two day) therapies may be available to improve your recovery and decrease your pain after surgery. These injections reduce the need for medications that often result in nausea/vomiting and other complications after surgery.

While you are expected to have some pain following a surgical procedure, the pain should NOT prohibit sleeping, eating or movement. The routine activities of daily life facilitate a quicker recovery your surgical procedure.

James Dorn, CRNA

Laraine Klunder, CRNA

Carmelle McHarg, CRNA

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