What is pre-anesthesia testing (PAT)?

Pre-anesthesia testing is done before the day of surgery, either by phone or in person. It is an assessment of your medical conditions and general health in order to provide you with a safe anesthetic. You may also need specific laboratory testing prior to surgery, depending on your medical conditions. Some common questions asked during PAT visit include personal or family history of anesthetic complications, medication history, pertinent medical conditions, prior surgical experience, allergies, and a noninvasive airway examination. PAT is performed by one of our experienced nurses.


I am told to not eat or drink anything after midnight. Why?

When you are under anesthesia (either sedation or general anesthesia), your ability to cough and swallow is reduced. This puts you at risk for inhaling stomach content, which can result in a lung infection. By refraining from eating or drinking for at least eight hours before anesthesia, your stomach remains empty therefore minimizing this risk.


But can I take my morning medications before arrival?

Your surgeon and/or PAT nurses will advise you on medications you should take on the day of surgery. Please take that with small sips of water.


My surgery is scheduled for 9 am and my surgeon’s office told me to come to the hospital at 7:30am. It seems like I will be waiting for a long time. Why is this necessary?

It is important that you arrive 1.5 hours before surgery for all the necessary preoperative preparations. You will need to verify your information at the registration desk on arrival. Then you will proceed to the surgical waiting room, where you will be escorted to the preoperative holding area by your nurse.


What happens in the holding area?

Once you are in the holding area, your nurse will check your vital signs and review the information you had provided to the PAT nurse. You will then meet your entire team of surgeons, anesthesiologists, and nurses. The anesthesiologist will also review your information once more, obtain your consent for anesthesia, and place an IV.


During my last surgery, several people in the holding area asked me the same questions multiple times. Why?

While we have your health information in our electronic medical record system, some questions are repeated or confirmed multiple times to ensure your safety before, during, and after your surgery. These questions include allergy information and side and site of surgery. Only the most vital information will be asked repeatedly.


My surgeon told me I will have a 'MAC anesthesia'. How is this different from general anesthesia?

General anesthesia makes you completely unconscious – and is necessary for some surgical procedures.

MAC stands for monitored anesthesia care, which is moderate-to-heavy sedation provided by an anesthesiologist or certified nurse anesthetist. This is different from sedation provided by trained nurses in medical procedures such as colonoscopies. MAC is suitable for many types of surgeries performed at Beth Israel Deaconess Hospital–Needham. Your anesthesia team will discuss with you the appropriate type of anesthesia for your surgery.


I’ve heard that I need a 'nerve block'. Can you explain?

We provide regional anesthesia for many of our patients and for a variety of surgeries. The types of regional anesthesia include

Spinal anesthesia

This is an injection that we administer to provide surgical anesthesia from the waist down. This is most commonly used in joint replacement surgeries and pelvic surgeries.

Epidural anesthesia

An epidural catheter is placed in your back to provide anesthesia along the torso. This is sometimes used in abdominal and chest surgeries. This is also used to provide continued pain relief after some abdominal and thoracic surgeries.

Peripheral nerve block

This is most commonly used in orthopedic surgeries and usually performed under ultrasound guidance. Peripheral nerve block reduces pain in a specific area. Your arm or leg will be numb for the surgery and the immediate postoperative period (usually 6-8 hours). With nerve blocks, recovery is typically faster with reduced chance for nausea, vomiting and sedation.


What should I expect after waking up from anesthesia?

You will spend some time in the recovery room where our nurses will monitor you for any symptoms associated with the surgery and anesthesia. In general, you will be quite drowsy. You will be given pain and anti-nausea medication during surgery, but a small number of patients may have mild to moderate discomfort or nausea afterwards. We will administer additional medications to improve your comfort. 

For same day surgery, you will be sent home with a responsible adult and your surgeon will give you a prescription for pain medication. Your recovery room nurse will review specific discharge instructions with you and your family member. You will receive a phone call from our nurses the next day to see how you are doing.