The day prior to surgery you will be given a number to call to find out the time you should arrive at the hospital. They will give you the location to come to and check in.
Once checked in the medical assistant will bring you into the pre-operative holding area where a stretcher will be. They will ask you to change out of your clothes into a hospital gown and collect your belongings, typically with the help of a security guard if there are valuables. A nurse will then greet you and collect information such as home medications, allergies, pain level, etc.
Anesthesia (see below) will then come introduce themselves and discuss the details of what type of anesthesia will be given. An IV will be placed and medication will be given to help with pain during the surgery. Your surgeon or PA will then come and get the consent for surgery and answer any last minute questions you may have regarding your procedure.
Multiple people, including Dr. Gomoll, will ask you what procedure will be performed, and what joint he will operate on, which can be confusing to some patients. We of course know what procedures and joints are involved, but we want to make absolutely sure for your safety.
Once you have been marked and the consent completed, operating room staff will come to bring you back into the room. Most OR rooms are cold but they will provide you with warm blankets to keep you comfortable. A brief time out is performed once you are in the room to make sure everyone is in agreement of the surgery being performed and allergies confirmed, and the correct side the surgery will be on. Anesthesia will then give medication to put you to sleep.
Anesthesia
Spinal
Spinal anesthesia is the most common from of anesthesia utilized at HSS. Similar to an epidural during child birth, the anesthesiologist injects medicine into the spine to numb your body from the waist down. In addition, they will provide a twilight sleep where you breathe on your own, but are not aware of anything going on in the operating room. The benefit of spinal is that you wake up more easily and quickly than after general anesthesia.
General
General anesthesia is sometimes used instead of spinal anesthesia. During general anesthesia the entire body, including the brain is anesthetized. The patient has no awareness, feels nothing and remembers nothing of the surgical experience afterward. General anesthesia is administered by injecting a liquid anesthetic into a vein, or by breathing a gas anesthetic flowing from an anesthesia machine to the patient through a mask or tube. A plastic endotracheal tube or a mask placed over the airway is frequently used to administer gas anesthetics. With the tube in place, the airway is protected from aspiration of stomach fluids into the lungs. It is normal to have a slight sore throat after your surgery.
Regional
Injection of anesthetic into the neck region for shoulder surgery, or thigh region for knee surgery blocks pain impulses before they reach the brain. General anesthesia will be provided in addition to make you comfortable throughout the surgical experience. To receive the injection, you lie down while the anesthetic is injected. To make placement of the needle almost painless, your skin is first numbed with local anesthetic. This anesthetic may last for 6 to 8 hours and sometimes longer. It is important to start taking your postoperative pain medicine as soon as you begin to feel the onset of discomfort or when the numbness begins to wear off.
** Your anesthesiologist will speak with you directly prior to surgery to review your choice of anesthesia