Anesthesia Services

About Anesthesia
Patient Anesthesia Information
Frequently Asked Questions

About Anesthesia

Inpatient/Outpatient Anesthesia Services
Metro Anesthesia & Pain Management presently provides all outpatient anesthesia at the Surgery Centers of Des Moines (East & West in Des Moines), Wolfe Eye Clinic, Heartland Plastic Surgery, and Dallas County Hospital in Perry, IA. 

The Inpatient/Outpatient Services Provided Include:

• Inpatient and Outpatient Anesthesia for General Surgery, Plastic Surgery, Gynecological Surgery, Podiatry, Urology, Vision Surgery, and Orthopedics.

Preoperative Anesthetic Consultations
We will provide individualized preoperative consultations for those patients who have unique medical problems. Your Surgeon, Chiropractor or Primary Care Provider can arrange this by calling us at 515-221-9222.
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Patient Anesthesia Information

Understanding pre-operative instructions

We hope that your surgical experience will be a pleasant one. We are providing the following information to assist you with your pre-operative preparation. Please follow all instructions you are given from your surgeon and/or the surgery center.  If we can be of assistance in answering your anesthesia related questions before the day of your surgery, you can reach us at 515-221-9222.
 
It is important for your safety and to ensure the best quality service that you understand as much as you can about your anesthesia and surgery. In the pre-operative area, highly trained physicians and nurse anesthetists will focus on obtaining the information that is needed to ensure your safety and comfort. In order to do this, they must become familiar with any medical conditions you have. It is therefore very important that accurate medical information be available to our staff so that optimum care can be given.

You will have opportunities to have your questions answered in the pre-op area the day of your surgery. Please take advantage of this opportunity! We recommend that you read our Questions Section for any questions that you may have.

These instructions are intended for patients of Metro Anesthesia and Pain Management, LLP only. This is not intended as a sole source of information nor does it constitute a doctor/patient relationship.

The following are general Pre-Operative instructions to assist you the day of your surgery. 

Pre-operative instructions

Day Before Your Surgery

1. Do not eat or drink anything after 12 midnight- not even water, chewing gum or mints.
2. Do not drink any alcoholic beverages 24 hours before your surgery. It can be dangerous to be put to sleep or sedated when you have food or liquid in your stomach.
3. Notify someone in your surgeon's office or the pre-op area if you have any change in your physical condition such as a cold, fever, rash, nausea, vomiting or diarrhea.

You are welcome at any time to call us if you have any specific questions related to anesthesia which must be answered prior to your surgery.

We have a representative of our department in the Admissions Testing Area who will be glad to speak with you between the hours of 8:30 AM and 5 PM Monday through Friday. 

 Morning Before Your Surgery

1. Do not eat or drink anything.
2. You may brush your teeth, but do not drink any water.
3. Do not smoke tobacco or use chewing tobacco on the day of surgery.
4. Do not wear any nail polish, hair pins, false eyelashes or make-up. Acrylic nails should not be worn for hand, arm or shoulder surgery.
5. Please bring a container for your contact lenses, glasses or removable dental work.
6. Wear casual clothing such as a jogging suit or loose-fitting clothing.
7. Bring only those valuables designated as absolutely necessary by the Admissions Area.
8. Please take all of your medicines which you were instructed to take by the pre-op area. If you have any questions concerning which medications you are to take, please call either our department or the pre-op area.

After Surgery

After surgery, you will be taken to the Post Anesthesia Care Unit (recovery room) until most of the effects of anesthesia are gone. Here, specially trained nurses will watch you carefully. They will treat any discomfort you might have under the direction of your anesthesiologist.

If you are to return home on the day of surgery, you will proceed to the Postoperative Holding Area. There you will do things to get ready to go home, such as awaken more fully, drink fluids, and use the restroom. Some patients may spend the evening in this area, and go home early the next morning.
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Frequently Asked Questions

The following is provided as a service to our patients and is not intended to provide medical advice or in any way constitute a doctor/patient relationship. If you have any anesthesia related questions, please call us at 515-221-9222. It is important for your safety and to ensure the best quality service that you understand as much as you can about your anesthesia and surgery.

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Who provides anesthesia care?
 
The Anesthesia Care Team

During your visit you will be taken care of by a team of highly trained physicians and nurse anesthetists who specialize in the practice of anesthesiology.
 
The Anesthesiologist

Anesthesiologists are physicians who are trained in the specialty of anesthesiology and pain management. They have completed medical school and then received many more years of additional training. Many anesthesiologists at MAPM have received advanced training in a specific area of anesthesiology and pain management. All of our physicians are Board Certified or board eligible. Your anesthesiologist either personally provides or directly supervises the care you receive during surgery and is responsible for diagnosing and treating any problems. Your anesthesiologist supervises other members of the Anesthesia Care Team who will take care of you including certified registered nurse anesthetists (CRNAs).
 
The Certified Registered Nurse Anesthetist

Certified Registered Nurse Anesthetists (CRNA's) are registered nurses who have undergone two years of additional training and received certification in Nurse Anesthesia. CRNA's at MAPM have been specifically chosen for their expertise in patient care. They are skilled practitioners who function under the supervision of an anesthesiologist.

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Why is a pre-operative visit necessary?
 
The purpose of the visit is to make sure that you are in optimum condition to undergo surgery and anesthesia. This visit will also familiarize you with some of the events that will take place on the day of your surgery. It should increase your comfort level and reduce your anxiety. Knowing your health status will allow the anesthesiologists to "tailor" the anesthetic to your needs and take necessary precautions to ensure a safe anesthetic course. Also, this visit allows us to order necessary tests so that the results are available before you are ready for surgery. This gives us time to address problems so that your surgery will not be delayed.
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What will happen during your anesthesia experience?
 
Before surgery - Preoperative Evaluation

Before your surgical procedure, a member of the Anesthesiology Team will speak with you about your medical condition and anesthesia issues.
 
- Your preoperative instructions

Before the day of your surgery, you will be given instructions to help prepare you for your procedure. These instructions tell you about eating and drinking before surgery and the medications you should take. You will be told where and what time to arrive on the day of surgery and what you should bring with you.
 
During surgery

You will receive medications through your IV which will make you feel relaxed and sleepy. A variety of different techniques may be used, including spinal, epidural, or nerve blocks. Usually you will receive sedation and pain medications through your IV as well.
 
- Monitoring during anesthesia

While you are unconscious, a member of the Anesthesia Team will watch over you constantly. Special equipment (monitors) will be used to measure a continuous electrocardiogram (your heart rhythm), blood pressure, the oxygen in your blood, breath sounds, heart sounds, and body temperature. Other monitors may be used depending upon your medical condition, the type of surgical procedure you are having, and the type of anesthesia you are receiving. This will be discussed with you in detail before your procedure begins.
 
After Surgery

After surgery you will be taken to the Post Anesthesia Care Unit (recovery room) until most of the effects of anesthesia are gone. Specially trained nurses will watch you carefully. They will treat any discomfort you might have under the direction of your anesthesiologist. If you are to return home on the day of surgery, you will proceed to the Postoperative Holding Area. There you will do things to get ready to go home, such as awaken more fully, drink fluids, and use the restroom. Some patients may spend the evening in this area, and go home early the next morning.

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What is anesthesia?
 
Anesthesia is the process of providing for your comfort and ensuring your safety. It is a process that begins before you arrive at the hospital and continues until you recover.
 
Types of anesthesia

There are different types of anesthesia. The type of anesthesia you will receive depends upon the type of surgical procedure, your medical condition, and your preferences. The anesthesiology staff will discuss these options with you and answer any questions you have.
 
- General anesthesia

General anesthesia causes the loss of consciousness. It usually begins in the operating room when medications are given through your IV (a small plastic tube placed in your arm to give you medications). It is usually continued during your procedure along with other medications given through your IV, and gases you breathe.
 

- Regional anesthesia

When you receive regional anesthesia the part of your body where surgery is to be done is made numb by injecting medicine (like Novocain) around the nerves. The numbness wears off soon after surgery.
 
- Local with sedation

Local with sedation is similar to regional anesthesia except that only the small area where the procedure is to be done is made numb by injecting special medications (local anesthetics) directly into that location.
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What are the risks associated with anesthesia?
 

• All types of anesthesia have some risk associated with them. Side effects can be minor or severe and can occur during your procedure or after. Some of these are described below. Your anesthesiologist can best describe the risks and benefits associated with the particular type of anesthesia you are to receive. The chance of having a complication is related to your medical condition and the type of procedure you are having. Death is extremely rare, but can occur with any anesthetic technique or surgical procedure. Many safety measures and precautions are taken by anesthesiologists in order to prevent any injury to you. Your safety is our first concern!
• General anesthesia - minor side effects can include sore throat, headache, nausea and/or vomiting, sleepiness, muscle aches and fatigue. A very rare, but serious complication is called aspiration pneumonia (stomach contents into your lungs). This is why you must follow the eating and drinking rules! Other rare complications include severe allergic reaction, chipped teeth, blood pressure problems, heart problems, and stroke.
•  Regional anesthesia - some of the risks of regional anesthesia are similar to those for general anesthesia including drowsiness, headache, severe allergic reaction, blood pressure problems, heart problems, and stroke. You may also have some pain or an infection (very rare) at the place where the anesthetic was placed. If you have a spinal or epidural you may have trouble emptying your bladder for a very short time after your procedure. You might also experience prolonged numbness in some of the areas where you received anesthesia. Permanent nerve damage is extremely rare with these procedures.
• Sedation with local - some of the risks of sedation with local anesthesia include drowsiness, severe allergic reaction, blood pressure problems, heart problems, and stroke. You may also have some pain after your procedure at the place where the anesthetic was placed.

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How will I receive pain relief after surgery?

There are several ways to relieve pain after a surgical procedure. The type used for you will depend on the procedure you are having. Your surgeon can discuss these options with you and answer any questions you may have.

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Should I stop smoking if I am going to have surgery?
 
Patients who smoke tobacco and/or use chewing tobacco and undergo general anesthesia may have an increased risk for severe coughing, wheezing, and pneumonia which may require special treatment. To significantly decrease the chance of these complications, you should stop smoking at least one month before your surgical procedure. Some benefit may be obtained by quitting even two days before surgery.

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Will I receive a separate bill from my anesthesiologist?
 
You will receive a statement from your anesthesiologist just as you will from other physicians who take care of you during your visit. If you have any questions or concerns about any financial matters, you can discuss this with our billing department at 515-963-9464.
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