ANESTHESIA AND YOU: THE SENIOR CITIZEN AS A PATIENT

This article is designed to help you prepare for surgery by explaining what modern anesthesia is and what to expect. You can help to ensure a safe and comfortable anesthetic experience by becoming a well-informed and confident patient.

As you grow older, you are more likely to develop medical problems that require surgical treatment. It is the responsibility of your anesthesiologist to help prepare you for surgery and to take care of you during your operation and in the recovery room.

Your anesthesiologist is a physician who has completed four years of medical school after graduating from college. Following medical school, today's anesthesiologist completes four to five years of specialized medical training in the field of anesthesiology, which includes pain management and intensive care medicine.

Your anesthesiologist is responsible for managing vital life functions, including breathing, heart rhythm and blood pressure while administering anesthesia. Throughout surgery, your anesthesiologist makes medical judgments and is responsible for the management of your physical condition. The anesthesiologist may be assisted by other medical personnel. Should you develop any medical problems during surgery, your anesthesiologist will immediately diagnose and treat them. In addition, should your condition require special care in the recovery room, it is most likely that the physician who treats you will be your anesthesiologist.

Before your surgery, an anesthesiologist will speak with you to evaluate your medical condition, review your chart, and plan your particular anesthetic, taking into consideration any physical problems you may have such as asthma, diabetes or unusual heart and circulation conditions. Many times, additional information is required to assess your medical condition. For this reason, blood tests, an electrocardiogram or X-rays may be done either before the day of surgery or on the same day as your operation.

Any current and recent prescription or over-the-counter medications should be discussed during your pre-anesthesia interview. This interview also provides you an opportunity to ask questions and become better informed about your anesthetic care, available options, and their risks and benefits.

Before the day of your operation, you will be given instructions about eating and drinking for a specified number of hours before your surgery. It may be extremely important for you to continue some of your medications, such as those for heart, blood pressure and breathing problems. Other medications may need the dose adjusted or may be temporarily stopped to prevent unwanted reactions. Discuss the preoperative use of your current medications with your anesthesiologist or the person designated by the anesthesiologist to call or interview you before the day of surgery. It is important to follow all of these instructions carefully. They are designed to ensure a safe anesthetic.

There are three main types of anesthesia: general, regional and local.

· General anesthesia temporarily makes a person unconscious so that the entire body feels no pain. It is a carefully balanced combination of both inhaled and intravenously injected drugs.

· Regional anesthesia, which includes spinal anesthesia, epidural anesthesia and axillary blocks, eliminates pain following an injection of local anesthetic medication near large groups of nerves to temporarily block pain signals from reaching the brain. Regional anesthesia can be used for surgery on selected regions of the body, either alone or in combination with general anesthesia. If you need hip or prostate surgery, your anesthesiologist might determine that, in your particular case, epidural or spinal anesthesia may be preferable.

· Local anesthesia may be used to numb only a small area of nerves at the site where the surgeon plans to operate, such as for cataract surgery. During local and regional anesthesia, patients often receive intravenous drugs for sedation so that they can be comfortably drowsy during surgery and remember little of their time in the operating room.

Your anesthesiologist will discuss an anesthetic plan that is best for you. Before determining the most appropriate anesthetic plan in your particular situation, your medical evaluation must be complete. Many factors are taken into consideration, including the type and duration of your scheduled surgery and your preferences.

All anesthetic techniques have some risks associated with them. More important than your age are such factors as your medical condition and your type of surgery. Various safety measures and precautions are taken in the delivery of your anesthesia care to help prevent unwanted events, just as you take certain safety precautions when driving a car or crossing the street. As a result, anesthesia today is safer than ever before for all age groups and for ambulatory outpatients as well as hospitalized patients. If you are an outpatient, it is essential that you arrange for a reliable adult to take you home because your coordination, decision-making ability and driving abilities may be somewhat impaired for up to 48 hours.

It is important for you to realize that you will be dependent on others for a period of time, but your independence will return.

You may receive a separate statement from your anesthesiologist just as you will from your other physicians. If your financial situation is a concern, your anesthesiologist or appropriate office staff will welcome a confidential talk with you about the bill and your ability to pay.

Please feel free to direct any questions or express any of your concerns to your anesthesiologist. This physician wants to make your surgical and anesthetic experience as safe and pleasant as possible.