Surgery Ready
Getting ready for anesthesia and surgery, explained from guidelines, trials and FDA labels by a practicing nurse anesthesiologist's standard. Your surgical and anesthesia teams set your plan; these guides help you understand it and ask better questions.
Anesthesia
The kinds of anesthesia, how they differ, and the drugs involved.
Types of anesthesia and sedation
How the American Society of Anesthesiologists defines the levels of sedation, what monitored anesthesia care is, and what the research shows about spinal, epidural and nerve block anesthesia.
TIVA or inhaled anesthesia
Two ways to keep someone under general anesthesia, and what large reviews of randomized trials found about safety, nausea and recovery.
The drugs you may hear about
Propofol, midazolam, fentanyl, ketamine, dexmedetomidine, sevoflurane, rocuronium and sugammadex, and local anesthetics, in the words of their FDA labels.
Before surgery
Fasting, the medicines to bring up, sleep apnea, and getting the body ready.
Fasting before surgery
Why the team asks for an empty stomach, what the guidelines say about clear fluids and solid food, and what trials found about shorter fasts and carbohydrate drinks.
Medicines to discuss before surgery
What labels and guidelines say about the medicines anesthesia and surgical teams most need to know about. The plan for each one is set by your team.
Sleep apnea and anesthesia
Why obstructive sleep apnea matters around surgery, and how the STOP-Bang questionnaire helps the team screen for it.
Getting the body ready
What research shows about the things that can be improved before a planned operation, and where trials found less benefit than hoped.
Risks and side effects
What the large studies show, in plain numbers.
Nausea and vomiting after surgery
The four risk factors teams look for, how much each preventive step helps, and what large trials found.
Delirium and thinking after surgery
What postoperative delirium and cognitive change are, and what trials of anesthesia type, brain monitoring and medicines have found.
Awareness under anesthesia
What large studies found about waking during general anesthesia, and the role of muscle relaxants.
Malignant hyperthermia
What malignant hyperthermia is, what triggers it, how it is inherited, and the antidote.
Allergic reactions during anesthesia
How often anaphylaxis happens during surgery, the usual culprits, and why food allergies and propofol come up.
Children
What the brain-development research found.
After surgery
Recovery programs and pain plans.
Procedures
What to expect, in general, for common procedures.
Colonoscopy and endoscopy sedation
How sedation for scopes works, what the trials found about propofol, and why GLP-1 medicines and blood thinners come up beforehand.
Cataract surgery
What guidelines say about numbing the eye, and what a large trial found about routine tests before cataract surgery.
Hip and knee replacement
What large studies found about spinal versus general anesthesia for joint replacement, and why nerve blocks are recommended.
Labor epidurals and cesarean birth
What a Cochrane review found about epidurals for labor pain, and what is known about regional and general anesthesia for cesarean birth.
Dental sedation
What sedation levels mean in the dental chair, the safety system pediatric guidelines describe, and the drug label facts behind them.
Cosmetic surgery
What the evidence shows about sedation risks, the fat-grafting deaths task force, and what to ask about who gives anesthesia and where.