Editor’s Note: This story is Part 3 of a 4-part series about surgery. Part 1 covers pre-admission, Part 2 covers the pre-operative process and Part 4 covers post-surgery.

A crucial part of any surgery is anesthesia. But anesthesia can also be confusing, with patients sometimes wondering if they’ll remember anything about the procedure and how they’ll feel afterward.

Below, Dr. Kathleen Roman, an anesthesiologist at UCHealth Yampa Valley Medical Center, outlines what you need to know about anesthesia.

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Anesthesia options: The main types of anesthesia are general anesthesia, sedation and regional or local anesthesia. The most common is general anesthesia, in which medications are used to decrease pain and to induce a sleep-like state of unconsciousness so patients don’t have a memory of the procedure.

With sedation, medications relax patients and decrease their awareness, though patients may remember bits and pieces of the procedure. With regional or local anesthesia, only a specific area of the body is numbed. Epidural and spinal anesthesia, along with nerve blocks, are examples of regional anesthesia.

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Which type will be used? Before surgery, your anesthesiologist will discuss options, choosing the most appropriate method based on factors such as the type of surgery, the surgeon’s preferences and the patient’s preferences.

“In some surgeries, there’s only one choice — with a laparoscopic abdominal surgery, we’d only use general anesthesia,” Roman said. “With other surgeries, such as putting in a port for chemotherapy, we can do local, sedation or general anesthesia, so we can often leave those up to the patient to determine what they prefer.”

Health review: Before surgery, the anesthesiologist asks the patient various questions about their medical history, current medications, allergies and previous issues with anesthesia.

“We often say the second anesthesiologist has an easier job,” Roman said. “Everybody reacts to anesthesia very differently, so knowing what a patient’s experiences have been in the past is very important to us.”

Roman encourages patients to ask questions through the process.

“We definitely welcome questions,” Roman said. “We do feel like it’s a collaboration between us and the patient to get the best result. We want them to understand what’s going on so we’re all on the same page as far as expectations.”

Starting surgery: While sedation may be given in the pre-op area, full general anesthesia is started in the operating room after monitors are placed and oxygen is given.

During surgery, the anesthesiologist never leaves a patient’s side.

“We stay with them the entire time, watching trends of vital signs and making sure they stay relaxed and comfortable,” Roman said.

Blood pressure, heart rate and oxygen saturation are among the many vital signs that are continuously monitored.

As the procedure is wrapping up, the anesthesiologist will decrease and turn off the anesthesia medications so that a patient will wake up shortly after surgery is complete.

After surgery: The patient is transferred to a room in the Post Anesthesia Care Unit (PACU), where the anesthesiologist continues monitoring vital signs.

“We make sure they’re breathing really well on their own and like them to be able to open their eyes and follow a command or two,” Roman said.

Some patients who receive sedation or local anesthesia remember aspects of the surgery, but most of the time, patients don’t remember a thing. “Anesthesia kind of shuts the brain down for a period of time so you’re not feeling the procedure,” Roman said. “Some patients don’t remember going to a recovery room.”

Even if anesthesia isn’t a memorable part of surgery, it’s a critical one.

“We keep people safe and comfortable throughout surgery, and we are there the entire time with them and into recovery,” Roman said.

Susan Cunningham writes for UCHealth Yampa Valley Medical Center. She can be reached at cunninghamsbc@gmail.com.