Q. I always read your columns and find them interesting. You often discuss anesthesia, but you never really say why it’s so important. Can you explain why it’s so important to know who is doing your anesthesia and what to ask beforehand.
Does oxygen and brain death mean anything to you? Just kidding. While most patients and surgeons primarily discuss the surgical aspects of cosmetic procedures, it’s the anesthesia that makes it happen. More importantly, the team work among the anesthesiologist, the nurses and the surgeon is what makes for a safe operation. I define a safe operation as an uneventful operation that the patient undergoes and is taken to a recovery room in good condition.
This definition does not include anything about the cosmetic outcome. Safe, outpatient anesthesia starts with good pre-operative planning. Patients should undergo a medical history screening along with appropriate laboratory testing in order to undergo a safe operation.
Once it is established that the patient is a good operative risk (everything has risk), the facility that you will have the surgery should meet minimal requirements. This is one of the reasons why I stress that if you are going out of the country for surgery, you should definitely know all aspects about who will give you anesthesia along with information about the facility.
Your facility should have the following equipment: An anesthesia machine; an oximeter to measure your oxygen level; a Bis monitor to monitor your brain waves to make sure you are anesthetized and suctioning equipment as needed. You should also have resuscitative equipment and an EKG monitor, if by chance you have a reaction or need to have cardiac monitoring.
In addition to the equipment and the appropriate drugs, your facility should be accredited by one of many accrediting organizations. The nurses who are attending to you in the operating room should also be veteran operating room nurses and not the same nurses who are assisting your surgeon.
The experience and knowledge needed during an emergency situation is paramount.. And finally, it is advisable that you also have a board-certified anesthesiologist to “pass the gas” and who will monitor you, with or without a nurse anesthetist. Good luck.