Before you are escorted to the operating room on the day of the operation, you may be given a medication to help you prepare for this journey in a more relaxed manner. In the operating room, you will be transferred onto an operating table and taken to a preparation room or directly to the operating room. Here, the equipment and cables to monitor your cardiovascular and respiratory function are attached. Furthermore, a needle is placed in a vein through which we can apply the anesthesia and infusions into your bloodstream.

Local Anesthesia

If local anesthesia alone is planned for your procedure, now is the time to administer it. Depending on the procedure chosen (this was explained in the consultation on the previous day), you will sit upright or the affected extremity will be positioned so that the anesthetist can locate the structures to be anesthetized in the best possible way. After anesthetizing the skin, a thin needle is inserted and the anesthetic is administered to the corresponding area.

In the case of spinal or peridural anesthesia, this is done in the sitting position; in the case of nerve blocks of the arm or leg, in the lying position. Ultrasound-guided procedures are also used here to find the optimal position for the needle.

The effect of regional anesthesia is not immediate; the drugs need a few minutes to take full effect. In some cases, movement and touch of the anesthetized region can still be felt, but pain and temperature cannot. This is completely normal. Before the operation begins, it is ascertained whether the anesthesia is sufficient so that the pain is completely eliminated at the time of incision.

Depending on the anesthetic used, the effect lasts for different lengths of time. With short-acting drugs, sensation can slowly return after just two hours, while longer-acting drugs can retain their effect for eight hours or longer. It is also possible to apply the anesthetic via a so-called pain catheter, which remains in place for a certain time even after the operation. This is a very thin plastic tube through which painkillers can be continuously administered to the corresponding nerves. This makes it possible to keep the surgical area pain-free even after the end of the operation.

General Anesthesia

If regional anesthesia is not possible for the planned procedure, or if there are findings in your medical history that make regional anesthesia inadvisable, we will perform a general anesthetic, popularly known as "general anesthesia". Here, strong painkillers and sleeping pills will put you into a state of deep unconsciousness. Often, drugs are also given to make the muscles go limp. Since the body is no longer able to breathe on its own under these drugs, you must be artificially ventilated. For this purpose, a mask is first used, through which you are supplied with additional oxygen while the anesthetic drugs are being injected. To ensure ventilation throughout the anesthesia, aids are used (tube, laryngeal mask), which are advanced through the mouth or nose to the larynx or into the trachea.

It is important to adhere to the fasting guidelines that were explained during the preparatory consultation. In general, solid food is prohibited for six hours and beverages for two hours before the start of anesthesia. If this is not observed, the loss of protective reflexes associated with anesthesia can cause stomach contents to enter the trachea and lead to pneumonia.

For larger operations on the abdomen and thorax, general anesthesia can be supplemented by a regional anesthesia procedure close to the spinal cord: A peridural catheter placed before the start of anesthesia provides a significant reduction in pain after surgery. For procedures on the extremities, it is possible to use ultrasound to place a pain catheter on the nerves supplying the surgical area both before and after initiating general anesthesia in order to optimize pain therapy.

After Surgery 

If local anesthesia is used, it is usually possible to return to the room immediately after the end of the operation. If an anesthetic was administered, the anesthetic medication will be issued at the end of the operation. Once you are sufficiently awake and breathing is restored, the breathing tube or laryngeal mask will be removed. You will then be taken to the recovery room, where your cardiovascular and respiratory function will continue to be closely monitored.

After major surgery, such as heart surgery, you will not be woken up in the operating room, but will be taken to an intensive care unit while still under anesthesia. If all requirements are met, the anesthetic medication is discontinued there and, if you are sufficiently awake, the tube is removed. The awakening process can take several hours, especially after longer procedures.