Introduction

For many patients, their procedure will be the first time they are meeting an anesthesiologist. This is usually a very stressful time and sometimes the medical language used by the anesthesia provider may seem foreign and confusing. We hopefully can provide some level of understanding of the anesthesia services for our patients and how they might differ from the "general anesthesia" or "conscious sedation" they may have had for their prior procedures.

To begin, we need to clarify two terms that are commonly used MAC (monitored anesthesia care) and GA (general anesthesia). There is a spectrum of sedation that can range from stress-reducing medication to being entirely unconscious. At the same time, there are many different ways to help patients breathe ranging from oxygen in the nose, a face mask, a laryngeal mask airway (LMA) or a breathing tube (endotracheal tube). The sedation and airway management are somewhat related but not necessarily lock-step.

A common question is: "Will I remember anything?". This is a very complicated question as the answer is: "It depends ...". Normally with moderate-deep sedation or general anesthesia, the answer will be: "No". Infrequently at the end of the anesthetic, you may remember being asked to follow simple commands prior to removing the breathing device as this is a safety measure, but the large majority of patients do not remember even that. Even after a small dose of anxiety reducing medication, many patients will not remember the events due to a combination of the medications and the stress-response of having the procedure. Patients who have a chronic use of opiate pain medications or alcohol can sometimes be more challenging to sedate and may have a higher incidence of remembering things during the sedation process. These are important points to bring up to the anesthesia provider taking care of you.

For most of the procedures that are performed, the patient will be under moderate to deep sedation without a breathing device, but this depends on the individual procedure,the individual patient and the patient's medical history. This is different from the operating room, where most of the surgeries are performed under general anesthesia. If the patient has had prior procedures in the past with nurses, they will likely have had conscious sedation which normally ranges from mild to moderate sedation.

Your anesthesia providers have expertise in airway management and therefore can increase the depth of the sedation while at the same time being able to manage any airway problems that might arise. They are very experienced in managing patients with multiple medical problems and the complications from the use of sedating medications either directly or due to the patients medical problems. Given the difference in training, the anesthesia providers also have a larger repertoire of medications and techniques that they can use to balance patient safety while still providing the proceduralist with optimal working conditions.

Above, you will see multiple different procedure categories as the anesthesia service provided for each of these can vary greatly. This website is a guide as to what to expect as a patient, and it is important to discuss the anesthesia plan with the anesthesia provider if you have any concerns.