TAMG
TAMG - Torrance Anesthesia Medical Group, Inc.

3330 Lomita Boulevard, Torrance, CA 90505
Telephone: 310-517-4759. Fax: 310-517-4658

About Anesthesia

  1. What is an anesthesiologist?

    2. An anesthesiologist is a physician with specialized training to allow patients to undergo surgical and medical procedures such that pain and physiologic changes are monitored and controlled. Anesthesiologists go to college for four years, medical school for four years and anesthesia residency for four years with the option of receiving even more specialized training in a fellowship after residency. Then anesthesiologists have to pass both a written and oral exam to become board certified in anesthesia.

  2. Are there different types of anesthesia?

    3. Local anesthesia can be used for procedures that are relatively minor and can be performed using a minimal amount of intravenous medication. Generally, the surgeon can numb the site of operation with a local anesthetic such as lidocaine. Then the anesthesiologist can inject some intravenous medication to cause relaxation and/or make you drift in and out of sleep. Your anesthesiologist will give you the appropriate amount of medication to make sure that you are comfortable.

    Regional anesthesia involves performing a nerve block, spinal or epidural to numb a larger region of the body. You might be awake for the procedure or you might receive some intravenous medications that will relax you. Your anesthesiologist will use local anesthetic delivered by a very small needle prior to performing the block.

    General anesthesia involves using intravenous and/or inhalational agents to cause you to be unconscious. Your anesthesiologist will control your vital signs, monitor multiple organ systems, possibly control your breathing with a breathing tube, and administer a variety of medications including anti-nausea medications, antibiotics and pain medications.

  3. Is anesthesia safe? What are the risks of anesthesia?

    4. Fortunately, with the advancements in medicine and monitoring, anesthesia is very well tolerated. Your specific risks are dependent on the type of surgery you are having as well as your medical history and how well optimized each medical condition is. Generally, risks can include but are not limited to simple things such as nausea, vomiting, sore throat, or dental damage, to more severe things such as allergic reactions, respiratory depression/obstruction, aspiration, heart attack, stroke, end-organ failure and even possibly death. However, anesthesiologists rigorously train to safely minimize all of those risks.

  4. What is a spinal?

    5. A spinal involves using a small needle to inject medicine into the fluid area surrounding your spinal cord at the level of your lower back to cause numbness from just below your chest down to your lower extremities.

  5. What is an epidural?

    6. An epidural involves using a small needle to introduce a small, soft catheter into the space just outside the fluid surrounding the spinal cord. The epidural catheter can be used to continually administer medication during the procedure as well as for several days after the procedure to provide pain relief. Epidurals are usually used for pregnant women who are in labor or for surgical procedures involving large incisions to the abdomen or lower extremities.

  6. What are the risks of a spinal or epidural?

    7. The risks include but are not limited to bleeding, infection, minor back pain, headache, lowering of blood pressure, shivering, urinary retention, incomplete anesthesia and very rarely, nerve damage.

  7. What is a nerve block?

    8. A nerve block involves injecting local anesthetic around a specific nerve or bundle of nerves. This is usually performed under visual guidance using a high resolution ultrasound. The nerve block will not only provide pain relief during the surgery, but also assist with post-operative pain management. Generally, nerve blocks are used for orthopedic surgical procedures.

  8. What are the risks of a nerve block?

    9. The risks include but are not limited to bleeding, infection, local anesthetic toxicity and very rarely nerve damage.

Preparation

  1. Should I continue to take my medications prior to surgery?

    2. It is important to tell your doctors about the medications you are taking prior to surgery so that they can be involved in whether you continue or stop these medications.

    Some common medications of particular interest include the following:

    • Aspirin and Plavix are drugs that are used to prevent blood from clotting. They are used to treat patients with certain disorders of the heart and blood vessels. Because of the way aspirin and Plavix work, they can cause increased bleeding when you undergo surgery. If you are taking either of these drugs, you should talk to your primary care physician about stopping them before surgery. The decision to stop aspirin or Plavix is based on the reason why you need to be on the drugs and on the risk of bleeding from the surgery.
    • If you are currently taking blood thinners such as Coumadin, Heparin, Lovenox, Pradaxa or Fragmin, discuss this with your surgeon and/or the health care provider who manages this medication (usually your family physician or specialist). Discontinuing the medication depends on your medical condition, surgery, and past medical history.
    • Diuretics ("water pills") are commonly prescribed for treating high blood pressure. This class of drugs can cause changes to important electrolyte levels, such as potassium. If you take diuretics, your anesthesiologist may perform certain laboratory testing before surgery.
    • Diabetic patients are commonly treated with insulin or oral agents. Your primary care provider or surgeon may decrease your usual morning insulin dose or discontinue your oral agents before surgery.
    • For your safety, herbal medicines should be stopped one week before surgery. These may interact with anesthetics and/or lead to increased bleeding.

    Always speak with an anesthesiologist or your regular doctor to discuss your particular medications before any surgical procedure.

  2. How can I minimize my anesthetic risks?

    3. One of the most important things you can do to keep yourself safe is to have a thorough preoperative discussion with a member of our anesthesia team. It is an opportunity to provide your anesthesiologist with information vital to your care and for you to express your wishes about anesthesia and postoperative pain control. Your medical history is important. Mention any adverse reactions to anesthesia in yourself or your parents, siblings, or children. Anesthesia reactions can run in families, and some hereditary disorders need special attention.

    Bring a list of all the prescription and over-the-counter medications you take. Make note of any allergies. Be sure to report any loose teeth, dentures, or crowns as they could be damaged if a breathing tube is placed.

    The preoperative interview is a good time to learn what to expect when you wake up from surgery. For example, some anesthetics are more likely to produce nausea or headaches than others. It's also wise to find out how long the effects of anesthesia may last. Depending on the type of anesthesia, you may be advised not to drink alcohol, drive a car, or operate any complex machinery for at least 24 hours following anesthesia.

    Some additional suggestions:

    • Be involved in your own care and ask questions. Make sure your consent form is accurate and be involved in the process of clearly marking the intended surgical site.
    • Refrain from eating or drinking for at least six hours prior to your surgery.
    • If you have a pacemaker or implantable cardioverter-defibrillator, bring your device card or know your device maker.
  3. Why can I not have anything to eat or drink prior to receiving anesthesia?

    4. It is very important that patients have an empty stomach before any surgery or procedure that requires anesthesia. When anesthesia is given, it is common for one's normal reflexes to relax, increasing the likelihood of the stomach contents to go backwards into the esophagus, mouth, or even the windpipe and lungs. If this regurgitation occurs, it could cause a serious infection of the lungs.

Day of Surgery

What to Expect

  1. Preoperatively

    2. Once you check into the hospital and complete some paperwork, you will meet one of our preoperative nurses. They will have you change into a hospital gown, obtain a medical history, record your vital signs, place an intravenous line and draw blood to obtain pertinent labs.

    Before surgery, an anesthesiologist will meet with you, evaluate your medical condition, perform a focused physical exam, formulate an anesthetic plan that is appropriate for you and address questions and concerns you may have.

  2. Intraoperatively

    3. During surgery, advanced technology is used to monitor your body's functions and your anesthesiologist will interpret these sophisticated monitors in order to diagnose, regulate, and treat your body while a personalized, delicate balance of anesthetic medications is administered.

  3. Postoperatively

    4. After surgery, your anesthesiologist will reverse the effects of the anesthetic medications you received and return you to consciousness once again, safely and comfortably. You may be drowsy when awakening from sedation. You will be transported to a specialized recovery area called the post-anesthesia care unit (PACU) where specialized nurses will closely monitor you. You will then stay in the PACU until you have met the appropriate criteria for discharge to home or to your hospital room.

Pediatric Anesthesia

  1. How many hours before surgery should my child stop eating or drinking?

    2. The most recent guidelines set forth by the American Society of Anesthesiologists suggests the following for healthy patients undergoing elective surgery:

    • Solid food: 6 hours
    • Breast milk: 4 hours
    • Clear liquids (e.g. water, apple juice): 2 hours

    It is very important that patients have an empty stomach before any surgery or procedure that requires anesthesia. When anesthesia is given, it is common for one's normal reflexes to relax, increasing the likelihood of the stomach contents to go backwards into the esophagus, mouth, or even the windpipe and lungs. If this regurgitation occurs, it could cause a serious infection of the lungs.

  2. Can I accompany my child into the operating room when she has surgery?

    3. Your anesthesiologist recognizes the importance of fostering a nurturing environment of comfort and calm prior to surgery. Although parents are not allowed into the operating room with children, we are committed to making the peri-operative experience as least traumatizing as possible. To that end, our anesthesiologists may prescribe sedation to be given to your child (usually by mouth) by the nurse prior to surgery.

  3. Could my child need anesthesia or sedation for an MRI?

    4. Magnetic resonance imaging (MRI) is a special type of imaging study that uses a strong magnetic field to take detailed pictures of the body. For children, an MRI study can prove challenging since it requires holding very still, typically for 30-60 minutes. Sedation may be needed to complete the study. Our anesthesiologists will examine your child before the MRI and discuss with you the best options based on your child's medical history and anesthesia needs.

Obstetrics Anesthesia

  1. When can I receive an epidural during labor?

    2. The decision on when to receive an epidural is a joint decision made by you, your anesthesiologist and your obstetrician. It depends on multiple factors, including your pain level, how dilated you are, and whether this is your first pregnancy.

  2. Can an epidural during childbirth harm my baby?

    3. Generally, medications given through an epidural will have very little effect on your baby. An epidural may lower your blood pressure which might affect your baby, but you will receive fluids prior to your epidural to minimize any decreases in blood pressure.

  3. How can the epidural affect my labor?

    4. An epidural may slow the progress of your labor, but you will likely receive medicine from your obstetrician to speed up your labor. Also, your anesthesiologist can adjust the rate of your epidural infusion according to what you specifically need.

  4. Does placement of the epidural/spinal hurt?

    5. Your anesthesiologist will make every effort to make you comfortable during placement of the epidural or spinal. Your anesthesiologist will inform you during each step of the process and will use a local anesthetic to numb the skin. Generally, placement of the epidural/spinal is no more painful than placement of your IV.

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