If your surgeon has scheduled you for surgery at Virtua-Memorial Hospital, Burlington Anesthesia Associates will be involved in your anesthesia care. Please read the following orientation to the surgical process here at VMH. We strongly feel that being more informed about your surgery will help improve your surgical experience and hopefully will help alleviate any anxiety which you may have regarding the surgical experience.

Prior to your surgery, you will come into contact with the Preadmission Testing Department of VMH. This department will help ensure that your surgery can occur when scheduled. You will either have a scheduled visit with the PAT department or at least a phone interview by a member of the department. The information gathered from the PAT department is reviewed by the Anesthesia staff prior to your surgery. The information gathered can include but is not limited to the following: scheduled surgical procedure, your medical history, surgical history, allergies, current medications, anesthesia history and any problems you or your immediate family may have had with anesthesia in the past, and various tests which may include blood tests, an EKG, Chest Xray, and/or other tests as deemed necessary.

 After review of the above information, the anesthesia staff will determine whether any additional tests, specialist consultation, and/or anesthesia interview is required prior to your surgery. Very rarely, this can delay your originally scheduled date of surgery. If you have any questions prior to your surgery, please ask a member of the PAT staff, who can either answer your question directly or refer it to the proper person (i.e. anesthesiologist, surgeon, cardiologist, etc.). The PAT staff will also provide pertinent instructions prior to your surgery (i.e. dietary restrictions day prior to/day of surgery, what medicines you should/should not take and when to stop if appropriate, etc.) These instructions are in addition to any instructions provided by your surgeon. It is very important that you follow these instructions because noncompliance can sometimes lead to delay or cancellation of your surgery.

On the day of surgery, you will first check in with the hospital secretaries who will get you registered. Once this process is completed, you will then be brought to the patient holding area. A member of the nursing staff will then meet you and ask a series of questions. You will get changed into a hospital gown once the nurses instruct you to do so. After or simultaneously with these questions, your vital signs will be taken and an IV will then be started. You will eventually meet your anesthesiologist who will briefly ask you relevant questions regarding your medical history and procedure. He/She will then discuss the options for anesthesia for your surgery. The anesthetic option chosen depends upon a multitude of factors including but not limited to your medical history, your scheduled operation, and the anesthesiologist’s preference and/or familiarity with a certain anesthetic technique. Occasionally, surgeon’s preference and patient preference can be considered in choosing which technique would be optimal. You and your anesthesiologist will decide which option will be best. Keep in mind that an anesthesiologist is trained to provide safe anesthesia care. At times, unfortunately, one does not have a choice regarding what type of anesthesia one will receive.

After your anesthesiologist has asked his/her questions, please ask any questions that you may have regarding your anesthesia and surgery. Once your questions have been answered, you will be given an anesthesia consent form and an insurance authorization form to look over and sign. Please take the time to read the consent form now. The anesthesia consent form goes over the specific anesthetic option that will be performed and lists various risks associated with each type of anesthesia. Keep in mind that most of the risks listed on the form are rare. This form is not meant to scare you, but merely to inform you that, as with anything in life, there are risks associated with anesthesia and surgery. Fortunately, in the modern era, anesthesia has become very safe and most complications of anesthesia are short-lived and not serious. Certain medical problems which you may have can influence risk of anesthesia and surgery. It is important that you are completely honest with your surgeon and anesthesiologist regarding your health so that a meaningful discussion about risk can take place between you and your anesthesiologist.

Once you have spoken with your anesthesiologist, you may or may not also meet a certified registered nurse anesthetist. Your anesthesiologist and CRNA work as a team to provide your anesthesia care. You will also see your surgeon or his representative prior to going to the operating room.  Please ask any surgical questions that you may at this time. Your surgeon may also ask you to sign the surgical consent form at this time if this wasn’t done previously.

After all the consents forms are completed, all your questions have been answered, and when the operating room is ready, you will be brought to the operating room. Once in the operating room, the nursing staff will first ask you some questions (you will have already heard these questions but these act as a final verification prior to your anesthesia). You will then be placed on the operating room table and monitors will be placed prior to your anesthesia (including but not limited to EKG, blood pressure, pulse oximeter, etc.). Occasionally, more complicated monitors may need to be placed for your surgery. These will be discussed with you by your anesthesiologist prior to your surgery. Your anesthesia will begin only when the anesthesiologist, nurse anesthetist, surgeon, and nursing staff are absolutely ready to begin.

After your surgery is completed, you will usually be brought directly to the PACU (Post Anesthesia Care Unit or recovery room). The PACU is staffed by full time nursing staff trained in caring for patients recovering from surgery. An anesthesiologist is responsible for your care while you are in the recovery room. Often, the doctors who will be caring for you in the hospital will also give orders to the recovery room nurses as well. You will remain in the PACU until the anesthesiologist feels it is safe and appropriate to release you. Where you go after the recovery room depends on the type of surgery you have undergone, your medical history, and/or any specific events that may have occurred either prior to or in the operating room which may necessitate increased postoperative care. If your surgery was minor and the anesthesiologist and surgeon feel it is safe and appropriate to do so, you may be released from the PACU to another area to prepare to go home. Your surgeon and the nursing staff will give you appropriate postoperative instructions prior to your release home. Otherwise, you will be released from the PACU to either a regular floor bed, a telemetry bed, or an ICU bed. These different areas of the hospital basically reflect differing amount of postoperative monitoring and nursing staff, with ICU beds requiring the most postoperative monitoring and nursing staff and regular floor beds requiring less. If you have any questions about where you will go after your surgery, please ask the anesthesiologist or surgeon.

It is our sincere goal to provide you with safe and state of the art anesthesia care. We will attempt to do this in the most comfortable way so that your surgical experience can be as pleasant as possible (although remember this is surgery so it is nearly impossible to make this a completely pleasant experience). Our staff will likely check on you on your first postoperative day if you are in the hospital. Please let the anesthesiologist (or your surgeon or primary doctor) know if you are experiencing any unpleasant symptoms after your surgery. Fortunately, complications related to anesthesia are rare and are usually minor and short lived if they do occur. However, complications can occur. If you feel that a postanesthesia complication may have occurred, please call our office (609-261-1660) and you will be forwarded to staff who can answer your questions. You can also contact your surgeon’s office who may be able to answer your questions directly or refer you to our staff if related to anesthesia. Fortunately, anesthesia complications are rare as stated above.

We, Burlington Anesthesia Associates, sincerely hope that your surgical experience here at Virtua-Memorial Hospital will be a pleasant one. If you have any questions at all (and no question is silly or stupid, remember), please do not hesitate to call or ask. We will strive to make your surgical experience as safe and comfortable as possible.