Anesthesia for Cancer Surgery

Anesthesia is the use of medicines to cause a loss of feeling or sensation during surgery or other procedures. This loss of feeling might only be in the surgical area, or you might lose consciousness (fall asleep).

Learn more about the types of anesthesia, when each is used and what recovery is like.

Depending on the type of surgery you are going to have, your surgeon will suggest a type of anesthesia. Sometimes, you may get to choose the type of anesthesia used.

Local anesthesia

Local anesthesia numbs only a certain area, so you won’t feel pain there. It is often used for minor surgeries, such as biopsies of areas near the surface of your body.

A needle is used to inject medicine into the area. This numbs the nerves that cause pain. You stay awake and usually feel only pressure during the procedure. You can usually go home soon afterward. 

Topical anesthesia

Topical anesthesia can cause numbness when rubbed or sprayed onto a body surface instead of being put in with a needle. For example, a spray is sometimes used to numb your throat before a scope is passed down to the stomach or lungs. Same as with local anesthesia, you can usually go home soon after the procedure.

Regional anesthesia

Regional anesthesia (such as a nerve block or spinal anesthesia) numbs a larger part of the body, but you stay awake. For example, a needle can be used to put medicine into an area around the spinal cord to affect certain nerves coming out of it.

A nerve block is an injection of medicine around the nerves in the arms or legs. Where the injection is given is based on the part of the body that needs to be numbed.

Regional anesthesia might be given as a single injection or an ongoing IV infusion. You stay awake, but you may be given something to help you relax. You will go to the recovery room after your surgery until the anesthesia wears off. 

Sedation 

Sedation medicine make you feel relaxed and sleepy. It may be given a pill or liquid by mouth or through an IV. Sedation might be given alone or along with local or regional anesthesia. It can make you more comfortable and reduce pain.

There are 3 levels of sedation:

Minimal sedation makes you relaxed. If you feel anxious or nervous, it helps you feel comfortable during a test or procedure. This level of sedation means you are awake during the procedure and can answer questions.

Moderate sedation reduces pain and makes you less aware of things around you. This is also called conscious or twilight sedation. You might be able to talk and respond to questions, or you might doze off.

Moderate sedation might be used for minor surgery, along with local or regional anesthetic. You might not remember the surgery and the time right after. You will be in the recovery room after surgery until some of the anesthesia wears off.

Deep sedation makes you unaware of the procedure. This usually means you can’t talk or answer questions. You may also receive pain medication to reduce any discomfort.

The medicines used for deep sedation might affect your memory so you don’t remember the surgery. You might be given oxygen or need a breathing tube to help you breath during deep sedation. You will go to the recovery room after surgery until some of the anesthesia wears off.

General anesthesia

General anesthesia puts you into a deep sleep so you are unconscious for the surgery. Because of the medicines given, you won't remember the surgery and the time right after is often very hazy.

What happens when you get general anesthesia?

You will be given general anesthesia in these ways:

• Through an IV line placed in a vein in your arm
• Through a face mask or tube in your windpipe, so you will breathe in the medicine
• Both of these methods

Anesthesia often begins to take effect in less than 1 minute. Once you are asleep, an endotracheal or ET tube is put in your throat to help you breathe during surgery.

Your heart rate, breathing rate, and blood pressure will be watched closely during the surgery. A doctor or nurse who specializes in giving anesthesia (either an anesthesiologist or nurse anesthetist) takes care of you while you are asleep. They will also keep track of your anesthesia level to make sure you do not wake up until the time is right.

The anesthesiologist will stop the anesthesia and take out the ET tube when your procedure is over.  

You might also be given medicine to help you wake up. Next, you will go to a recovery area (post-anesthesia care unit – PACU) until some of the anesthesia wears off. Specially trained nurses will take care of you as you finish waking up.

What are the possible side effects of general anesthesia?

Anesthesia is safe for most people. But as with any medicine, you might have side effects. They can include:

• Feeling groggy, sleepy, or confused
• Nausea or vomiting
• Shaking chills
• Itching
• Blurry vision
• Dry mouth or sore throat, especially if you needed a tube to help you breathe during the procedure
• Trouble emptying your bladder

These side effects usually go away on their own in the PACU. Your surgical team will help you manage them. The nurse in the PACU is there to watch how you are waking up and will decide if and when to offer you something to drink.

Serious complications of anesthesia are rare, but they include serious injury and death. The risks can be higher for older adults, especially people with severe heart or lung disease.

Another rare side effect is anesthesia awareness. This means a person briefly wakes up during the procedure or remembers what happened at times during surgery. This happens in no more than 2 out of every 1,000 people. Risk factors for anesthesia awareness are:

• Having emergency surgery
• Use of certain types of anesthesia
• Using certain medicines for a long time, including tranquilizers, opioids, and medicines called anti-convulsants
• Having excess weight or obesity
• Daily alcohol use

What is recovery from general anesthesia like?

It could take you some time to feel like yourself after general anesthesia. Your surgical team will let you know how long you need to be monitored after your surgery. This will depend on the type of surgery you had and your overall health.

Your reaction speed and judgment may be slow or different for a while after anesthesia. Avoid these activities for at least 24 hours after waking up from surgery: 

• Driving a car
• Operating other heavy machinery
• Making important decisions

Ask your health care team when you can start taking your regular medicines again. Also ask if you need to be careful about what you should eat and drink. For instance, you may have trouble digesting some foods. Start by drinking liquids and eating light food until you feel normal again. Examples of light foods include:

• Broth or soup
• Tea or black coffee
• Yogurt
• Gelatin
• Toast, crackers, or plain rice

If you feel you are having trouble recovering from anesthesia, contact your surgical team right away.

Who will give the anesthesia?

Who gives you anesthesia depends on the type of anesthesia you will receive.

Anesthesiologist.  An anesthesiologist is a doctor who specializes in giving anesthesia and caring for people while they are getting it. If you are receiving certain types of anesthesia, such as general anesthesia, an anesthesiologist will lead a team of professionals who will monitor you while you are having the procedure.

Certified registered nurse anesthetist (CRNA). This specially trained nurse might give your anesthesia and monitors your vital signs. They might work with the anesthesiologist or on their own.

Surgeon or other doctor.  In some cases, the doctor performing the surgery may administer the anesthesia themselves. This is especially true if it is topical or local anesthesia.

Anesthesia assistant. The assistant has a college degree and additional training in anesthesia care. They specialize in taking care of patients during and after anesthesia.

How to get ready for anesthesia

Your anesthesiologist may meet with you before you have general anesthesia and ask you some questions. They might meet with you before or on the day of your surgery. They will likely ask you:

• About your health, now and in the past
• What medicines, vitamins, and herbal supplements you take, including prescription and over-the-counter products
• If you have allergies, including to foods, medicines, and items like latex
• If you have had anesthesia before, and your experience with it
• If you use other drugs, alcohol, or tobacco
• If you have any loose teeth, dentures, or dental bridges. Some types of anesthesia mean that you might need help breathing and your mouth may be moved around. Your team will want to protect your teeth.

This information helps your surgical team give you anesthesia as safely as possible.

It is important to follow your surgical and anesthesia teams’ instructions. You will probably need to not eat anything for at least 6 hours before general anesthesia. You may be able to drink clear liquids until a certain time. Do not eat or drink anything unless your doctor tells you it is OK.

You might need to stop taking some of your regular medicines before general anesthesia. Some medicines can affect the anesthesia or your procedure. Ask your doctor which medicines you should take and which ones you should not take. Also, make sure you follow their instructions for starting the medicine again.