Anesthesiology

If you need to schedule Pre-Admissions Teaching (PAT) including anesthesia evaluation for an outpatient procedure, please call 440-415-0184.

It’s known by a variety of names; general anesthesia, “twilight sleep,” MAC, regional, local anesthesia, numbing, conscious sedation—but what does it all mean to the patient?

Defining Anesthesia

Anesthesia is commonly described as various methods of blocking sensation to a body part, or to induce a lack of consciousness so a procedure can be performed for the patient without pain. There are, however, various levels of anesthesia, and the type of procedure often dictates the best method for the patient. Patient characteristics also have a major impact in the choices available for anesthesia during a procedure as well. This is why anesthesia is a department in itself at medical facilities. Anesthesiologists are MDs who have gone on for further education in the specialized science of anesthesiology. Anesthetists are medical personnel other than MDs who have completed education and been certified in anesthesiology.

The American Society of Anesthesiologists (ASA) has defined four levels of sedation;

  1. Minimal sedation,
  2. Moderate sedation (also knows as conscious sedation),
  3. Deep sedation, and
  4. General anesthesia.

As anesthesia moves through the four levels, from minimal to general, the patient is less easily roused and more able to tolerate procedures that may have a higher threshold of pain. Patients are able to respond to verbal commands for the first three levels of sedation—although during deep sedation, the patient may need to be repeatedly or assertively stimulated to do so. At the fourth level, general anesthesia, the patient is totally unconscious and not even a painful stimulation will rouse him/her. Also, as anesthesia levels increase, they are accompanied by a decrease in normal respiration, heart function and blood pressure. A patient’s request to the anesthesiologist during PAT to “just knock me out for the procedure” may be met with several questions as to why the patient prefers that choice—and other, more viable options may be presented. Anesthesia considerations are unique for each and every patient.

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