Your Anesthesia Care Team
Anesthesiology is a medical discipline practiced by several different provider arrangements. Regional Anesthesia, PLLC, has concluded that the practice of anesthesiology is best approached through the Anesthesia Care Team model. The Anesthesia Care Team consists of a supervising Anesthesiologist, and a Certified Registered Nurse Anesthetist (CRNA).
An Anesthesiologist is a medical doctor (MD) who has completed a medical internship and three or more years of specialized medical training in anesthesiology, after completing medical school. All Regional Anesthesia, PLLC, physicians are Board Certified by American Board of Anesthesiology, or in the certification process. Many of our doctors have also completed additional fellowship training in subspecialties of Anesthesiology.
A Certified Registered Nurse Anesthetist (CRNA) is a registered nurse (RN) who has completed two or more years of specialized nursing training in anesthesia and a state certification exam after finishing nursing school. The CRNA works under the supervision of the Anesthesiologist.
We believe that the Anesthesia Care Team model has proven to be the most cost effective, safe, and efficient anesthesia delivery system at every step of care.
Before, During, and After Your Surgery
Getting Ready For Surgery
You may be contacted by Pre-Anesthesia Testing (PAT) prior to your operation or procedure regarding your health and medications. In some cases, you may have a scheduled appointment with PAT. You may be required to undergo blood tests, electrocardiogram or chest X-ray as appropriate for your medical history and the planned procedure. If you have a more significant medical history, we may obtain your permission to request medical records from your other doctors.
In most cases, do not eat or drink anything after 10pm on the day of your surgery or procedure. Certain medical conditions may require modification of this guideline as instructed by your Anesthesiologist. For young children, please follow special instructions given to you by the PAT nurse.
You will be instructed on which regular medications to take the morning of your surgery. These medications can usually be taken with a sip of water.
You will meet your Anesthesiologist and CRNA the day of your surgery. Your medical history will be reviewed and the appropriate anesthetic plan will be made at this time. The risks, benefits, and alternatives of the anesthetic plan will be discussed with you. Any and all of your questions regarding your anesthetic plan will be answered.
Once you have met with your Anesthesia Care Team, you will sign a request for anesthesia consent. This anesthesia request form is signed by you or your representative (e.g. parent of child) and only after you understand your anesthetic plan. This form gives us permission to administer anesthesia to you (or your child) and verifies that risks and benefits of the anesthesia have been discussed.
Types of Anesthesia
Overall, there are three types of anesthesia:
- Monitored anesthesia care
- Regional anesthesia
- General anesthesia
For monitored anesthesia care, you will typically be given a sedative through your IV to help you relax. The surgeon will administer any required “numbing” medicine (local anesthesia) at the incision site. You will typically be drowsy during the procedure and may drift in and out of sleep. Many people have no recollection of the procedure.
For regional anesthesia, a certain region of your body is anesthetized by using local anesthetics placed near the nerves supplying sensation and control to that part of the body. At the same time, you will be given an intravenous sedative to relax you. Regional techniques include spinal / epidural anesthesia and nerve blocks to limbs and extremities.
With general anesthesia, there is complete loss of consciousness. Both intravenous and inhalation (gas) anesthetics are used. A breathing device may be inserted into your mouth with general anesthesia, if needed. Some people experience nausea with general anesthesia after awakening. Typically, medications are administered during your procedure to try and prevent this. Other medications are available after surgery should you require them.
Several factors are considered when choosing an anesthetic, such as your medical history, the type of surgery or procedure you are having, and plans to control your pain afterwards. Your Anesthesia Care Team will discuss with you the specifics of the selected anesthetic. A regional nerve block to help with post-operative pain may also be offered, as described in the Pain Management section.
During Your Surgery
The standard of care for monitoring your Vital Signs, recommended by the American Society of Anesthesiologists, will be used during your surgery Vital Signs include such things as blood pressure, heart rate and rhythm, blood oxygenation, breathing, etc.
Depending on the extent of the surgery, you may or may not be transfused with blood. Blood is generally used during operations where there is extreme blood loss. If you have any specific wishes regarding blood transfusions, please let your surgeon and Anesthesia Care Team know.
Controlling your pain as well as possible is very important to us. This can be accomplished before, during and after surgery.
Depending on the operation you are having, you may be offered a nerve block that will keep a part of your body numb during surgery and for hours, afterwards. These are administered before the operation begins. Your vital signs will be monitored throughout this procedure and you will typically be given medications to help you relax.
If a nerve block is not indicated for your operation, you will be given intravenous pain relievers to assist with your pain, as needed, before your arrival in the recovery area. Your surgeon may also place local anesthesia at the incision site to reduce your discomfort.
After surgery, further medications may be given in the Post Anesthesia Care Unit, either by mouth or IV, for your comfort. Medications for use at home after surgery will be taken care of by your surgeon.
Recovery After Surgery
After your operation, you will be taken to the recovery room, also known as the Post Anesthesia Care Unit (PACU). Your vital signs will also be monitored in the PACU as you recover from your anesthetic. We make every effort to minimize and treat your pain during and after your operation. Our goal is to keep you comfortable. The level of pain depends on the type of operation and your medical history. You will be given the appropriate pain medication before, during and after your surgery. As previously noted, any nausea problems will also be addressed.
Recovery from anesthesia depends on the type of anesthesia and surgery, length of the surgery, and your medical condition. Most people recover in the PACU for one to two hours. Depending on your surgery, you will either be discharged home, or stay in the hospital after your operation.
Paying for Your Anesthesia Care
The clinical care that you receive by Regional Anesthesia Associates, PLLC, will be billed separately from your surgeon and separately from the hospital or facility that you will have your surgery or procedure performed.
The hospital or facility will collect your insurance information and provide it to our Billing Office. We will file the professional services you receive from Regional Anesthesia Associates to the insurance they have listed for you. The bill from Regional Anesthesia Associates will be based on several factors, including the nature of the surgical procedure, type of anesthesia, and the time involved for your case. The hospital or facility may also charge you separately for anesthetic medicines, gases and the use of monitoring equipment and disposable supplies.
We encourage patients to call our Billing Office at (919) 384-0700 before your planned surgery or procedure. Our Billing Office can verify that Regional Anesthesia Associates is in network with your insurance and, if not, provide you with an estimated cost of service for the anesthesia professional charges.