June 17th, 2008 Submitted by Dr. James Split
Anesthesiologist
Chapel Hill Tubal Reversal Center
At Chapel Hill Tubal Reversal Center, we use general anesthesia for our tubal reversal surgeries. You will be completely asleep through your operation. When under general anesthesia, you will be totally unconscious and will not be able to feel any pain. In addition to the general anesthetic, your tubal reversal surgeon will place local anesthetic into the skin and deeper structures that are operated on to help you be as comfortable as possible when you wake up.
You will have an IV started after you arrive at the surgical center on the morning of your tubal reversal procedure. After you arrive in the operating room, we will give you an intravenous sedative similar to Valium to help you relax prior to going to sleep. We will take a blood pressure reading and then ask you to take several deep breaths of oxygen through a loosely applied face mask. We will put a sedative medication into your IV line that will make you fall asleep very quickly, usually in 10 to 20 seconds. We will keep you asleep during your surgery by having you breathe an anesthetic gas. During your operation, you will be given additional IV medications to prevent post-operative nausea and vomiting, and to minimize pain when you awaken.
We usually place a soft airway in your mouth after you are asleep. This airway is positioned behind your tongue to keep your airway open. This allows us to be sure you always have a safe open passageway for oxygen to enter your lungs. This airway goes into your mouth after you are asleep and is removed when you awaken. Most patients do not remember having a soft airway in their mouth, but some patients will have a scratchy or sore throat for 12 to 24 hours after surgery.
The anesthesiologist or nurse anesthetist will always remain with you while you are asleep. Throughout your tubal reversal procedure, we will monitor your blood pressure, heart rate, temperature and oxygen concentration in your bloodstream. You will awaken quickly after your surgery. Most patients are able to move themselves off the operating room table onto the stretcher to be taken into the recovery room.
Sometimes patients ask if they can have conduction anesthesia such as an epidural. We do not use epidural as outpatient anesthesia because of the risks involved. The method of general anesthesia that we use is safer than conduction anesthesia in the outpatient setting and less likely to cause a complication requiring hospitalization.
April 18th, 2008 Introducing James Split MD
It is a happy occasion to introduce another new member of the staff of Chapel Hill Surgical Center. Dr. James Split is a Board Certified Anesthesiologist. He has worked at Chapel Hill Surgical Center since December 2007. He previously lived and worked in Greensboro, North Carolina for the last 18 months. Before moving to North Carolina, Dr. Split practiced medicine in Michigan for 25 years. He obtained his medical degree at the University of Michigan in 1979 and practiced Emergency Medicine for the first 11 years of his career. He both practiced and taught Emergency medicine in an Emergency Medicine Residency and held a clinical faculty position at Michigan State University. In 1990, he returned to the University of Michigan to train in anesthesiology. He completed his anesthesiology residency in 1993 and has been in the full time practice of anesthesiology since then. Dr. Split is a member of the American Society of Anesthesiologists and The Society for Ambulatory Anesthesia.
Dr. Split will be speaking with many of you as part of your pre-operative evaluation. If you have any general questions about anesthesia, you can add comments to this blog or post them on the Tubal Reversal Message Board and he will to answer them. If you have specific questions that require privacy, or that may not be of interest to others, please send Dr. Split an e-mail to DrSplit@tubal-reversal.net and he will respond.
Dr. Berger’s Comment
The highest priority for patients who come to me for tubal reversal surgery to untie tubes is patient safety during and after surgery. This is ensured by the involvement of medical professionals who are the most highly trained and qualified specialists. Our two anesthesiologists are certified by the American Board of Anesthesiology. The anesthesiologist is the physician responsible for the monitoring and care of patients while they are asleep during their tubal reversal procedure and for their safe and comfortable recovery in the post anesthesia care unit (PACU). Dr. Split’s background in Emergency Medicine gives him an added dimension of knowledge and experience. On behalf of all of our staff, I am very pleased to welcome Dr. Split to Chapel Hill Surgical Center and Chapel Hill Tubal Reversal Center.
December 5th, 2007 Chapel Hill Tubal Reversal Center Anesthesia Team
The Anesthesia Team at Chapel Hill Tubal Reversal Center ensures your comfort before, during, and after your tubal reversal procedure. We are Caryn Hertz, MD, Pamella Mills, CRNA, and Ann Pflugrath, MD. Our team consists of two board certified anesthesiologists and a registered nurse anesthetist specializing in outpatient anesthesia. Our experience working every day with Dr. Berger results in the best care for each tubal reversal patient.
Ensuring Patient Safety
We assess the patient’s medical history even before they come to Chapel Hill Tubal Reversal Center. We speak with each patient by phone several weeks before their scheduled tubal reversal procedure. Most patients have just the basic preoperative lab tests. Some patients with medical conditions require additional tests. All of the preoperative lab work is done in the patient’s hometown, with the results being faxed to us for review. Each patient is sent written instructions of what to expect when they arrive at Chapel Hill Tubal Reversal Center.
On the day of your preoperative consultation with Dr. Berger, we will meet with you to review your medical history again. We will discuss instructions for the evening before surgery, such as about diet or other restrictions to follow to make sure you understand them. The day of surgery is less stressful for our patients because they have met our staff and have a full understanding of what to expect.
Ensuring Patient Comfort
Tubal reversal surgery by Dr. Berger is short. You will be asleep with “general” anesthesia during the 60-90 minute procedure. We work closely with Dr. Berger to assure excellent pain control after you awake from the operation. Dr. Berger injects local anesthesia into the muscles and surrounding tissues during tubal reversal surgery. This reduces the amount of anesthesia during surgery and the need for postoperative pain medication. Our postoperative focus is on nausea and pain control. Patients are discharged from the recovery room when they are comfortable, usually within one or two hours, and they are taken to their room at the Sheraton Hotel.
We Want You To Have The Best Medical Care Ever
We are fortunate at our day surgery center to have state of the art equipment with which we carefully monitor over 15 parameters during and after the tubal reversal procedure. We follow-up with all of our patients and review the evaluation forms that they complete when they have recovered. We pay special attention to any comments patients offer. Our goal is to keep tubal reversal surgery at Chapel Hill Tubal Reversal Center safe, comfortable, and the best medical experience our patients have ever had!
