Anesthesia for Surgery | Anesthesia for Obstetrics | Sedation Services | Pain Management
Surgical Anesthesia Services
We provide anesthesia for all types of surgery and various locations throughout the NY/NJ area including hospitals, ambulatory surgery centers, and physician offices. Because not all surgeries are the same, and not all patients are the same, we tailor the anesthetic to the situation. There are three basic types of anesthesia, discussed below. There is no difference in safety between the types of anesthesia, except in a few specific types of surgery or medical conditions. For more information, see Frequently Asked Questions.
General Anesthesia
In general anesthesia, the patient is unconsious and insensitive to pain. Often, during general anesthesia, the patient requires the assistance of a ventilator, or breathing machine. This is usually due to the effects of the drugs, but sometimes it is indicated by the type of surgery. By the end of surgery, patients are usually breathing without assistance. Most patients wake up comfortable, and any pain should be quickly treatable. General anesthesia can cause nausea and vomiting, as well as a "hung over" sensation. Any type of surgery can be performed under general anesthesia, but it is often overkill, and the techniques discussed below may be more approriate.
Regional Anesthesia
In regional anesthesia, a local anesthetic (like Novacaine) is injected near the nerves going to the site of surgery. This local anesthesia makes an entire part of the body (arm, leg) numb and weak, for as long as the local anesthetic lasts. Additionally, patients are usually given some sedation for general comfort. There are several potential advantages to this type of anesthesia. The local anesthetic can last up to 24 hours, providing long-lasting pain relief for painful procedures. There is less risk of nausea than with general anesthesia. There is also less risk of temporary cognitive dysfunction (confusion), a potential problem in the elderly. There are also some specific risks to regional anesthesia, including injury to the nerves and toxicity from the local anesthesia. These complications are uncommon. Common types of regional anesthesia are spinals, epidurals, and "nerve blocks."
Sedation, or Monitored Anesthesia Care (MAC)
In MAC, the surgeon gives local anesthesia in the area of the surgery, and the patient is sedated for comfort and to overcome anxiety. The patient is not fully unconscious, and frequently wakes up during surgery, but has no pain. This is ideal anesthesia for many minor surgical procedures, such as cataracts, lipoma removals, and some hernias.
Your anesthesiologist will discuss whatever anesthetic choice is appropriate for you and your type of surgery. For more information see the American Society of Anesthesiolgists patient brochure "Sedation Analgesia" available in our download section or by clicking here.
Anesthesia for Obstetrics:
We provide anesthesia for labor and delivery, as well as cesarean sections. The typical anesthesia for obstetrics is regional (spinal or epidural -- see above), because obstetrics is one of those special cases. Regional anesthesia is slightly safer than general anesthesia for cesarean sections, for most patients. Regional anesthesia also allows the mother to be awake and experience the entire birth process, without the pain. For rare patients who are not candidates for regional anesthesia (bleeding disorders), we can help with alternative pain management.
For our labor epidurals, we use low-doses of anesthesia that should not affect the course of labor, only the pain. For more information see Frequently Asked Questions or the American Society of Anesthesiologists publication “Planning Your Childbirth: Pain Relief During Labor and Delivery” which is available in our download section or by clicking here.
Sedation Services:
Having a test or procedure should not be so unpleasant that the patient vows never to return. We provide sedation, as necessary, for endoscopy, and radiologic procedures. Many adults do not require the level of sedation that only an anesthesiologist can provide. Many others are too uncomfortable or scared during invasive tests and procedures, often resulting in a limited procedure that may not be adequate. For those people, and for children, we assure a safe, comfortable experience.
Pain Management:
We offer a full range of acute and chronic pain management services:
Blocks for Post-Operative Pain
Many procedures that are best performed under general anesthesia result in significant post-operative pain that can be well managed with a nerve block placed pre-operatively. For example, patients having an ACL reconstruction usually receive a single-shot femoral nerve block to improve pain control for up to 24 hours at home. Patients having total knee replacements usually have a femoral nerve catheter placed, to improve pain control for up to 3 days while in the hospital.
Spinal Narcotics and Epidural Catheters
Patients having thoracic surgery or extensive abdominal surgery may benefit from either of these techniques. Spinal narcotics improve pain control for up to 24 hours. An epidural catheter can control pain effectively for up to 3 - 5 days. If these techniques are appropriate for you, your anesthesiologist will discuss them with you before surgery.
Chronic Pain Mangement
We have physicians who are dedicated to treating chronic pain using the most up-to-date techniques. Some patients are helped by a change in medication. Others benefit from more invasive therapy, such as epidural steroids, or even spinal-cord stimulators. If you have a chronic-pain syndrome, ask your doctor for a referal to our pain physicans.
For more information see the Morris Anesthesia Pain Group website.
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