Sinus Surgery and ENT Procedures

Ear, nose, and throat (ENT) procedures, also known as laryngology, are performed at Wilmington Hospital, Christiana Hospital, and Christiana Care associated ambulatory surgery centers.

In 2006, the Christiana Care Health System designated a special center for ENT and especially sinus surgery at Wilmington Hospital.  The Christiana Care ENT / Sinus Surgery Center has a team of dedicated surgeons, nurses, anesthesia providers, and support personnel working together to give exceptional care before, during, and after surgery.  The center has advanced technology for such surgery including the computer-guided VTI InstaTrack system which gives a three dimensional picture of the surgical field.  This allows the surgeon to know precisely the patient’s unique anatomy by direct vision and simultaneously through CAT scan images. This system greatly improves the safety of sinus procedures which are in close proximity to the brain and the eyes.  In addition to the InstraTrack system, the Center has both Argon and Carbon Dioxide lasers for various ear and throat procedures.  Other types of surgery at this specialty include tonsil surgery, sleep apnea surgery, hearing/vertigo surgery including cochlear implants, and salivary gland surgery.

Who are the anesthesia providers who will give me anesthesia?

Your anesthetic will be provided by members of the “Anesthesia Care Team” composed of an Anesthesia Doctor, called an Anesthesiologist, and an Advanced Practice Nurse in anesthesia, called a Certified Registered Nurse Anesthetist (CRNA). All anesthesia doctors here are nationally board certified in the specialty of anesthesia or are board eligible.  Members of your anesthesia team will be always with you during your anesthetic and will not leave your side until you are safely taken to the wake-up area know as the recovery room (Post Anesthesia Care Unit).

What kind of anesthesia will I receive?

The recommended anesthesia for your surgical procedure will depend on your medical history and the type of surgical procedure.  For most ENT procedures including sinus surgery, general anesthesia is needed to insure your safety and to provide your surgeon with the best operating conditions. During general anesthesia, you are completely asleep.  The degree of your anesthesia sleep is usually measured by specialty monitors called BIS monitors which assure us that you are safely asleep and that you will have no awareness during anesthesia. Your anesthetic is designed to allow you to wake up into a comfortable state.

While you are asleep, your anesthesia team will be continuously monitoring your vital signs for your safety. And they will continuously give you anesthesia drugs in solution through an intravenous and as an anesthesia vapor mixed with oxygen enriched air that you breathe during the procedure. At the end of surgery, waking up occurs quickly by simply stopping the administration of these drugs.

For some ENT procedures, general anesthesia is not required and a lighter type of anesthesia is sufficient. This lighter type of anesthesia is called Monitored Anesthesia Care (M.A.C.).  During this type of anesthesia you will be in a relaxed state throughout the procedure and stay pain free.  You may doze lightly but will not be deeply asleep.

Will I later have any undesirable effects from the anesthesia?

It is difficult to predict if you will have any undesirable effects after anesthesia.  Every patient is different. However, fortunately, the common undesirable effects presenting after having anesthesia with surgery are not life threatening and are short lived.

You may have nausea and vomiting which we treat with fast acting drugs through the intravenous. However, we will significantly reduce the chance of this happening by giving you drugs to prevent nausea and vomiting before you awaken from your anesthetic. You may have a sore throat which can happen after you have general anesthesia.  Although you will not be aware of this, during general anesthesia a plastic breathing tube is usually put in your mouth while you are sleep to assure your safety.  If you have a sore throat, it generally will be mild and be gone after two days.  You may have a feeling of fatigue after receiving anesthesia.  This could last for several days and is due to several causes among them are residual small levels of anesthetic drugs, medicine for pain taken after surgery, and the response of your body to the healing process.

What happens in the recovery room?

You will wake up from anesthesia just before you leave the operating room, but you will be somewhat sleepy.  You will go to the recovery room known as the Post Anesthesia Care Unit (PACU) where you will become more alert.  You should be comfortable, but as you spend time in the recovery room, you may begin to experience some discomfort from the surgical procedure as the anesthetic pain medications begin to wear off.  Specialized, highly trained recovery room nurses will give you pain medication through the intravenous to help maintain your comfortable state.  To assure your safety here, we will continue to monitor your blood pressure, your heart rhythm, your breathing, and your temperature as well as monitor the surgical site for its appropriate appearance.  Anesthesia staff are immediately available to evaluate and treat changes from expected behavior.  The surgeon would be contacted immediately to evaluate any changes associated with the surgical procedure.  Your safe recovery from surgery and anesthesia is the primary goal of the recovery room team of nurses and anesthesia physicians. After one to two hours, usually you will be discharged from the recovery room to an area where you will get ready to go home or to an overnight room in the hospital