Dr. Adrienne Levy and Dr. Brian Slepian, our two Board Certified Anesthesiologists, each possess over twenty five years of experience in providing anesthesia. Each physician has over a ten years of experience in hospital-based anesthesia; and, both physicians have close to twenty years expertise exclusively in the ambulatory anesthesia care setting, a unique niche addressing the special needs and requirements of a patient who will be returning home following their surgical procedure. Both physicians have been the exclusive providers of anesthesia services for Dr. Epstein’s office based surgical facility since 2001. They are both key members of the office personnel, familiar to co-workers and returning patients, and knowledgeable about office policy and procedures, as well as equipment and skilled in emergency preparedness. Our anesthesiologists are members of the team in every sense of the word. When you book your surgery with Dr. Epstein, you can proceed with the confidence that your anesthesiologist has been carefully chosen for you.
Both anesthesiologists are certified in basic, advanced and pediatric life support. The available equipment to provide anesthesia is comprehensive, including a Glidescope videolaryngoscope.
Your anesthesiologist will contact you before your surgery to review your medical history, discuss your day of surgery including the anesthesia planned, address all of your concerns as well as to answer any questions that you may have.
General anesthesia is provided for most office-based surgical procedures. General Anesthesia means that you are completely asleep throughout your procedure. You will not see, feel or hear anything painful, unpleasant or uncomfortable during surgery. Your vital signs are continuously monitored before, during and after surgery while in the operating room. You are given medicine intravenously that causes you to fall asleep; then, you stay asleep with oxygen mixed with special gases that you breath in and out through your lungs. General Anesthesia guarantees that you don’t move or feel pain during surgery; and, you have amnesia to the surgery — you do NOT remember surgery after it is over.
Intravenous Conscious Sedation
Intravenous conscious sedation is provided occasionally for some office-based surgical procedures. Intravenous conscious sedation means that you may be partly aware of your surroundings during surgery; or, you may be unaware of your surgery after it is over. You can even give your anesthesiologist your preferences as to just how sedated you wish to be. While your vital signs are continuously monitored, you are given medicine intravenously that causes you to be groggy, sleep lightly, or sleep heavily during surgery. Intravenous conscious sedation is usually combined with local anesthesia. Intravenous conscious sedation CANNOT guarantee that you will not move, feel discomfort or remember surgery. Sometimes intravenous conscious sedation is provided so that you can participate in standing or turning during surgery.
Local anesthesia is provided for office-based surgery by the surgeon, without the services of an anesthesiologist. Local Anesthesia means that Dr. Epstein injects local anesthesia where he operates to numb the skin and/or tissues. Local anesthesia means that you are fully awake and aware during your procedure. Local Anesthesia is typically provided for small procedures, labiaplasties if the patient wishes to do so (sedation or general anesthesia are other options) and some VASER liposuction procedures only.
Your anesthetic is usually determined by your surgical procedure, not by individual choice. In cases where more than one anesthetic option exists, then Dr. Epstein and your anesthesiologist will discuss those options with you to find the best type of anesthetic option for you. When using local anesthesia, some patients benefit from ProNox®, also known as nitrous oxide or “sweet air” to allow them to feel more relaxed during the procedure. The advantage of ProNox® is that you can drive after your procedure, assuming that it is otherwise acceptable to drive afterwards aside from the ProNox®.
During your surgical procedure, your anesthesiologist will plan for three important outcomes:
- Rapid recovery from anesthesia
- No nausea
- Minimum discomfort
The anesthetic medications are dosed and timed to provide you with the safest and fastest wake-up possible. In addition to the nausea medicine that Dr. Epstein prescribes to many patients to take prior to surgery, up to four additional medications may be given during your surgery to minimize the chance of nausea when you awaken. And, the anesthesiologist will give you medicine through the intravenous tubing to minimize any discomfort when you awaken.
Your anesthesiologist contributes to making your surgery with Dr. Epstein a safe and memorable experience.