Preparing for Spine Surgery: What to Expect from General Anesthesia

If you’re preparing for spine surgery, you probably have questions about everything from the procedure and recovery to the general anesthesia that will be used during the operation. While it’s completely normal to be nervous about going under general anesthesia, you can ease your concerns and gain peace of mind by becoming informed about the process and risks associated with it.

General Anesthesia 101: What You Can Expect

General anesthesia is a combination of medications administered before surgery or another medical procedure to put you in a sleep-like state without pain. In most cases, general anesthesia uses a combination of intravenous (IV) drugs and inhaled gasses like nitrous oxide and anesthetic gasses. Here’s what you can expect before, during, and after spine surgery with general anesthesia.

Before Surgery

Fasting is usually necessary anywhere from 6-12 hours before surgery to avoid potential complications. Having food in the stomach when anesthesia is administered can cause nausea, vomiting, and aspiration. Follow your doctor’s instructions regarding avoiding food and drink to minimize these risks. Your instructions may say you are able to drink clear fluids until a few hours prior to surgery.

Your doctor will tell you whether or not to take your medications the night before and morning of the operation. Aspirin/blood thinners may need to be avoided for at least a week beforehand because these can cause serious complications during surgery.

During Surgery

Once in the operating room, anesthesia medications are delivered via an IV in your arm and sometimes through a gas mask before the procedure. Once you’re asleep, an anesthesiologist will likely insert a breathing tube to ensure you get enough oxygen. A sore throat or hoarse voice may occur from this tube and will go away after a few days. The anesthesia team may also place additional IVs or an arterial line (usually in your wrist and similar to an IV but placed in an artery instead of a vein). This allows close monitoring of your blood pressure and a way to check blood work throughout the procedure. 

The anesthesiologist then closely monitors you throughout the surgery and makes adjustments to your medications, oxygen, and fluids as needed. Many people express concerns about the potential of waking up during surgery, which is referred to as anesthesia awareness. While it’s possible for this to occur, it’s incredibly rare—only one or two of every 1,000 patients¹ experience anesthesia awareness.

Certain medical conditions and surgeries increase the risk of anesthesia awareness because the normal dose used cannot be given safely. Emergency C-sections, certain types of heart surgery, and surgery after a severe traumatic injury can all lead to increased risk of awareness. Your physician anesthesiologist will meet with you prior to your spine surgery to discuss any health conditions you may have and your previous experiences with anesthesia, to optimize your anesthetic plan.

After Surgery

After surgery is finished, the anesthesiologist will reverse or turn off the medications to wake you up slowly. Upon waking up in the recovery room, you may temporarily experience a few common side effects, such as:

• Dry mouth
• Nausea
• Vomiting
• Sore throat
• Grogginess
• Muscle aches
• Shivering
• Dizziness
• Itching
• Spinal surgery patients may also notice swelling of their face/lips from lying on their stomach for the procedure and receiving fluids (this is normal and will go away.)

If you experience any of these side effects, let your team know so they can treat them.

Anesthesia Risk Factors to Consider Before Surgery

While anesthesia is very safe overall, the risk of complications is closely linked to your general physical health. Certain conditions and can increase your risk of complications from anesthesia during surgery, such as:

• Smoking
• Obesity
• Seizures
• Sleep apnea
• Diabetes
• Heart disease
• Lung disease
• Kidney disease
• Hypertension
• Stroke
• Family history of anesthesia problems

Older adults and/or anyone with a history of heavy alcohol use, drug allergies, or adverse reactions to anesthesia have a higher risk of complications. If you fall into one of these groups, you should speak with your surgeon before moving forward with spine surgery. For most healthy patients, the risk of driving to the hospital is actually higher than their risk from general anesthesia.

Going under anesthesia may be somewhat nerve-wracking when you’re preparing for spine surgery, but you can ease your concerns by discussing the process, side effects, and risk factors in advance. Before you know it, you’ll be waking up and well on your way to recovery—and to living the pain-free, active lifestyle you love.

While this blog is meant to provide you with information to support your well-being while considering or waiting for spinal surgery, it is not intended to replace professional medical care or provide medical advice. If you have any questions about the information given, please ask your doctor, who is the only one qualified to diagnose and treat your pain and spinal condition.

References: 

1 Anesthesia Awareness (Waking Up) During Surgery,” Anesthesia 101: Effects of Anesthesia, American Society of Anesthesiologists, accessed July 30, 2020,  https://www.asahq.org/whensecondscount/anesthesia-101/effects-of-anesthesia.