Dr. Jeffrey Lee Anderson, M.D.

Most hand surgery does not require general anesthesia.   Common hand surgeries lasting less than one hour, such as trigger finger releases, corrections of Dupuytren's contractures, carpal tunnel releases, and excision of ganglion cysts, are routinely accomplished under regional anesthesia  (the hand/wrist/forearm are made numb with local anesthetic injections) and light to moderate sedation.  The level of sedation is usually driven by the desires of the patient, some patients want no sedation and others want heavier sedation, but all patients have the expectation of maintaining spontaneous breathing activity.  Most hand surgeons utilize a surgical tourniquet (about the size and shape of a blood pressure cuff, usually placed on the upper arm and inflated to create a bloodless operating field for the surgeon)  which can become uncomfortable for an awake or lightly sedated patient, especially if the surgery lasts more than 1 hour.  
For major hand surgery lasting two or more hours, a major regional block (such as a supraclavicular block) or true general anesthesia is usually necessary.  As always, the desires of the surgeon are important.  Additionally, other health conditions of the patient, such as heart, lung, liver, or kidney disease influence anesthetic risk and benefit;  before surgery, you should talk with your physician anesthesiologist about all of your health issues and medications to help choose the best anesthetic option for you.

Repair of the rotator cuff may be performed by an orthopedic surgeon either arthroscopically (usually 3-4 small incisions using a small arthroscope and a camera/viewing screen system) or open (single longer incision).  Likewise, the anesthetic for the procedure may be either general anesthesia (drug induced loss-of-consciousness) or regional blockade anesthesia (local anesthetics used to block the major nerves which supply sensation to the shoulder joint and upper extremity); the latter technique may or may not be accompanied by varying levels of sedation.  To complicate matters more, the position of the patient during the surgery may be either sitting (commonly called "beach chair") or lateral (the non-surgical side of the patient lays on the operating bed and the surgical shoulder is placed upward, often with the surgical extremity angled towards the ceiling of the operating room.  
Regardless of the surgical technique, the most common anesthetic approach is a combination of general anesthesia using an airway device (placed after the patient is unconscious to safely deliver oxygen) AND a regional block of some kind to address the significant postoperative pain involved with major shoulder surgery.  The most common shoulder surgery block is an interscalene block performed using ultrasound guidance to visualize the nerve network, blood vessels, lung cavity, and other anatomical structures in the neck/shoulder area.  The block is usually performed preoperatively so that when the patient wakes up from general anesthesia, he or she is comfortable.
Orthopedic surgeons often have a preference regarding anesthetic technique and surgical position; you should discuss with your orthopedic surgeon for more information.  
Both general anesthesia and regional blocks carry risks and benefits.  Common risks of general anesthesia in healthy patients include  sore throat (from airway device), nausea, and hypotension; uncommon risks of general anesthesia include breathing problems, heart problems, and other problems.  Common risks of interscalene blocks (and similar shoulder blocks) are patchy block (incomplete pain relief), nerve paresthesia ("twinge" when the injection needle travels near a nerve); uncommon risks of interscalene block include blood vessel injury, breathing problems (due to effect of local anesthetics on the nerve supply to the diaphragm [the diaphragm is your main muscle of breathing]), and injury to the lung cavity.
Problems with general and regional anesthesia are more common in patients with pre-existing health problems, including obesity, diabetes, asthma, and COPD. You should consult an anesthesiologist preoperatively for a thorough discussion of risks and benefits based on your individual health history. 

Generally speaking, general anesthesia is not associated with diarrhea following a surgical procedure. As a matter of fact, the medications associated with general anesthesia (particularly narcotics used for pain control during and after surgery) are much more commonly associated with constipation.  Because of this problem with constipation, many patients are placed on a stool softener (e.g., "Colace") after surgery.  If a patient is sensitive to a stool softener, they may develop diarrhea. 
There can be exceptions, but they are uncommon.  Other factors may also be associated with postoperative diarrhea, including the surgery site (e.g., surgery on the stomach/intestines may cause postoperative diarrhea) and antibiotics used to prevent surgical wound infections (may cause an unusual bacterial overgrowth in the large intestine known as pseudomembranous colitis).  If your diarrhea persists more than a day after surgery, or if you have fever/chills or blood in your diarrhea, you should contact your surgeon, primary care physician, or anesthesiologist.

At least 4 anesthesia options are available for surgery involving the lower part of the leg and foot:
(1) Local anesthesia: The surgeon injects a local anesthetic (e.g., "Lidocaine") into the tissues at/around the surgery site. Best for small procedures, such as removal of a skin lesion.
(2) Regional anesthetic: An anesthesiologist injects a local anesthetic around major nerves serving the extremity; in the case of the heel/foot, the anesthesiologist would seek to block branches of the femoral nerve and the sciatic nerve (usually performed at two injection sites using ultrasound guidance). Results in anesthesia ("numbing") of the lower leg and foot.
3. Neuraxial anesthesia (e.g., "spinal block"): An anesthesiologist makes an injection of a small amount of local anesthetic around the nerves coming from the lower end of the spinal cord. Results in anesthesia ("numbing") of the lower extremities.
4. General anesthesia: An anesthesia professional uses medications to induce unconsciousness for surgery; usually involves the insertion of an airway device, especially if the heel surgery requires prone ("face down") positioning.
The options are based on the patient's health history, size/length of surgery, and surgeon/anesthesiologist preferences. To make an informed decision, your best bet is to discuss these choices with your anesthesiologist and surgeon so they can create a surgical/anesthetic plan with knowledge of your health history and your needs/goals.

Back pain at/near the injection site following an epidural injection is fairly common and may have several causes, including:
(1) The anesthetic agents injected were not effective in treating the pre-existing back pain (when the injection is provided for a chronic pain condition)
(2) Trauma to the soft tissues near the epidural needle insertion site (as with any needle insertion).
(3) Trauma to a nerve/nerve plexus.
(4) Bleeding/hematoma near the epidural needle insertion site.
(5) Infection/abscess near the epidural needle insertion site.
In the absence of fever/chills/new-onset motor weakness/changes in bowel or bladder function, most patients can be observed and expected to improve in days to weeks without aggressive intervention. In a patient with new-onset fever/chills/motor weakness/changes in bowel or bladder function, emergent evaluation should be sought.

In response to your question regarding "stopping breathing" during anesthesia, physician anesthesiologists are the most highly trained experts in all types of airway management. This training includes medication-induced intentional cessation of breathing on most patients receiving general anesthesia, followed by manually-assisted or mechanically-assisted breathing using a mask or other airway device (such airway devices are normally placed into the patient's pharynx or trachea after the patient is unconscious). Some patients will receive regional-block anesthesia (such as an "epidural block"), forms of sedation, or total-intravenous anesthesia in which an airway device is not intended to be inserted. Such patients normally breathe without assistance, though they may have a small amount of supplemental oxygen supplied. In these types of anesthetics, if a situation develops in which the patient is not ventilating satisfactorily, the anesthesiologist will quickly proceed with assisted ventilation as described in the first paragraph. Such assisted breathing may be performed with a mask or other airway device.  
In summary: If you are receiving general anesthesia for a planned procedure, in most cases your breathing will be intentionally stopped and the anesthesiologist will take over control of your breathing using one of several options. If you are receiving sedation, a regional anesthetic, or total intravenous anesthesia, in which it is intended for you to breathe naturally and a situation arises in which you are not breathing satisfactorily, the anesthesiologist will take steps to assist your breathing.  

Jeffrey Anderson, MD

Anesthesia for septoplasty is generally accomplished by one of three techniques:

1.  Local anesthesia: Topical/local anesthetics (e.g., lidocaine, cocaine) are placed around the septum to numb the septal region. In this technique, the patient is not sedated; that is, the patient is wide awake. An anesthesia professional is not usually involved with this technique.
2. Local anesthesia PLUS sedation: Same as 1, but the patient is sedated with inhaled agents (e.g., nitrous oxide), oral agents (e.g., lorazepam), or injected agents (commonly midazolam and fentanyl). The patient is not wide awake, but maintains their own airway, usually with a small amount of supplemental oxygen. The patient may experience recall with this technique. An anesthesia professional is usually involved with this technique.
3. General anesthesia: The patient is rendered completely unresponsive via a combination of inhaled and/or injected medications. An airway device is inserted to safely deliver oxygen/ventilate the patient. Anesthesia professionals are always involved with this technique.  

The risks and benefits of each technique are best discussed with a physician anesthesiologist familiar with the patient's medical and surgical history. Surgeon preferences are usually taken into account by the anesthesiologist as well.  
Good luck with your procedure!

Jeffrey Anderson, MD

In general, the answer is "no," urologists do not use general anesthesia or intravenous sedation to perform diagnostic cystoscopy. Urologists usually use a lubricating jelly (similar to "KY Jelly") containing the local anesthetic lidocaine to lubricate the urethra and the shaft of the cystoscope. The most common patient response to cystoscope insertion (both females and males) is a sense of needing to urinate; most patients describe the procedure as mildly uncomfortable (at worst). The procedure is usually done in the urologist's office. Rarely, urologists will have an anesthesia professional provide sedation, regional anesthesia (e.g., "spinal block") or general anesthesia for a cystoscopy, usually in a situation where it is deemed "medically necessary." An example would be a patient with complicated urethral/bladder anatomy (perhaps caused by prior trauma, prior surgery, or radiation for cancer) or an unusual medical condition. For example, despite apparently lacking skin sensation below the umbilicus, a patient with paraplegia or quadriplegia due to a spinal cord injury can develop potentially life-threatening problems with blood pressure and heart rate during cystoscopy and bladder irrigation; such patients would typically receive care from an anesthesia professional in a hospital or an outpatient surgery center.

Jeffrey Anderson, MD

Yes, you may take painkillers after receiving local anesthetics for invasive procedures. The type of painkiller(s) will depend on the procedure performed and your personal health history. For example, patients having surgery with a high risk of postoperative bleeding will be advised avoid certain classes of painkillers which have a blood-thinning effect because such drugs may increase the risk of post-op bleeding. Similarly, patients with severe liver disease may be advised to avoid acetaminophen (Tylenol). In general, for healthy patients undergoing low risk surgery, the preferred post-op analgesics (in order of preference) are: Local anesthetics administered at the time of surgery (or, in some cases, via slow infusion catheter device for major surgery), Acetaminophen  (Tylenol), a non-steroidal anti-inflammatory (e.g., ketorolac), or an oral opioid (e.g., hydrocodone). Depending on the type of surgery, other analgesics might include: An antineuralgic (e.g., gabapentin, commonly used for major spine surgery and some joint replacement surgery in younger patients), anti-spasm meds (e.g., cyclobenzaprene), and many others. 

Yes, your son will receive general anesthesia ("go to sleep") for the procedure. Most commonly the anesthetic is delivered intravenously (IV) and, after induction, a breathing tube is placed by the anesthesiologist into to the trachea. This permits the surgeon to work while not competing with the anesthesiologist's oxygen mask; oxygen, air, and inhaled agents are delivered via the breathing tube. Medications (e.g., pain relievers, anti-nausea meds, and others) are delivered via the IV before, during, and after surgery. 

The side effects (AKA "risks") of general anesthesia are usually divided into common side effects, uncommon side effects, and rare side effects.  These side effects are dependent on multiple factors, including the patient's health (other medical problems) prior to surgery, the anesthetic agents utilized, and the surgery performed.  
Common side effects of general anesthesia for gallbladder surgery in otherwise healthy patients:Sore throat (from insertion of a breathing tube)Nausea and vomitingInsignificant cardiac arrhythmiasMinor changes in blood pressure and heart rateShort term (1-2 hours) memory deficits/confusion (usually resolved by the time the patient is dsicharged from the recovery room)
Uncommon side effects of general anesthesia for gallbladder surgery in otherwise healthy patients:Bronchospasm/"Wheezing"Eye Injury (Corneal abrasion--sometimes caused by a hand or airway tool during airway instrumentation, sometimes caused by the patient trying to rub her/his nose or eye in the recovery room)Muscle achesOral/Dental TraumaSignificant changes in blood pressure/heart rate
Rare side effects of general anesthesia for gallbladder surgery in otherwise healthy patients:Too numerous to list completely, but could involve almost every organ system:PneumoniaHeart Attack (Myocardial Infarction)Significant Cardiac ArrhythmiaStroke (Cerebrovascular accident)Kidney injuryLiver injurySerious allergy to anesthetic agent Disturbances of Temperature Control/MetabolismPeripheral nerve injurySkin Injury"Awareness" during general anesthesiaDeath
Again, these lists do not cover every imaginable side effect.  And, generally speaking, the more serious a "side effect", the more likely it is to transition in nomenclature from "side effect" to "complication".
And again, the above is for an "otherwise healthy" patient undergoing gallbladder surgery.  In my experience, most adult patients undergoing gallbladder surgery do NOT meet the anesthetic criteria to be considered "healthy" by an anesthesiologist.  Indeed, the most common public health problems of the US adult population add significant risk to general anesthesia and move some of the above side effects from the "uncommon" or "rare" category to the "common" category.
Those public health problems include:1. Obesity (BMI>25)2. Diabetes3. Tobacco abuse4. Alcohol abuse5. Other substance abuse6.  Gastrointestinal disorders (GERD/Hiatal Hernia)7.  Prior stroke or myocardial infarction8.  Cardiac arrhythmia (e.g., atrial fibrillation)And many others . . . this is just off the top of my head.
Put another way, the risks of general anesthesia for gallbladder surgery are much different for the following two patients:1.  A 35 year old who has a BMI of 22 (normal) who takes no medicines, has no allergies, does not smoke, drink, or abuse other substances, and who vigorously exercises 30-60 minutes per day 4-6 days per week.  2.  A 65 year old who has a BMI of 35 (obese), takes medications for diabetes, heart disease, atrial fibrillation, prior stroke, GERD, who smokes tobacco and drinks 3-5 alcoholic beverages/day, and who has not exercised since the Clinton Administration. 
What can you do to lower your anesthesia risks:1.  Maintain a BMI of <252. Don't smoke3. Don't abuse alcohol.4. Don't abuse other substances5. Exercise regularly6. Follow the directions of your anesthesiologist, surgeon, internist, and any other specialist (e.g., cardiologist) 
Good luck with your surgery. 

For the record, "nose job" is a bit non-specific and could range from a simple septoplasty (generally about 30-60 minutes of anesthesia time, depending on level of deformity) to a simple rhinoplasty (generally about 60-120 minutes of anesthesia time, depending on level of deformity), to a septorhinoplasty (two procedures in one, generally about 90-180 minutes of anesthesia time, depending on level of deformity) to a more radical nasal procedure (generally performed for malignancies of nasal/sinus structures) which can require many hours of operating time. General anesthesia is commonly done for these procedures, though some surgeons prefer "sedation + local anesthetics with vasoconstrictors" over general anesthesia for more superficial procedures. Even with general anesthesia, most surgeons will use local anesthetics with vasoconstrictors to reduce intraoperative blood loss and increase postoperative patient comfort. 
Hope that helps.