General anesthesia — everything you need to know before surgery

If you, or someone close to you, are about to have surgery under general anesthesia — it's natural to feel a little stressed and to have lots of questions.

"I know myself, I won't fall asleep."

In this video I'll walk you through 5 important things about general anesthesia: what it actually is, how to prepare properly, what happens on the day of surgery, what happens during the anesthesia and after — and at the end I'll answer some frequently asked questions, so you arrive as prepared as possible for that moment.

I'm Dr. Elisheva, I'm an anesthesiologist. Here you'll get clear, direct medical information — no scare tactics and no drama — so you can make informed decisions about your health.

Let's go.

## What is general anesthesia?

General anesthesia is a special sleep state we create by giving medications.

Under general anesthesia you don't feel pain, you're not aware of your surroundings, you can't wake up on your own, and the surgeon can work safely.

The anesthesia is made up of several medications — each with its own important effect: drugs that produce sleep, painkillers, muscle relaxants, and a few more, depending on the patient and the surgery. Some are given through the breathing tube, others through the IV.

It's also important to understand that anesthesia is a continuous process, given without interruption — it's not "one shot and done" — and the anesthesia is tailored to each patient based on their medical background.

## How to prepare for anesthesia

Before the surgery you might be invited to a pre-op meeting with an anesthesiologist.

The goal of that meeting is to explain the anesthesia and give you instructions for the surgery so you arrive in the best possible medical condition. Sometimes we'll also ask you to complete tests — blood work, ECG, chest X-ray, or whatever your case requires.

But in many hospitals, healthy adults with no underlying conditions only meet the anesthesiologist for the first time on the day of surgery — so it's important to highlight what you need to know in advance from home.

The most important is **fasting**: before surgery you must be fasting — 6 hours from food (and the last meal should be light and not fatty), and 2 hours fasting from clear liquids.

Pre-op fasting is mandatory and not up for negotiation. The reason: doing general anesthesia on a non-fasting patient raises the risk of complications during anesthesia. We won't go into all the details now, but I'll soon publish a video that explains in depth why fasting matters and what's allowed and forbidden before surgery — subscribe so you don't miss it.

**Your medications** — if you take regular medications, the instruction for the vast majority is to continue them as usual. But it's very important to check specifically about your own treatment, and in that case you'll usually be invited to a pre-anesthesia clinic for precise instructions.

Don't forget to bring any medical paperwork you have at home — tests, summaries — even things that seem irrelevant to you. They may matter to us. Bring everything to save time and prevent delays.

It's also important to arrive without jewelry, without nail polish, and without contact lenses — and with someone to accompany you, so bring along a person.

## What happens on the day of surgery — step by step

Sometimes you're admitted the night before to the ward, and sometimes you arrive directly at the operating room complex on the same day — what's called "day admission."

Either way, on the day of surgery you go through intake with a secretary and then with a nurse who'll ask a few questions and take vitals — pulse, blood pressure, temperature. After that you meet the anesthesiologist who will put you under for surgery. We'll ask a few questions about your medical background, and also confirm you're fasting — because I wasn't joking when I said this matters to us. A lot.

You'll also meet the surgeon and the nursing team, and when the time comes you go into the operating room and say goodbye to whoever came with you to that point.

In the OR itself we'll hook you up to monitoring — stickers on the chest for heart rate and rhythm, an oxygen saturation monitor on the finger, and a blood pressure cuff. At this stage we insert an IV — that's usually the only uncomfortable part — and we start giving the anesthesia medications through it. From that moment you're asleep within a few seconds. You won't even make it to ten counting.

And don't worry — you're not the one in a million, you will fall asleep.

(11, 12…)

## What happens during the surgery

During the surgery my job as an anesthesiologist isn't just to put you to sleep — it's to keep you stable, breathing, and well cared for throughout the operation. That means managing your breathing, balancing pain control so you don't wake up hurting, watching your blood pressure, heart rate, and the rest of your vitals, and constantly adjusting medications based on what's actually happening in the surgery.

So even while you're asleep — someone is managing your entire physiological side, continuously and precisely. (Hey, that's me — congratulations, you won me.)

It's important you know that the anesthesiologist doesn't step out of the room for a second. Our job is to monitor you throughout the entire surgery and anesthesia.

## What happens after the surgery

When the surgery is over, we stop giving the anesthesia medications, and they start clearing from your body gradually. We move you to the recovery area — at that point you're usually not awake enough to remember arriving there, and you'll only really start waking up after about fifteen to thirty minutes. But everyone wakes up at their own pace, and it's fine if it takes more or less time. Depending on the type and length of the surgery and your baseline health, the time it takes to fully "come back to yourself" can vary — but as a rule, after a few hours it'll usually feel completely behind you. That said, for the next 24 hours it's better to avoid driving and life-changing decisions — so this isn't the time to buy a house.

After general anesthesia you can have various mild and temporary symptoms — dizziness, nausea, muscle aches, dry mouth, a bit of a sore throat. These usually pass within the hours after surgery and aren't worrying.

In many surgeries we give medications during anesthesia to prevent nausea, and we can add more treatment in recovery if needed.

More serious complications — respiratory, cardiac, or life-threatening allergic reactions — can happen but are very, very rare, and we're right there to respond immediately and treat.

## Frequently asked questions

**Can I "accidentally" wake up in the middle of the anesthesia?** This is a very common fear. It's something that can in principle happen, but it's extremely rare — under 0.1% of cases. Even in those cases, the descriptions are usually from patients who remember some things said in the OR around the induction and emergence phases, without any sensation of pain. We have many monitors that help us be sure you are asleep.

**And what if I don't wake up from the anesthesia?** Like I said — every medical intervention carries some risk. But the chance of serious complications after anesthesia is very, very low. The role of the anesthesia team is also to respond immediately if something happens, and in the vast majority of complications we know how to treat.

**Will it hurt after I wake up?** During the anesthesia we give pain medications to manage pain, but sometimes there can still be some pain in recovery. In that case — tell the team right away so we can add painkillers.

**What's the difference between general and regional anesthesia?** Regional anesthesia is anesthesia of only one part of the body. It's sometimes performed as the sole anesthetic — and then you're awake but feel no pain during the surgery. Sometimes we do regional anesthesia in addition to general anesthesia, to control pain after surgery. For example, in an orthopedic surgery we might do general anesthesia plus a special injection that numbs only the nerves of the operated area, so you wake up pain-free. And if you're interested, I have a whole video on epidurals in childbirth — worth watching too.

If this video helped you, subscribe to the channel. If you have questions — write to me below and I'll answer.

See you in the next video!