This is a neurosurgical anesthetic procedure being performed. The topic of anesthesia was discussed during last week’s “Meet the Physicians” program at the Peter White Public Library. (Mining Journal stock photo)

MARQUETTE — Being under general anesthesia is a strange thing: You’re alert one second, out the next. And when you reawaken, hopefully you’re a healthier person.

Explaining the various procedures available in today’s medical world was anesthesiologist Maureen McNeely, who gave the presentation, “Anesthesia & Your Anesthesiologist,” Wednesday at the monthly “Meet the Physicians” medical lunch-and-learn series at the Peter White Public Library. The series is sponsored by UP Health System-Marquette and the library.

McNeely, who is sub-specialized in pediatric anesthesia, asked a basic question: What is an anesthesiologist?

“The simple answer is that we provide anesthesia care, and that means we’re responsible for the medical management and anesthetic care of the patient throughout the entire duration of the surgery or whatever procedure you’re having,” McNeely said.

This means having to match the anesthetic needs of the patients to their medical conditions, their responses to anesthesia and the types of surgery they’re undergoing. An anesthesiologist also controls breathing, blood pressure and heart rate.

Then what is anesthesia?

“It’s a temporary or induced loss of sensation, and sometimes, alertness,” McNeely said. “It can include analgesia, which is loss of pain; amnesia, which is loss of memory; paralysis, which means that you’re really relaxed, all your muscles are relaxed; and unconsciousness.”

Not all anesthesia is the same.

McNeely discussed the various types, starting off with a familiar one.

A local anesthesia is basically a numbing medicine like novocaine or lidocaine that anesthetizes a very small spot and usually is performed in an office, she said.

“When you have dental work done, they use a local anesthetic,” McNeely said.

Nurse sedation is medicine given by a trained nurse to make the patient drowsy and give mild to moderate relaxation and pain relief from certain procedures, such as an endoscopy.

Similar to nurse sedation is monitored anesthesia care.

“This is medicine that makes you very sleepy and often times near unaware,” McNeely said.

The method is given by an anesthesia team to provide moderate to intense relaxation and pain relief. The patient is awake fairly quickly following this type of anesthesia, which is used for procedures like carpal tunnel syndrome surgery or a colonoscopy, she said.

Regional anesthesia involves local anesthetics to focus on a large region of the body, such as an arm or a leg. McNeely noted this often can be combined with monitored anesthesia care or general anesthesia, and is used for things like a broken bone or shoulder surgery.

“Oftentimes we use it for post-operative pain relief,” McNeely said. “These blocks can last up to 24 hours and sometimes a little bit longer.”

Neuraxial anesthesia involves an epidural or a spinal. Again, local anesthetics are placed around the nerves of the central nervous system, she said, which are around the back and spine. Procedures such as knee replacements and cesareans involve a spinal anesthetic that wears off, while an epidural catheter can be put in place and the patient kept as numb for as long as needed.

Sometimes monitored anesthesia care is used with this type, and sometimes the patient is awake.

General anesthesia involves complete loss of consciousness and sedation.

“That’s usually what people think of when people are like, ‘Oh, I’m going to have anesthesia,'” McNeely said. “People just assume you’re going to have a general anesthetic.”

A breathing device is almost always used, and patients are kept asleep by anesthetic gases. General anesthesia can be applied either through a mask, or an IV or intravenous induction.

However, the procedure doesn’t end with the anesthetic’s administration.

“What happens when you’re sleeping?” McNeely asked. “That’s the part nobody knows about because they’re sleeping, right? That’s the big mystery.”

What happens is the anesthesia team performs a lot of monitoring during the patient’s slumber time.

“We monitor your heart rate and rhythm, your blood pressure, your oxygen level, your temperature — we like to make sure you don’t get too cold — and your breathing,” McNeely said.

She also stressed a lot of communication takes place between the anesthesia team and the surgeon to know what’s going on and what that surgeon, or whoever is performing the procedure, needs from the team.

“Mostly, we keep you safe,” McNeely said. “If something unexpected happens, we take care of it so that the surgeon can keep doing their job and we can wake you up safely.”

She acknowledged that some discomfort can occur after monitored anesthesia care, for example, and someone who underwent general anesthesia might have a sore throat or have nausea.

“We try really hard to prevent you from vomiting,” McNeely said. “Occasionally, it still happens.”

However, she said medicines can be given before the procedure to prevent patients from becoming sick. “Non-routine” medications can be administered to people with a history of becoming nauseated from anesthesia.

To prepare for anesthesia, McNeely recommends patients refrain from eating or drinking after midnight to make for an easier time in the operating room.

“We don’t say that just to be mean because we want you to starve until we bring you back to the OR,” McNeely said. “It’s because any contents that you have in your stomach could potentially come up and get into your lungs when you’re under anesthesia, so we want that to be empty.”

She suggested people stop smoking several weeks before surgery –they will feel better afterward, not to mention the medical team wants them to not smoke anyway. Patients also should take off jewelry, take care of loose teeth and remove long facial hair.

Even the Mayo Clinic noted on its website, mayoclinic.org, that smoking can increase the risk of complications during surgery. Other conditions that can up the risk include seizures, obstructive sleep apnea, obesity, high blood pressure, diabetes and a history of adverse reactions to anesthesia.

It also was noted, though, that the risks generally are related not to the anesthesia but the surgery itself.

The next “Meet the Physicians” program is scheduled for Aug. 16 in the Shiras Room at PWPL. The featured speaker will be Dr. Tyanne Dosh who will talk about “Optimizing Your Mental Health.” The event is free.

Christie Bleck can be reached at 906-228-2500, ext. 250.