Certified Registered Nurse Anesthetists are advanced practice registered nurses that have completed a bachelor’s degree in nursing, worked in an intensive care unit for a minimum of 1 year, and graduated with a minimum of a master’s degree from a nurse anesthesia educational program accredited by the Council on Accreditation of Nurse Anesthesia Educational Programs.

Nurse anesthetists have been providing anesthesia care to patients in the United States for more than 150 years.  In that time, CRNAs have been recognized for providing safe, high quality, and cost-efficient care

CRNAs provide anesthesia in collaboration with physician anesthesiologists, surgeons, dentists, podiatrists, and other qualified healthcare professionals. When anesthesia is administered by a nurse anesthetist, it is recognized as the practice of nursing; when administered by a physician anesthesiologist, it is recognized as the practice of medicine.  When CRNAs and physician anesthesiologists work together collaboratively, it is known as the Anesthesia Care Team. 

Monitored Anesthesia Care/Sedation Anesthesia

Sedation anesthesia or twilight anesthesia is often used to supplement local anesthesia or regional anesthesia to increase patient comfort.  Medication is delivered through an IV and the goal is to make you comfortable/relaxed while being able to breathe on your own.  While receiving sedation anesthesia, it is possible to remember parts of the operating room (not the surgery) and the CRNA or surgeon speaking to you, but most often, you won’t remember anything at all.  However, if you do, this is not considered “awareness” or “awakening” under anesthesia.

Regional Anesthesia

Regional anesthesia is when a certain region of your body needs to be anesthetized in order to perform an operation.  The specific region of your body will be anesthetized by placing local anesthetics near the nerves that provide sensation to that region of the body.  Frequently, regional anesthesia is accompanied by sedation anesthesia to help make you comfortable throughout the operation.

• Peripheral Nerve Blocks (PNB’s)- PNB’s can be used as a primary anesthetic to numb an entire limb of the body or PNB’s can be used as an adjunct to a general anesthetic in order to significantly reduce the amount of pain you experience pre-operatively, intra-operatively, and post-operatively.
• Epidural Anesthesia- Epidural Anesthesia is the placement of a very small epidural catheter into a space in your back called the epidural space.  Medications are given through this catheter to provide numbness for the surgery or pain relief in the post-operative period.
• Spinal Anesthesia- Spinal Anesthesia involves injecting numbing medication into the fluid surrounding the nerves in your back. This numbing medication will block sensation, pain, and movement in your lower extremities for a period.  Spinal anesthesia usually works quickly and can last up to 4 hours after the procedure before it gradually wears off.

General Anesthesia

General anesthesia involves the induction of a complete loss of consciousness.  Complete loss of consciousness occurs by administering medication through an IV or by breathing anesthesia gas through a mask. Once loss of consciousness occurs, a breathing device is inserted into your mouth to assist with breathing.  Throughout the surgery, medication will be administered to keep you comfortable and to prevent you from becoming nauseous.  At the end of your operation, the breathing device will be removed.

It is common for patients to be nervous about pain in relation to their medical condition and their surgery.  Making your pain tolerable is a high priority to us.  We can help control your pain before, during, and after surgery.  We can help control your pain through the use of nerve blocks and/or IV medication throughout the entire peri-operative period and will work diligently to develop a pain management plan that will keep you safe and comfortable.

Anesthesia providers at Granville Medical Center provide 24-hour Obstetrics anesthesia service and epidural placement/management for laboring mothers to keep you and your baby comfortable and safe.

Types of Anesthesia for Obstetrics

Epidural Anesthesia

Around 70% of laboring mothers in the United States receive an epidural to help manage the pain of contractions and delivery during labor.  Epidural Anesthesia is the placement of a very small epidural catheter into a space in your back called the epidural space.  Medications are continuously given through this catheter to provide numbness and pain relief during your labor and delivery. 

Spinal Anesthesia

Spinal Anesthesia for laboring mothers is usually used during c-sections and involves injecting numbing medication into the fluid surrounding the nerves in your back. This numbing medication will block sensation, pain, and movement in your lower extremities for a period.  Spinal anesthesia usually works quickly and can last up to 4 hours after the procedure before it gradually wears off.

General Anesthesia

General anesthesia in obstetrics is normally used only in emergency situations when there is insufficient time to perform spinal anesthesia, your epidural is not adequate, or if you have a condition that prevents use of a spinal or epidural anesthetic.  General anesthesia involves the induction of a complete loss of consciousness.  Complete loss of consciousness for c-sections occurs by administering medication through an IV.  Once loss of consciousness occurs, a breathing tube is inserted into your mouth to assist with breathing.  Throughout the surgery, medication will be administered to keep you comfortable and to prevent you from becoming nauseous.  At the end of your operation, the breathing device will be removed.

Nerve Block

For mothers who have undergone c-section and have required a surgical incision, we offer an injection of numbing medication into the abdomen that will provide pain relief after surgery.  This injection will provide you pain relief for many hours and will reduce the amount of pain medicine needed after surgery.

Anesthesia for C-section

There are multiple factors that influence the choice of anesthesia for a C-section, but they are usually done under epidural or spinal anesthesia. You are numb from the level of the nipple line down but will remain awake during the birth of your baby and your partner may be present.

If your baby needs to be delivered quickly due to an emergency or if epidural/spinal anesthesia is not adequate, general anesthesia will be required.

Before Surgery

You will undergo Pre-Anesthesia Testing (PAT) prior to the date of your procedure.  This testing will involve obtaining your health history and your home medication list.  It’s possible depending on the complexity of your health history that you may need to have additional testing such as: blood tests, EKG’s, or x-rays.  It is important for us to complete a thorough examination in order to provide the best possible care for you.

Day of Surgery

The morning of your surgery, you will meet your pre-op nurse and your anesthesia team.  Your anesthesia team will consist of a Physician Anesthesiologist and CRNA.  Your health history will be reviewed, and the appropriate anesthetic plan will be made at this time. The risks, benefits, and alternatives of the anesthetic plan will be discussed with you. Any and all your questions regarding your anesthetic plan will be answered.

There are multiple factors that are considered when choosing your plan for anesthesia.  Your health history, the type of surgery, and the plan for management of pain will all be considered while developing the best plan to keep you safe and comfortable.

During Surgery

You will be closely monitored and cared for throughout the surgery.  You will have either a CRNA or Physician Anesthesiologist or both throughout the entire procedure monitoring your heart rate, blood pressure, and breathing in order to keep you safe.

After Surgery

After surgery you will be accompanied by an anesthesia provider to the Post Anesthesia Care Unit (PACU) where you will be monitored and cared for by a PACU nurse.  During this time, the PACU nurse and an anesthesia provider will work together to ensure that your needs are met.  You will spend 30 minutes- 2 hours in recovery before you are discharged home or to another location in the hospital if you are in inpatient.