General Anesthesia FAQs
Obstetrical Anesthesia FAQs
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Your obstetrician may provide intravenous medications to help relax you and provide pain relief. If you wish for a more complete method, anesthesiologists may be called in to provide regional anesthetics in the form of either an epidural, a spinal or both.
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It is a local anesthetic delivered through a small catheter placed in the small of the back near the spinal canal. It is generally considered one of the most effective methods for patients wishing for significant pain relief but wanting to be awake and able to participate in the birth.
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It is similar to an epidural but, because anesthetic is injected directly into the spinal canal, the effects are felt faster. It is more difficult to move and push via this method, however, due to greater numbness. For this reason, the epidural is the more popular method.
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People on blood thinners or with a history of bleeding disorders, those with nervous system disorders, with an infection in the back or those with a history of back surgery and/or spinal abnormality may not be good candidates for these methods of pain relief. If you have specific questions about whether you are a candidate, you should be sure to discuss this with your anesthesiologist.
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The epidural will not be placed until you are in active labor (usually at least 4-5cm dilated). You will have already been administered several liters of intravenous fluid, such that at least 1-2 liters have been given. You will be asked to position yourself on your left side or in a sitting, fetal-like position. The skin of your back will be wiped with an antiseptic solution to reduce the chance of infection. Following injection of a local anesthetic, a needle will be placed through the numbed area and into the epidural space of your spine. A catheter is then inserted through the needle and left in place after the needle is removed in order that an anesthetic may be administered continuously. The catheter is removed after the baby is born. The effects generally last 1-2 hours after catheter removal.
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Risks include severe headaches, inadequate pain relief, and/or allergic reaction to the medication. Epidurals may inhibit the ability to push in some patients, which may increase the chances of a forceps delivery (a procedure which carries its own set of risks). Additionally a sudden, and possibly dangerous, drop in the blood pressure of the mother and/or baby can occur. This can usually be easily treated but, for this reason, periodic blood pressure monitoring is required. Finally, although rare, additional unexpected but severe complications may also occur. Accidental injection into blood vessels resulting in seizures, inadvertent injection into spinal canal causing temporary but total paralysis, a broken needle or catheter which may require surgical removal, post delivery back pain, weakness or paralysis of the lower part of the body, bleeding and/or infection are all unusual but distinct possibilities.
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Since all medical information is retained by the facilities where we practice, we follow the privacy policies of those facilities.
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Insurance companies often take 60 days or more to process claims. In some cases, they request additional information, which can restart the review process multiple times. Because of this, it may take several months after your procedure before you receive a bill from us.
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Your insurance plan may include a deductible, copay, or coinsurance that you are responsible for. If we are out-of-network with your insurance or have difficulty obtaining payment, we may ask for your help in contacting your insurer to help resolve the balance.
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Some insurance companies send payment directly to patients for anesthesia services. If you receive a check related to your care with CASE, please contact our billing office before depositing or cashing it, at 916-481-6800. In many cases, the payment may need to be forwarded to our office to apply toward your account balance.
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Yes, the hospital or surgery center will send you a bill for the facility services, and you will also receive a bill from your surgeon. If you have certain tests or procedures, you may receive separate bills for services such as radiology, pathology, cardiology, or other physician services.
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We are here to help. Before your surgery, please contact us at (916) 481-6800 for pre-pay and self-pay options. Or click on the link to pre-pay.
Patient Billing FAQs
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Anesthesiologists are physicians who have specialized training in providing pain control and caring for the general well-being of the patient in the operating room. They monitor your vital signs (heart rate, blood pressure, respiratory rate, etc.), administer medications to ease pain and avoid recall, monitor your fluids and act as your advocate while you are unable to do so for yourself. S/he will monitor and record all of these things and make adjustments as necessary (and in accordance with your pre-identified preferences) to provide you with the safest and most comfortable outcome possible. At a minimum, anesthesiologists have completed four years of college, four years of medical school and four years of internship/residency before starting to practice in our group. Many of our anesthesiologists have completed additional training and fellowships in such areas as chronic pain management, pediatrics, cardiothoracic and obstetric anesthesia.
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Informed consent means that you have been presented with your treatment options and that the most common risks and possible side effects have been explained. You will have an opportunity to ask questions and, if you wish to proceed with anesthesia, to sign an informed consent indicating that this process has occurred. Clearly, in extreme emergencies it may be necessary to waive this step.
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In some cases, multiple options may be medically appropriate. In these instances, your anesthesiologist will be happy to consider your preferences if you make them known during the pre-operative discussion.
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There is a risk of aspiration if there is anything in the stomach when anesthesia is given. Aspiration means that the contents of the stomach end up in the lungs and this can be life-threatening. This is why it is most important to follow the instructions given and to tell your anesthesiologist if you have had anything to eat or drink (including a sip of water or coffee) during the time period for which they ask.
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It is not uncommon to have a sore throat for a few days, especially if you had a breathing tube placed. Dental injuries are also a possibility, especially if you have been less diligent about preventive dental care and/or have artificial dental devices such as caps or bridges. This is not necessarily related to anything that the anesthesiologist did. In some instances, it may be impossible to insert a breathing tube quickly, especially in someone with a small mouth, without touching any teeth. Just as frequently, dental injuries may occur during the “wake-up” phase, when you may roll over or bite down on a tooth that is fragile, causing it to crack or break. Again, these situations are rare, but certainly not impossible.
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As with any other medical procedure, results cannot be guaranteed. Unexpected reactions or complications may occur. Patients with apparently similar medical conditions may have varying responses to certain anesthetics or procedures. Possible risks include, but are not limited to allergic reactions; infection; pneumonia; inflammation of the veins; nerve injury or paralysis; damage to or failure of the heart, liver, kidneys and/or brain; and death. These more severe complications are highly unlikely but can occur in some cases, regardless of the experience, care and skill of the anesthesia provider.
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Since all medical information is retained by the facilities where we practice, we follow the privacy policies of those facilities.