“Will I wake up during surgery?” This is a question I get again and again from patients and for good reason – it’s a scary thought. The truth is: it’s a bit complicated, but you need not be afraid. Your anesthesiologist will review your case and medical history with you and your surgeon and decide which anesthetic option is best for your circumstances prior to surgery.
At HSS, there are two types of anesthesia you may hear about: regional and general anesthesia. Regional anesthesia is used to numb the site of surgery and, in doing so, stop any messages from the site of surgery to your brain. With regional anesthesia, you will not be kept awake during surgery – unless you want to be! Keep in mind that, if it is your preference, certain surgeries can be performed safely and pain free under regional anesthesia without any sedation. However, in the absence of certain significant medical conditions, there is almost always the option to be completely asleep with a regional anesthetic. I’ve found that close to 90% of patients prefer to be asleep for surgery. If this applies to you, your anesthesiologist will give you intravenous (IV) sedation – sometimes called twilight sleep. This sleep is comparable to the sedation you would be given for a routine colonoscopy.
With general anesthesia, your anesthesiologist uses medications to keep you in a deep sleep where your brain does not perceive signals from the site of surgery. It would be highly unlikely for you to be aware of anything happening in the operating room during surgery under general anesthesia. General anesthesia is routinely used in spine surgery and other select orthopedic cases. Rest assured that a member of our anesthesia team will be at your bedside throughout your surgery working hard to keep you safe and sleeping comfortably.
You, your surgeon, and your anesthesiologist will discuss your options and decide which anesthetic approach is best for you before surgery. If you have any questions or concerns about your upcoming procedure, please contact your surgeon’s office for a pre-anesthetic consultation.
Meghan Kirksey, MD, PhD, is an assistant attending anesthesiologist at Hospital for Special Surgery. Dr. Kirksey focuses on the management of cardiopulmonary sequelae of acute and chronic disease. She is dual-boarded in critical care medicine and anesthesia.