We understand that having surgery can be can be a very anxiety provoking experience, and we will try to alleviate much of this anxiety and make this day as easy and as pleasant as possible.
When you arrive at the MGH Orthopaedic Ambulatory Surgery Center (ASC), you will be greeted in the reception area and registered as a patient. You will then be escorted to the pre-operative prep area (also called the holding area). A member of the peri-operative nursing staff will admit you.
You will be asked to change into a gown or appropriate dress for your surgical procedure, the nursing staff will start an intravenous line in a vein and you will be asked several questions in preparation for your surgery. They will ask you: when you last ate or drank, if you took any medications that day, if you have any allergies to medications, foods, or latex, what the proposed surgery is to be and the side it is on, along with other administrative questions.
You will meet the Anesthesia Care Team (ACT) that consists of an Anesthesiologist, Certified Registered Nurse Anesthetist (CRNA) and may also involve a senior anesthesia resident from MGH. The Anesthesiologist and/or the resident will review your medical history, and then discuss the available options for your proposed surgical procedure if they have not previously been discussed in a pre-op phone interview. For more information concerning anesthetic options proceed to Anesthesia Options for your Surgery. You may also have already discussed these options with your surgeon during your pre-operative office visit. Together we will formulate an anesthetic plan. We will also discuss the possible side effects, risks and benefits of each type of anesthesia. If you have any questions, they will be answered and you will then be asked sign an anesthesia consent form.
Your surgeon or his representative will also meet you in the prep area and again review the planned surgical procedure. He will also mark the surgical site after answering any questions you may have.
The possible options for anesthesia will include local anesthesia with IV sedation (MAC), general anesthesia, regional anesthesia or a combination of anesthetics (e.g. regional anesthetic with IV sedation or light general anesthesia). If general or MAC anesthesia have been decided on, you will receive IV sedation and proceed directly to the operating room from this area. However if it is decided that you will receive a regional anesthetic technique, also called a nerve block, you will be sedated in your pre-op slot, and the nerve block will be performed there. After the nerve block is complete and the operating room (OR) and OR team is ready you will then proceed to the OR.
For a more in-depth discussions about a particular type of anesthesia see Anesthesia Options for your Surgery.
While in the operating room you will be under the care of the ACT. We will give you medications to make sure that you are comfortable during your surgery. Your blood pressure, heart rate, blood oxygen level, breathing and temperature will be monitored to insure a safe anesthetic course.
After your surgery, you will be transferred to the post-anesthesia care unit (PACU) also called the recovery room where you will be monitored by a team of PACU nurses under the supervision of the anesthesiologist. These nurses are specially trained in post-anesthetic and critical care. They will monitor your vital signs, help resolve any side effects from the surgery or anesthesia (e.g. nausea +/- vomiting) and assist in your pain management. For more information see Post-Anesthesia Care Unit. Once you are stable, comfortable and meet the discharge criteria, your intravenous will be removed and you can get dressed. The PACU nurse will then review your post-operative instructions with you and your responsible adult companion, review the instructions for your pain medication prescriptions, which can be filled here at our on-site pharmacy or on your way home, and then escort you to your vehicle.