Patient’s Resource Guide

Thank you for visiting the Wisconsin Association of Nurse Anesthetists (WIANA) Patient’s Resource Guide! Surgery can be a concerning, stressful event in anyone’s life; one which may or may not require anesthesia. If necessary, the anesthesia care you receive will help your body comfortably and safely through it. This webpage is intended to provide answers to commonly asked questions regarding your upcoming anesthetic. Certified registered nurse anesthetists (CRNAs) have been providing safe anesthesia care in the United States for more than 100 years. The earliest existing documents of a nurse providing anesthesia care are from 1887. To learn more about the history of nurse anesthesia please click here.

CRNAs are educated, trained and experienced in providing anesthesia care for highly complicated medical procedures. In fact, before entering a nurse anesthesia program, CRNAs already have an average of three and a half years critical care experience – the only anesthesia professionals who can make this claim.

Nurse anesthetists work independently and in collaboration with surgeons, dentists, podiatrists and other health care professionals. There are over 650 CRNAs in Wisconsin practicing in all types of heath care settings. They safely deliver the majority of anesthetics in the state of Wisconsin making it likely they will participate in your care. CRNAs are proven to deliver safe anesthesia care time and time again:

Quality NAP
Studies on CRNA Anesthesia Care

Pre-Operative Evaluation

Before you have surgery, you will need to have a pre-operative history and physical and an anesthetic evaluation. The history and physical can be completed by your surgeon or your primary care physician. This may be scheduled within thirty days prior to your upcoming procedure and may include laboratory tests, an ECG or X-rays. Your anesthetic evaluation will be completed by your anesthesia provider on the day your surgery is scheduled. This evaluation will review your allergies, current medications, previous experiences with anesthesia, familial reactions to anesthesia, and any known blood disorders.

In order to be prepared for your pre-operative evaluation, please use the link below. To facilitate an efficient, yet thorough interview, please fill out this questionnaire and bring it with you on the day of surgery. Pre-Anesthesia Questionnaire

Preparing For Surgery

When completing your health history, your doctor will instruct you on how to prepare for surgery. Neglecting these instructions may cause your procedure to be delayed or canceled.

Eating and Drinking should be avoided six hours prior to your anesthetic. Most doctors will instruct you to not eat or drink after midnight. Children may be allowed to drink clear liquids (water, apple juice, Pedialyte) up to two hours before the procedure. Please ask your surgeon for specific guidelines.

Medications should be reviewed prior to your procedure. An updated list of your current prescription and non-prescription medications, including dose information, should be given to your physician. This list should include herbal medications and dietary supplements. Some of these medicines have severe side effects when combined with anesthesia, so it is important to make a precise list. It is often recommended that you stop taking all non-prescription or over-the-counter medicines two weeks prior to your surgery. A health care professional will review your medications and instruct you on which are safe to take the day of surgery and if there are any dose modifications that need to be made. This is especially important if you have diabetes and take oral agents or insulin to control your blood sugars. Alcohol and street drugs need to be listed as well, as serious and potentially lethal complications may occur if these substances are mixed with anesthetic agents.

Change in Your Health If you’ve had a recent change in your health status, you should notify your surgeon or your primary care physician. The development of a cough, cold, or fever with congestion of the nose or chest is very important. These symptoms may increase your risk of adverse side effects from anesthesia and may require you to reschedule your procedure.

Driving Home will not be allowed after your procedure. If you are having outpatient surgery, you will need to have arranged a ride home. If you do not have a driver, your surgery will be canceled.

Children should be specifically prepared for anesthesia. Anesthesia may be delivered to your child in several ways. In adults, it is common to start an intravenous (IV) line for the initial delivery of anesthetic agents. Although this may be used in children, another method is to let your child breathe anesthetic agents through a mask. These anesthetic vapors allow your child to safely drift off to sleep. As a parent, you can facilitate a smooth anesthetic induction by explaining to your child what will happen the day of surgery. To provide extra security, allow your child to bring their favorite toy, blanket, or stuffed animal.

Pregnancy does not exclude you from having anesthesia. If you must have surgery while you’re pregnant, your CRNA has safe anesthetic techniques and medications to choose from. The technique used will depend on what type of surgery you are having.

To make sure you are prepared for surgery and have all your questions answered, look at this questionnaire before you leave your doctor’s office: Questions You Should Ask

The Day of Your Procedure

You will meet your CRNA on the day of your procedure. A CRNA will be with you throughout your procedure, constantly monitoring your vital signs and modifying your anesthetic to meet your needs. To facilitate your safety and comfort, you may receive one or a combination of anesthetics. There are three major types of anesthesia: monitored anesthesia care (MAC), regional anesthesia and general anesthesia. The anesthetic chosen for each patient is individualized based upon several different factors including the patient’s health history and the surgical procedure. The type of anesthesia that is chosen will be discussed on the day of your procedure where you will have the opportunity to ask additional questions. No matter which type is chosen, you can be assured that anesthesia carries a very low risk.

Types of Anesthetics:

Monitored Anesthesia Care is defined as IV sedation with or without the use of local anesthetic agents. With a small surgical site, a surgeon may be able to numb the area with local anesthetic, such as novacaine, lidocaine or Marcaine. However, this component is not always necessary, for instance, with a colonoscopy. The intravenous sedation may range from relaxation to a deep sleep. This type of anesthesia does not guarantee amnesia, but it is very likely to occur. MACs are commonly used for minor procedures such as wisdom teeth extractions and cataract surgery.

Regional Anesthesia also incorporates the use of local anesthetic agents. Regional anesthetic techniques target a specific nerve pathway to render a large part of the body pain free. The most frequently used techniques include spinal anesthetics and epidural catheters. To perform this type of block, a needle is inserted into your back and medication is injected around a targeted nerve root. When performing these regional techniques, IV sedation is often used to keep you comfortable. Nerve catheters may remain in following surgery to allow for extended pain relief and to decrease the need for oral narcotics. The decisions surrounding regional anesthesia will be made in collaboration with you, your surgeon, and the anesthesia provider.

General Anesthesia is state of amnesia, analgesia, total loss of consciousness and muscle relaxation. This is the most common type of anesthetic delivered in hospitals and surgery centers. An IV will be placed pre-operatively and will be used to administer the intravenous anesthetic agents that induce anesthesia. An airway device will be inserted into your mouth, after you are asleep, which will facilitate delivery of anesthetic gases to keep you asleep. Once the procedure is finished, the anesthetic gas is turned off. The airway device is removed as soon as you can protect your airway yourself. The majority of patients do not remember the airway being removed. Recovery from the anesthetic is completed in the post operative anesthesia care unit.

Labor Analgesia is important to consider during your pregnancy.Even if a natural childbirth is planned, we recommend exploring the analgesic options your hospital has to offer. The two main options for laboring mothers are systemic analgesics and regional analgesia (epidurals or spinal narcotics). Systemic analgesics are given into a vein or muscle and affect the whole body, decreasing pain. Regional analgesia involves the injection or infusion of narcotics and/or local anesthetic into the epidural space or spinal fluid. Each technique has specific advantages and disadvantages. Your anesthesia provider will work with you to decide your best option prior to providing the service. Please note that epidural and spinal analgesic techniques are not offered at every hospital.

Postoperative Care

The most common complaints of anesthesia include nausea, vomiting and a sore throat. In the recovery room, a nurse will assess any side effects and monitor your airway, vital signs and pain levels. The length of time you remain in the recovery room depends on your surgery, type of anesthetic, and response to anesthesia. Before you are discharged, you must meet a certain set of criteria developed for your safety. Upon leaving after surgery, you will receive instructions on postoperative activity level, pain management and diet. You must have a responsible adult drive you home and accompany you for the next 24 hours. In that time, you should quietly rest and stay at home. You should not be driving or performing any activity that involves coordination or decision making for at least 24 hours. If you have small children, you may want to arrange someone to care for them during this time. Remember to drink plenty of fluids and start by eating light foods, such as broth or soup, and progressing to crackers, toast, or yogurt. Alcohol should be avoided for 24 hours after anesthesia.

If you have any questions feel free to call your anesthesia provider or the facility where you were treated. CRNAs are proud to be at your side keeping you safe during surgery. We are interested in your welfare and want your recovery to progress to your satisfaction.