The most common choice today remains the general anesthetic. In this situation, the patient is given medications through an IV and an airway to keep them asleep so the surgery can continue uninterrupted. A general anesthetic has multiple components that may be active depending on the circumstances of the surgery. A key feature is sedation, the patient becomes sleepy. A second feature is loss of awareness. You certainly do not want to remember when they are making an incision in your abdomen. In addition, it is important you be relaxed. Your muscles will relax as you become sedated but often surgeons want the muscles specifically relaxed or paralyzed to make their job easier. Finally, it is essential that pain is controlled even when you are asleep. Of course, as a patient you will appreciate if this pain control continues into the postoperative period and you awaken with little or no pain. During the episode of general anesthesia, the patient remains asleep (sedated, relaxed, unaware and without pain). The way this is accomplished is part of the “Art of Anesthesia.” A good anesthesia provider does this balancing act quite well.