Which Type of Anesthesia Will I Have for My Skin Cancer Surgery?

If your doctor has told you that you will need surgery to remove your skin cancer, you will more than likely have several questions. One of those questions might be which type of anesthesia your doctor will be using for the surgery.

Anesthesia and skin cancer

Anesthesia is used to help keep a patient from feeling pain during surgery. Anesthesia will temporarily block the pain signals in your body, although the effects of some types of anesthesia will last longer than others.

Who administers anesthesia?

Your doctor may be the one to administer your anesthesia (for instance, if a local anesthetic is being used) or an anesthesiologist or nurse anesthetist may be needed to administer general anesthesia.

Types of anesthesia and when they're used

There are several types of anesthesia available, but not every type is appropriate for every surgery. According to the Cleveland Clinic, the four main types of anesthesia are:

Local anesthesia

Local anesthesia numbs a small area of the body. Local anesthesia may be used before a biopsy is performed or before a less-extensive excisional surgery. Local anesthesia can also be used in conjunction with sedation during surgery. Surgeons will sometimes inject local anesthesia after surgery to help control a patient’s pain post-surgery.

Regional anesthesia

Regional anesthesia is used to numb a larger part of your body (such as an arm or a leg). A patient may be conscious while regional anesthesia is used, or sedation can also be used with the regional anesthesia so the patient is drowsy or asleep.

Sedation

Sedation can be administered to make a patient drowsy or relaxed but the patient can easily be awakened. Light-to-moderate sedation can typically be administered by the doctor performing the procedure, but heavier sedation is generally administered by an anesthesiologist since the patient’s breathing can change with deep sedation. A patient under sedation, even though not in a deep sleep, will most likely not remember the medical procedure that was performed.

General anesthesia

General anesthesia makes the patient unconscious and unaware. A patient will be monitored at all times while under general anesthesia. General anesthesia is used for more invasive surgeries, more complicated procedures, or surgeries that may go on for an extended period of time.

How is anesthesia administered?

Anesthesia can be administered in several ways, including topically (such as a liquid or spray applied to the skin), an injection (whether by shot or by IV), or inhalation.

My experience with anesthesia during skin cancer surgeries

I have had local anesthesia administered by my dermatologist and also by my Mohs surgeon. Each time, multiple injections were given to make sure the area was appropriately numbed before the procedure. (As an aside, keep in mind that if you have red hair or were born with red hair, you may require additional anesthesia; be sure to mention this to your doctor).

I kept waking up during surgery

After I woke up during two different surgeries while under sedation, my plastic surgeon decided to switch me to general anesthesia for an upcoming skin cancer surgery, as he was removing multiple areas (23) of skin cancer, and he said I had a tendency to wake up during surgery. I remember opening my eyes during one of the surgeries and saying “I thought you said I’d be asleep!”

Make sure your doctor knows your medical history

My doctor jumped when I said it and told me that I had been asleep, and I then realized he was sewing up my face. I decided that wasn’t a good time for me to talk with him – or for me to be awake, so I closed my eyes again. I was fine with having general anesthesia for my next surgery, but it is important for you and your doctor to discuss any risk factors you may have, including (but not limited to) sleep apnea, high blood pressure, smoking, drug allergies, seizures, or pre-existing conditions, prior to having general anesthesia.

Be communicative!

Be sure to talk with your doctor about any concerns you have, and make sure you are as comfortable as possible with your anesthesia plan. Remember, you are your own best advocate!