Both, my wife and I will not risk surgery with general anesthesia if it is at all possible for the sugery to be done with epidural, spinal, regional, or local. When my wife had hip replacement surgery she shopped around for 3 years until she found a surgeon willing to do the procedure only with epidural and with no sedation whatsoever.
After surgery she insisted on a non-narcotic pain killer, Toridol, which would not make her sleepy. I will not undergo surgery unless it is a life threatening situation.

                                              SOL