Question 1

What is the difference between a nurse anesthetist (CRNA) and an anesthesiologist?

Accepted Answer

An anesthesiologist is a physician (MD or DO) who completed medical school followed by a 4-year anesthesiology residency. A CRNA is an advanced practice registered nurse who completed a nursing degree, gained critical care experience, then completed a master's or doctoral nurse anesthesia program. Both provide the full range of anesthesia services and can work independently or in teams. Research consistently shows that anesthesia outcomes are comparable between CRNAs and anesthesiologists. CRNAs are the primary anesthesia providers in many rural and underserved areas. The choice between a CRNA or anesthesiologist often depends on availability, facility practice models, and patient preference rather than safety considerations.

Question 2

Will I wake up during surgery or feel pain?

Accepted Answer

Awareness under general anesthesia is extremely rare, occurring in only about 1-2 cases per 1,000 anesthetics. CRNAs use multiple monitors to ensure adequate anesthesia depth, including brain wave monitors (BIS) in high-risk cases. They continuously assess vital signs for any indication of inadequate anesthesia and adjust medications accordingly. If you've had awareness during previous anesthesia or are concerned, tell your CRNA during your preoperative consultation - they can take extra precautions. With regional anesthesia (spinal, epidural, nerve blocks), you may feel pressure or movement sensations, but you should not feel pain. If you feel any discomfort, tell your anesthesia provider immediately - they can give additional medication.

Question 3

How do I know which type of anesthesia is best for my procedure?

Accepted Answer

Your CRNA will recommend the most appropriate anesthesia based on several factors: the type and duration of surgery, the surgical site, your medical conditions and risk factors, your preferences, and the surgeon's requirements. Some procedures are best done under general anesthesia (complete unconsciousness), while others are suitable for regional anesthesia (numbing a specific body area) or sedation. For example, cesarean sections are typically done under spinal anesthesia so mothers can be awake for delivery, while abdominal surgery usually requires general anesthesia. Your CRNA will discuss options, explain the pros and cons of each, and work with you to develop the best plan for your situation.

Question 4

What are the risks of anesthesia, and how are they minimized?

Accepted Answer

All anesthesia carries some risk, but serious complications are rare due to modern monitoring, medications, and training. Common side effects include nausea/vomiting (managed with anti-nausea medications), sore throat from breathing tube, temporary confusion in elderly patients, and mild discomfort at IV sites. Rare but serious risks include allergic reactions, aspiration (breathing stomach contents into lungs - prevented by fasting rules), nerve injury with regional anesthesia, and cardiac or respiratory complications. Your CRNA minimizes risks by thorough preoperative assessment, choosing appropriate anesthesia techniques, continuous monitoring during the procedure, and being prepared to manage any complications. Informing your CRNA about your complete medical history, including previous anesthesia problems and all medications, helps ensure the safest care.

Question 5

Why do I need to fast (not eat or drink) before surgery?

Accepted Answer

Fasting before anesthesia prevents aspiration, which occurs when stomach contents enter the lungs during anesthesia when protective reflexes are suppressed. This can cause serious pneumonia or lung damage. Standard guidelines typically require no solid food for 6-8 hours before surgery and no clear liquids for 2 hours before surgery (these times may vary based on your specific situation). CRNAs take fasting requirements seriously because aspiration, while preventable, can be life-threatening. In emergencies when patients haven't fasted, special precautions are taken including rapid sequence intubation. Always follow the specific fasting instructions given by your surgical team, and if you accidentally eat or drink, tell your anesthesia provider immediately - your surgery may need to be delayed for safety.

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