Your physician, surgeon, and anesthesia care team will determine what type of sedation or anesthesia you receive during your surgery at DASC.

Your anesthesia will be provided by the anesthesia care team. This includes an anesthesiologist and a nurse anesthetist. Anesthesia for local and IVCS cases is provided by the physician or operating room nurse.

Your vital signs will be continuously monitored during your procedure. Your entire health care team will individualize your care.

We want to make your experience as positive and comfortable as possible. Please feel free to ask any questions or express any concerns you may have.

Types of Pain Management

Local

Patients who have a local procedure do not receive any IV sedation, but receive numbing medication at the surgical site.

Anesthesia and conscious sedation

If you have intravenous anesthesia (IVA), general, or regional anesthesia you will have the opportunity to talk with a member of the anesthesia care team either over the phone or at a preoperative (pre-op) interview on a day before your procedure.

Intravenous conscious sedation (IVCS)

If your physician orders IVCS for your procedure, you will have an IV inserted in the pre-op area. You may receive several medications through your IV, including a narcotic such as Fentanyl, for pain control. You may also receive a relaxing medication, such as Versed.

Intravenous anesthesia (IVA)

Your surgeon and anesthesia team may decide on IVA anesthesia for your surgical procedure. With this type of anesthesia, an IV will be inserted in the pre-op area. You could receive several medications through your IV. These could include a narcotic, such as Fentanyl, for pain control, and a relaxing medication, such as Versed.

There are various levels of sedation ranging from awake and comfortable to sleeping soundly. This sound sleep often mimics general anesthesia, but it is not to be confused with general anesthesia, which is often called being “put to sleep.”

Regional anesthesia (Block)

Your surgeon and anesthesiologists may recommend regional anesthesia as a choice for your procedure. In addition to the IVA anesthesia, your anesthesiologists may place some numbing medication into the nerve area to block any sensation or pain for a period of time.

General anesthesia (GA)

Some surgical procedures require general anesthesia. Often with general anesthesia you will receive your IV in the pre-op area. You may receive a variety of medications depending on factors such as the type and length of your surgical procedure.

You may receive several medications through your IV, including a narcotic such as Fentanyl, for pain control. You may also receive medications to help you relax, such as Versed. Other medications may be given, such as Propofol, which is used to “put patients to sleep.”

In addition, you may receive inhalation agents, referred to as gas. There are also various medications that may be given to help prevent nausea. Your physician may also request that an antibiotic be given.

With general anesthesia you will require some type of airway assistance, again depending on factors such as the type and length of the procedure.

Post-Surgery Care and Medications

A variety of medications may be given to you during your care at Davis Ambulatory Surgical Center (DASC). Your medications are selected specifically for you by your surgeon or anesthesiologist.

Following your surgery or procedure, you will be taken to the post-anesthesia care unit (PACU). After awakening, you will be given something to drink and asked about your level of pain.

Many factors are considered to determine the type of medication you may be offered. Such factors may include your type of surgery and anesthesia, allergies, pain scale, and nurse’s evaluation. Below is a summary of some of the medications more commonly given.

Narcotic medications

Narcotic medications are used frequently after surgery. They are given to patients who need analgesia for moderate to severe pain. These medications bind with opiate receptors in the central nervous system altering your perception of and emotional response to pain.

All narcotics may cause drowsiness, lightheadedness, nausea, vomiting, and constipation. It is advised to take narcotic medications with food in order to lessen nausea. Increasing the fiber and fluids in your diet will help to decrease constipation. Avoid driving and making important decisions during this time.

It is important that patients prescribed a CPAP machine previously continue to use it during narcotic ingestion.

Examples: oxycodone (Percocet), hydrocodone (Vicodin) acetaminophen with codeine (Tylenol with codeine), propoxyphene (Darvocet), merperidine (Demerol), hydromorphone (Dilaudid), and morphine.

Many of these narcotics contain acetaminophen (Tylenol), such as: Percocet, Vicodin, and Tylenol with codeine. Do not take acetaminophen when taking these medications. Most narcotic medications can be given in tablet, injection, or liquid form.

Non-steroidal, anti-inflammatory medications

Non-steroidal, anti-inflammatory medications (NSAIDS) may also be given to decrease pain. These medications are different from narcotics in that they produce anti-inflammatory, analgesic, and antipyretic effects.

Advise your doctor if you have peptic ulcer disease, asthma, or kidney problems while taking these medications.

Examples: ketorolac (Torodol), ibuprofen (Advil), naproxen sodium (Aleve), and mobic (Meloxicam).

Antiemetic medication

Antiemetic drugs are given for prevention of nausea and vomiting. Many times these type drugs are given during and after surgery. These medications may cause headache, drowsiness and dry mouth. Make your doctor aware if you have asthma, glaucoma, seizure disorder, or kidney problems.

Examples: ondansetron (Zofran), dolasetron (Anzemet), and metoclopramine (Reglan).

Antihistamine medication

Antihistamine drugs are given for allergies and also to prevent nausea and vomiting. They compete with histamine for h1 receptor site on effector cells. These medications may cause sleepiness, dry mouth, and photosensitivity. Advise your doctor if you have asthma, glaucoma, seizure disorder, or take the medication lithium.

Examples: diphenhydramine (Benadryl), promethazine (Phenergan), and cetirizine (Zyrtec). If taking these medications at home, take with food, avoid alcoholic beverages, driving, and dangerous activities. Use sun block while outside.

On occasion Phenergan may be given along with a narcotic in order to prevent the nausea and vomiting associated with taking narcotic medications. Phenergan may also be given in suppository form.

Non-narcotic, analgesic, and antipyretic

Non-narcotic analgesic and antipyretic medications, such as acetaminophen (Tylenol) and ibuprofen (Advil), are what you may take at home for pain and fever. The action of these medications produce analgesia by blocking pain impulses and also decrease fever by affecting the hypothalamic heat-regulating center.

They do not cause sleepiness and can be taken in tablet, caplet, suppository, and liquid form. With children, a Tylenol suppository may be given during surgery. This helps with postoperative pain control.

Your PACU nurse will inform you if this was done and advise a time that the next dose of the medication may be given if needed.

Examples: ketorolac (Torodol), ibuprofen (Advil), naproxen sodium (Aleve), and mobic (Meloxicam).

Antibiotics

Antibiotics are given intravenously during surgery if ordered by the surgeon. This is done to prevent infection and promote healing. Your PACU nurse will advise when to take your antibiotic at home, if given.

Steroids

Steroids decrease inflammation. It is not clearly defined how this works but is thought to stabilize leukocyte lysosomal membranes. In surgeries where edema (swelling) may be a problem, steroids may be given. Occasionally a steroid may be given to prevent nausea and vomiting as well. Steroids are usually administered during surgery and may be repeated in the PACU area.

Examples: decadron (Dexamethasone) and prednisone.

This information may not include all medications that may be given to you during your visit to DASC, therefore address any questions or concerns to a member of your care team.