What do I have to consider before anesthesia?

Before an anesthetic, please do not eat any solid food for six hours and avoid drinking any liquids for two hours (except for a small sip of water to take your medication). During a general anesthetic ("full anesthesia"), among other things, the laryngeal muscles also go numb, and the body's protective reflexes (e.g., coughing) no longer function, so that stomach contents could get into the trachea. Therefore, fasting is mandatory for planned procedures. For safety reasons, you must also remain fasting before local anesthesia.

An anesthesiologist will inform you during the consultation about which medications must be discontinued prior or on the day of surgery.

Is there a risk that I will wake up during the anesthesia?

The phenomenon of "awareness" is fortunately a very rare event (1 to 2 cases out of 1000 anesthesia). In order to also minimize the residual risk, we take measures, depending on the anesthetic procedure, to adequately determine the depth of anesthesia based on various parameters and, if necessary, to intensify the anesthesia.

How long does the anesthesia last?

The duration of anesthesia depends primarily on the duration of the surgery. Towards the end of the operation, anesthesia is issued, so that a patient wakes up about 10 to 15 minutes after the end of the operation. However, after major operations such as heart surgery, anesthesia is often not terminated in the operating room, but only in an intensive care unit.

Is it possible that I will not wake up?

Fortunately, anesthesia-related complications are very rare. Advances in patient monitoring technology and new drugs have continuously minimized the risk of anesthesia over the past years. Nevertheless, complications cannot always be ruled out, especially in patients with severe secondary diseases and in major operations. In otherwise healthy patients, however, the risk of complications is extremely low. If you have had problems during a previous procedure, please let us know during your anesthesia consultation.

What is done about the pain after the surgery?

For each patient, the anesthesiologist in charge determines a pain medication for the period immediately after surgery. Various types of proven medications are used, either administered via a drip or as tablets. In addition, catheter-based local anesthesia procedures are used whenever possible and appropriate. A pain catheter is a thin plastic tube that is placed near a nerve and through which an analgesic can be delivered directly to the nerve. If necessary, our analgesic service is available around the clock to optimize therapy.

I am afraid of paraplegia with spinal anesthesia.

Local anesthesia procedures close to the spinal cord, such as spinal or peridural anesthesia, are very safe as long as appropriate contraindications are observed. Damage occurring with these procedures is almost exclusively caused by impaired blood clotting, resulting in the formation of a hematoma that presses on the spinal cord. For this reason, regional anesthesia close to the spinal cord cannot be used if certain anticoagulant medications have been taken or if you have a coagulation disorder, e.g., a genetic predisposition. If you have any such predispositions, please inform the anesthesiologist of this during the informative consultation. During this discussion before the anesthesia, the anesthesiologist will decide whether a spinal or peridural anesthesia is an option for you or not.

What happens if the effect of the local anesthetic wears off before the end of surgery?

In general, local anesthesia is dosed in such a way that its effect lasts sufficiently long for the duration of the operation. The effect of the anesthesia does not end abruptly, but rather wears off continuously over a longer period of time. If the operation takes considerably longer than planned, pain therapy can be supplemented intravenously. Catheter-based procedures are also possible in local anesthesia. These allow continuous administration of the anesthetic to the corresponding nerves. If local anesthesia is not sufficient, it is also possible to switch to general anesthesia (" full anesthesia") at any time.

I want to be absolutely unaware of anything during the surgery. Can I still receive local anesthesia?

The use of local anesthesia procedures does not necessarily mean that they have to be "wide awake". It is true that the big advantage of local anesthesia is that there is no need for anesthesia with the associated suppression of the protective reflexes and the respiratory passages. Nevertheless, it is also possible to sleep during local anesthesia. For this purpose, well-tolerated, short-acting drugs are used to help you sleep.

I was very nauseous after my last surgery. Is that avoidable?

Thanks to modern anesthetic drugs, the incidence of postoperative nausea is much lower today than it was a few years ago. Nevertheless, some patients experience nausea and vomiting after the end of anesthesia, depending on their predisposition and previous surgery. If this is already known from previous operations before the start of the operation, we will, on the one hand, as far as possible select anesthetic medications that contribute particularly little to nausea and, on the other hand, already administer prophylactic medication against nausea during the anesthesia. Therefore, please let us know if such problems have occurred during previous anesthesias. Even after the end of anesthesia, fast-acting medications against nausea and vomiting can be administered, for example, in the recovery room or in the intensive care unit.

Can anesthesia worsen existing neurologic deficits?

During general anesthesia, higher brain functions such as memory are suppressed. As soon as the effect of the medication wears off, these functions also return. In the case of pre-existing diseases of the central nervous system, this process can also take a longer time. A disturbance of thinking ("delirium") lasting several days can occur after major surgical interventions and especially in patients with pre-existing conditions (e.g., dementia). However, according to current findings, this seems to be independent of the anesthesia, but rather depends on the type of surgery. Often, previously undetected dementia becomes apparent during a hospital stay, as the patient has to leave his familiar environment.