What is CAG?
CAG is Columbia Anesthesia Group based in Vancouver, Washington. The group is made up of anesthesiologists who are all either certified or in the process of certification by the American Board of Anesthesiologists. This means they are “board-certified”. (back to top)

What is anesthesia?
Anesthesia is a mix of medicines, vapors, or gases that renders a patient pain free for surgery. There are three types: general, which causes unconsciousness; regional, which affects a certain area of the body; and local, which affects a very small specific area. (back to top)

May I choose my anesthesiologist?
This question is a very common one as today more and more patients search for medical specialists. Many people find their doctors through recommendations from other doctors or through family and friends and the same situation exists when choosing your anesthesiologist. You do have a choice as to who your anesthesiologist will be. However, you must make that choice known to your surgeon in advance so that arrangements may be made to honor your request. In most situations no request exists and your anesthesiologist will be assigned by a member of Columbia Anesthesia Group. (back to top)

Are there different kinds of anesthesia?
There are three main categories of anesthesia: general, regional and local. Each has many forms and uses.

In general anesthesia, you are unconscious and have no awareness or other sensations. This is what is described as “going to sleep.” There are a number of general anesthetic drugs. Some are gases or vapors inhaled through a breathing mask or tube and others are medications introduced through a vein. During anesthesia, you are carefully monitored, controlled and treated by your anesthesiologist, who uses sophisticated equipment to track your vital signs. A breathing tube may be inserted through your mouth and frequently into the windpipe to maintain proper breathing during this period. The length and level of anesthesia is calculated and constantly adjusted. At the conclusion of surgery, your anesthesiologist will reverse the process and you will regain awareness in the recovery room.

In regional anesthesia, your anesthesiologist makes an injection near a cluster of nerves to numb the area of your body that requires surgery. You may remain awake, or you may be given a sedative. You do not see or feel the actual surgery take place. There are several kinds of regional anesthesia. Two of the most frequently used are spinal anesthesia and epidural anesthesia, which are produced by injections made with precision in the appropriate areas of the back. They are frequently preferred for major orthopedic procedures. Regional anesthesia is sometimes combined with general anesthesia to help provide better pain control after your surgery.

In local anesthesia, the anesthetic drug is usually injected into the tissue to numb just the specific location of your body requiring minor surgery, for example, on the hand or foot. (back to top)

May I request what type of anesthesia I will receive?
Yes, in certain situations. Your anesthesiologist, after reviewing your individual situation, will discuss any available options with you. Together with your anesthesiologist, you will determine the most appropriate anesthetic plan.

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Why are so many questions asked about my past and present medical conditions?
Because anesthesia and surgery affect your entire system it is important for your anesthesiologist to know as much about you as possible.

Your anesthesiologist is not only responsible to make you comfortable during your procedure, he or she is also responsible for your medical care during the entire course of surgery. Therefore, it is important to know exactly what medical problems you have and any medications you have been taking recently since they may affect your response to the anesthesia. You also should inform your anesthesiologist about your allergies, any drug or alcohol usage, and past anesthetic experiences.

Your anesthesiologist must be very familiar with your medical condition so that the best anesthetic and medical care may be provided throughout your operation. This will help prevent complications, and expedite diagnosis and treatment of any medical problems should they occur. Your continued medical management during surgery is necessary to help facilitate your speedy recovery. (back to top)

What are the risks of anesthesia?
All operations and all anesthetics have some small risks, and they are dependent upon many factors including the type of surgery and the medical condition of the patient. Fortunately, adverse events are very rare. The specific risks of anesthesia vary with the particular procedure and the condition of the patient. You should ask your anesthesiologist about any risks that may be associated with your anesthesia.

To help anesthesiologists to provide the best and safest patient care possible, national standards have been developed by the American Society of Anesthesiologists to enhance the safety and quality of anesthesia. Specific standards already have been developed regarding patient care before surgery, basic methods of monitoring patients during surgery and patient care during recovery. New standards continue to be developed to further ensure patient safety. These standards, along with today's sophisticated monitoring and anesthesia equipment as well as improved medications and techniques, have contributed enormously toward making anesthesia safer than ever before.

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Will I wake up during my surgery?
Every individual patient responds to anesthetic drugs a bit differently. In extremely rare cases, patients will remember (“recall”) parts of their experience when they were supposed to be "asleep." In most instances it is just a fragment of a conversation they heard; sometimes there are sensations of touch or movement. Rarely is there actual pain.

Most instances of recall occur in very ill patients or in people with massive hemorrhage having emergency life-saving surgery. Such patients cannot tolerate normal anesthetics as they can depress already stressed vital functions even further and could hasten death. Such patients get resuscitation first, anesthesia second. “Recall” even during these situations is uncommon. (back to top)