Outpatient Surgery Centers

Anesthesia Services

The Commonwealth Surgical Suites are staffed with four anesthesiologists. For a complete biography of each of the anesthesiologists, click on their name below.

Anne M. Bielamowicz, M.D.
Nancy R. Couleman, MD
Allen G. DeLaney, MD
Brett Malcolm Robinson, MD

Our surgical facilities are constructed, maintained, and staffed to a standard equal to or exceeding that in a modern hospital. We are accredited by the Joint Commission just like any major hospital.

If you are considering whether to have outpatient surgery at one of our Commonwealth Orthopaedic surgical facilities, then we need to talk about whether or not you should have your procedure with us; what about your history that is important; and what you should expect during your visit with us. Below are answers to questions you may have about our surgical facilities.

Frequently Asked Questions

1. Is it safe to have a surgical procedure done in an outpatient surgical suite?
2. Is it better for some patients to have surgery at a hospital?
3. What kind of anesthesia will I have?
4. Who will be administering my anesthesia?
5. What should I expect on the day of my surgery?
6. Are there risks associated with anesthesia?
7. What should I expect after my surgery as I recover from anesthesia?

1. Is it safe to have a surgical procedure done in an outpatient surgical suite?
   Yes, it is a safe environment.  We are a state of the art facility.  Our staff is highly trained and experienced.  We specialize in orthopedic anesthesia and surgery.  We pride ourselves in our ability to give you excellent personal care in a timely manner.   We are accredited by the Joint Commission which means that our facilities were evaluated against a set of national standards by a Joint Commission  survey team experienced  in the delivery of outpatient health care services.  Achieving this elite accreditation demonstrates our commitment to provide the highest quality, safest care to our patients.
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2. Is it better for some patients to have surgery at a hospital?
   Yes.  If you have significant co-existing medical problems which might complicate or prolong your recovery or require specialized monitoring during surgery, it may be better for you to have your surgery in a hospital.  We contact all of our patients before surgery to obtain a medical history in an effort to identify those who would be better cared for in a hospital environment.  We base our decisions with your safety and best interests in mind.
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3. What kind of anesthesia will I have?
   You will meet with your Anesthesiologist on the day of your surgery and together choose the type of anesthesia that is most appropriate for you.  We use short acting anesthetic agents to hasten your recovery. We emphasize post operative pain management as part of your anesthetic care plan.
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4. Who will be administering my anesthesia?
   Our anesthesia staff is a highly trained professional group.  We use the team approach.  You will have both a physician Anesthesiologist and a Certified Registered Nurse Anesthetist (CRNA) taking care of you. All of our staff is Board Certified and has current certification in Advanced Cardiac Life Support and Pediatric Advanced Life Support.
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5. What should I expect on the day of my surgery?
   You should arrive at the Outpatient Surgery Center about 90 minutes prior to your scheduled procedure.  For your safety, it is important that your stomach is empty so be sure you do not have anything to eat or drink that morning.  If you have been advised to take any of your regular medications on the morning of surgery, you may take them with sips of water, but otherwise you should refrain from eating or drinking.  After your arrival at our facility, you will have an opportunity to meet your Anesthesiologist and speak to your surgeon while you are fully awake.  We obtain an initial set of vital signs and begin an intravenous line through which you will receive medication.  During surgery, your anesthesia team will monitor you extensively to ensure your safety and to match the anesthetic drug dosages to your personal needs.  We continue to monitor your vital signs in the recovery room as you awaken from anesthesia.  After most orthopedic procedures you will be ready to go home after about one hour.  We escort you out to your car by wheelchair.
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6. Are there risks associated with anesthesia?
   Modern anesthesia is extremely safe.  However, like most things we do in life it is not entirely without risks and side effects.  The more common side effects include:
   1. A feeling of nausea.  This may be due to anesthetic agents or pain medication.  We can treat this with medication.
   2. A feeling of “hung over”.  This is quite common after general anesthesia but resolves rapidly.
   3. A tingling or aching in a limb as local anesthesia wears off.
   4. A mild sore throat after general anesthesia.
   5. Irritation of the nerve roots in your back following spinal anesthesia.
   
   Serious or life threatening risks from anesthesia are extremely rare.  These include:
   1. Brain injury, paralysis, or death
   2. Permanent peripheral nerve injury
   3. Severe allergic reaction to medication or anaphylaxis
   4. Angina, stroke, or heart attack
   5. Severe injury to the larynx (voice box)
   6. Rare reactions to anesthetic agents due to underlying genetic or metabolic defects, such as malignant hyperthermia
   
   Our facilities and our staff have the training and the equipment to address these life threatening complications should they occur.
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7. What should I expect after my surgery as I recover from anesthesia?
   Following your operation, you may experience any of the following:
   
   When your surgery is completed you will be taken to the recovery room, also known as the Post Anesthesia Care Unit (PACU). Depending on your state of arousal, you may go to phase 1 to wake up more or to phase 2 which is a step closer to going home.
   
   When you arrive in the PACU, the nurses will assess your vital signs, assist in your recovery, and help you get dressed prior to discharge. It is very possible that you will not remember these things occurring due to the medications you receive.
   
   Depending on your body’s response to the type of anesthesia you receive, you may feel sleepy for the remainder of the day. This is why it is important to have someone available to stay with you.
   
   Depending on the type of anesthesia you receive, you may feel little or no pain. Remember that you have had surgery and if a regional block or local anesthesia were used, these will wear off. You will receive written instructions regarding your pain management at home.
   
   We have made every effort to make sure that you do not feel nausea after your procedure. However, it is not always possible to prevent this from occurring. If you are having issues with nausea, we will treat this in the PACU and you may be discharged with a prescription for an anti-nausea medication.
   
   You will be offered something to drink during your recovery period. Please understand that drinking is not a requirement for discharge, but we will offer you something anyway.
   
   The nurses will go over all of the post-operative instructions with your ride home prior to discharge. All of these instructions will be written down, so don’t worry about trying to remember them ahead of time.
   
   It is safe to go home still feeling sleepy. Our board certified anesthesiologists will assess your readiness for discharge, and it may be more beneficial for you to spend time sleeping at home instead of at our center.
   
   There is no required length of time in our PACU. Your stay may be significantly shorter than if you were in the hospital. Once you have met our discharge criteria, you will be discharged with your caretaker.
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