General Anesthesia
Pain management depends on the surgery that requires the colpotomy, and may involve local, regional, or general anesthesia.
Doctors who specialize in anesthesia are always present during an operation to make sure the the anesthesia they have administered to the patient is going well, as planned. There may be surgeries where the anesthesia requires an adjustment of some kind. Therefore the anesthesiologist must be present at all times.
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General anesthetics cause a lowering of the blood pressure (hypotension), a response that requires close monitoring and special drugs to reverse it in emergency situations
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Circumcision can generally be completely with general anesthesia in 15 to 20 minutes. However keep in mind that circumcision is generally not covered by most health insurances plans when it is not a medically necessary procedure. General anesthesia requires the presence of an anesthesiology in addition to the doctor performing the surgery.
Surgical excision is the only way. This can be done by as outpatient surgery under local anesthesia and requires as little as 1 or 2 stitches.
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The anesthesia provider is responsible for keeping the patient anesthetized during surgery and vigilantly monitoring their vital signs, ABCs (airway, breathing, circulation) while the patient is under anesthesia or sedation. They monitor fluid input and output; placing IVs or central lines as necessary to deliver IV fluids, drugs, or blood or blood products during surgery. General anesthesia requires the anesthesia provider to intubate the patient, which is to place a breathing tube through the mouth into the trachea, or "windpipe," which remains in place during surgery. Surgery can be done with general anesthesia, regional anesthesia (spinals, epidurals, or peripheral nerve blocks), or monitored anesthesia care (MAC), which was formerly known as "local [anesthesia] with sedation." The anesthesia provider is responsible for the patient's care during the initial post-operative period in the recovery room. They determine when the patient is ready for extubation (removal of the breathing tube), which is usually -- but not always -- done in the operating room after the patient is awakened from general anesthesia, but before they go to the recovery room (or "PACU," post-anesthesia care unit).
The necessary steps of preparation vary depending on the extent of the surgery. For example, if the procedure is short and requires only local anesthesia, no steps are truly necessary. However, if general endotracheal anesthesia is to be used, one should be sure to fast before the surgery.
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