Frequently Asked Questions (FAQs)

Anesthesia is medically-induced numbing of all or part of the body. Sedation is drug-induced sleep or relaxation.

• General anesthetic numbs your whole body, relaxes your muscles, and puts you to sleep.
• Local and regional anesthetics numb specific parts of your body, and do not have any relaxing effect.
• Sedative drugs are used to relax your or put you to sleep if you are having regional or local anesthesia.

Anesthetic is used in surgery for a few reasons.

• You will not feel pain from the operation.
• You will be relaxed or asleep (either from general anesthetic or from a sedative).
• You won't move while the surgeon is operating.
• If you have general anesthetic, you won't remember the operation.

An anesthesiologist is a doctor who

• Has been specially trained to give safe and effective anesthesia.
• Plans your anesthetic based on your health and your operation.
• Stays with you during surgery to monitor your heart, lungs, and other vital organs.
• Supervises your care in the recovery room just after surgery.

Three types of anesthesia are general, regional, and local.

General anesthesia is unconsciousness and numbing of the whole body.

• You will be given anesthetic drugs to relax your muscles, relieve your pain, and put you to sleep.
• You will not remember the procedure.
• A breathing tube may also be put into your windpipe to help you breathe while asleep.

Regional anesthesia, also called a nerve block, is freezing of a large part of the body.

• A local anesthetic is injected near a nerve, a bundle of nerves, or the spinal cord so that it spreads and freezes a larger part of the body.
• You will usually get a sedative drug with the anesthetic to help relax you or put you to sleep.
• A small plastic tube called a catheter may be inserted at the injection site so that you can get more anesthetic for pain relief after surgery.
• Some procedures require both regional and general anesthesia.

Local anesthesia is freezing of a small area of the body.

• Local anesthetic is applied directly to the area being operated on, like in dental surgery or mole removal.
• It can take up to 30 minutes for local and regional anesthetics to take full effect.
• The freezing can last several hours.

After anesthesia, you may experience:

• headaches
• drowsiness
• nausea
• vomiting
• sore throat, if you have a breathing tube put in during surgery.

Some patients also feel confusion, and may have trouble remembering what happened just before and just after surgery. Most side effects pass after 48 hours.

You must have an empty stomach to decrease the chance of vomiting under anesthesia. If you vomit while under anesthesia, the vomit can get into your lungs and cause serious illness or death.

Your surgery may be cancelled or delayed if you eat anything after midnight before surgery.

Anesthesia is very safe, and major complications are rare. If you have concerns, please speak to your anesthesiologist.

The type and risk of complications depends your health and what kind of anesthetic you will have.

General anesthetic can sometimes result in pneumonia, blood clots, or confusion. In rare cases, unhealthy patients may experience stroke or heart attack. Very few patients (1 in 1,000) may experience partial awareness during surgery. The risk of from anesthetic is very low (1 in 10,000). General anesthesia patients who are given a breathing tube may be at slightly higher risk of developing pneumonia.

Regional and local anesthetics can sometimes trigger allergic reactions. Permanent injury is very rare. If the nerve or spinal cord is damaged during injection, the affected area may become numb or paralyzed.

To lower your risk of serious complications from anesthesia and surgery, you should:

• Take your medication as instructed.
• Follow the preparation instructions.
• If you smoke, stop smoking. Tobacco, cannabis, and vape use increases your risk of infection and breathing-related complications. It is best to go as long as possible without smoking. Stop all tobacco, cannabis, and vape use several weeks before surgery.
• If you have obesity, manage your weight. Obesity puts strain on the organs and makes the patient more vulnerable to complications like heart attack and stroke.

This decision is made between your anesthesiologist, your surgeon, and you. The anesthesiologist will consider your medical history and your current health, as well as the type of your surgery you are having.

Your anesthesiologist may decide that you need to have a breathing tube put into your mouth or nose for your safety. This process is called intubation. The breathing tube blows air into your lungs to maintain proper oxygen levels in your blood.

The anesthesiologist can decide that you need a breathing tube right before surgery begins. The decision is made with your safety in mind. If you are intubated, you will likely have a sore throat after surgery and should avoid acidic or spicy food and drinks for a few days.

It is difficult to predict how much pain you will feel, since everyone has a different pain tolerance. Two people having the same kind of surgery may experience different amounts of pain.

Staff will monitor your pain and give you medication when needed to keep your pain level as low as possible.

You might feel pain after surgery because:

• Your skin and tissues were cut during the procedure
• Drainage tubes were placed near the incisions
• Your muscles are sore from staying in one position during surgery

Pain is usually felt in the area that was operated on. Ask your doctor or nurse where you may expect to have pain.

If you have general anesthesia you may also have a sore throat from a breathing tube, and should avoid spicy and acidic food and drinks to prevent further irritation.

If you feel less pain, it will be easier for you to move and breathe. You will need to keep moving and do post-operative exercises to prevent dangerous complications that can slow your recovery.

Walking after surgery and doing leg stretches will keep your muscles strong, improve blood circulation, and prevent blood clotting. Deep breathing and coughing after surgery will help prevent lung problems like infection and pneumonia.

Tell your nurse about your pain:

• as soon as you start feeling pain (do not wait until it is severe)
• if the pain medication does not help
• if the type of pain you are feeling changes (e.g., from a dull ache to a sharp pain).

The nurse will usually ask you to rate your pain.

• You can rate your pain on a scale of 0–10 (0 being no pain, and 10 being the worst pain you can think of), or
• You can use the words mild, moderate or severe to describe your pain.

Pain medication containing an opioid (like morphine) is usually given for pain after surgery. Usually the medication is given through IV or needle. Once you start to drink or eat, you will usually get pain pills instead.

Some patients are hooked up to patient controlled analgesia (PCA). The PCA is a pump hooked up to your IV that gives you small amounts of pain medication when you push the attached button. The goal is to give you enough medication to relieve your pain without making you feel sleepy or sick.

The PCA pump has a 'lockout' feature. If you push the button within 5 minutes of your last dose, you will not receive any medication. The lockout is designed to keep you from getting too much medication too quickly.

Remember: only the patient can push the PCA button. Friends and family cannot push the button for you, even if they think you are in pain.

When you are on PCA, the Acute Pain Services team will visit you daily to make sure that your pain is managed.

Some side effects of pain medication include:

• nausea
• constipation
• itching
• dizziness
• drowsiness

If you feel nauseated, try taking your medication with some food. If you are constipated, try drinking more liquids and eating foods high in fiber.

• You can rate your pain on a scale of 0–10 (0 being no pain, and 10 being the worst pain you can think of), or
• You can use the words mild, moderate or severe to describe your pain.

Unless you have problems with addiction, the risk of becoming addicted to your pain medication is low. It is important to wean yourself off the medication, or reduce how much medication you take slowly as you get better and feel less pain.

If you have difficulty reducing your medication, or if there is a history of addiction in your family, let your doctor know.

You can manage you pain by:

• Taking your pain medication 30 minutes to one hour before an activity that will increase your pain (like getting up or doing your exercises)
• Asking for or using your medication before your pain becomes severe
• Asking for help from the nurse if your pain is 4/10 or higher
• Changing your position in bed; ask your nurse for help if you need it
• Holding a pillow against your incision while doing your lung exercises, if you had surgery in the stomach or chest area
• Walking at least three times per day to reduce gas pain
• Doing something to take your mind off the pain. You can try reading, watching television, listening to music, talking on the telephone, or other calm activities

Every patient has different needs. You may need a transfusion depending on your condition during surgery.

Here are some common reasons a transfusion might be needed:

• If you are anemic or if your organs are low on oxygen, you may need a red blood cell transfusion. This is the most common transfusion.
• If your platelets are low or are not working properly, you may need a platelet transfusion to stop or prevent excess bleeding.
• If your blood is clotting slowly or inefficiently, you may need a plasma transfusion to stop or prevent bleeding.

Donations of blood and blood products are collected by Canadian Blood Services. The donors are volunteers, and they are health screened before their donation is accepted. The blood donation is then screened for viruses.

Blood transfusions are very safe, and the risk of infection or complication is very small. All blood donations are tested for HIV, Hepatitis B, Hepatitis C, HTLV, West Nile Virus and Syphilis.

There is a very small risk of allergic reaction or fever, and even smaller risk of the immune system attacking the donated blood.

There are currently no effective substitutes for platelet or plasma transfusions. There are some potential alternatives to donor red blood cell transfusions.

Some patients may qualify for autologous blood collection, where the patient’s own blood is collected for a few weeks before surgery for transfusion. Another possible option is erythropoietin injections, where medication is started a few weeks before surgery to stimulate red blood cell production.

If you are interested in an alternative to donor transfusion, ask your nurse or doctor if you qualify.

The risks of refusing a blood transfusion depend on your health, your surgery, and your condition during the operation.

If your organs do not receive enough oxygen during surgery and you opt out of a transfusion you risk damaging important organs like the lungs, brain, or heart. Ask your healthcare team about what risks might be involved if you refuse a transfusion.