Anaesthetic

General Anaesthetic

Under general anaesthetic, you are put into a state of unconsciousness for the whole operation. This involves either giving an injection of an anaesthetic drug or breathing an anaesthetic to make you sleep. While you remain unaware of what is happening around you, the Anaesthetist monitors your condition closely and constantly adjusts the level of anaesthetic.

Local Anaesthetic

Under local anaesthetic, you will be awake but the part being operated on is made numb by an injection. Examples include spinal and epidural anaesthesia, arm blocks and eye blocks. Local anaesthetic is injected into the major nerve pathways to the part of the body where the operation is, or local injection at the site of surgery. You can be wide awake, or if preferred, the Anaesthetist can give other drugs to make you relaxed and drowsy.

Sometimes a combination of these types of anaesthetic is used to produce the best result for you.

Before the operation

Before the operation your health will be assessed. Your Anaesthetist requires information from you to plan the best anaesthetic for you. You will be asked to fill out a Health Questionnaire. This information is very important as it provides an indication for any investigations you may require before surgery. You will be asked about:

• Your medical history
• Current prescribed medications (bring these with you)
• Previous anaesthetic experiences
• Drug allergies
• Any concerns you may have

Some investigations such as chest x-rays, electrocardiographs (ECG) and blood tests may be requested. If you smoke, please try to reduce or stop prior to an anaesthetic.

Medications

Please read the Medications section on this website for information. If you have any concerns please contact your surgeon or the hospital.

The day of the operation

Please follow the instructions for the day of your operation carefully, including when to stop eating and drinking before the operation. An empty stomach makes it less likely that any vomit could get into your lungs while you are under an anaesthetic.

You will meet your Anaesthetist who will discuss your anaesthetic and obtain your written consent.

You will be asked to change in to theatre clothes and may be given a “pre med” before coming to the operating theatre. A “pre med” is a tablet to relax you if you are nervous or to help with your pain relief after the operation.

During the operation

On arrival in the operating theatre you will be met by your Anaesthetist and the theatre team. This includes the nursing staff and the surgeon. The anaesthetic nurse will discuss your involvement in the ‘final check’ process with you.

The ‘final check’ occurs just before surgery begins. The theatre team check for the last time that they have the correct patient and are doing the correct operation on the correct site.

This important step is to ensure everything goes as planned for your surgery.

You will be continually monitored throughout the operation. This monitor helps the anaesthetist to watch your heart, blood pressure, oxygen level and breathing during the operation. An intravenous line will be placed in your arm.

You may be asked to breathe in oxygen through a mask as you go off to sleep.

Your surgeon and anaesthetist work as a team to ensure that the best possible outcome is obtained for you.

After the operation

After your operation you will wake up in the Post Anaesthetist Care Unit (PACU) with an oxygen mask in place.

Staff are skilled in a range of methods to treat pain, and nausea. PACU staff will care for you until you are ready to return to the ward or day surgery suite.

Going to the ward/day surgery suite

Pain relief and fluids will have been charted by your Anaesthetist and the nurses will follow these instructions to keep you comfortable.

Day Surgery

If you are going home on the day of your operation it is essential to have someone with you as the full effects of an anaesthetic may not wear off for 24 hours. For this reason you should not drive a car, drink alcohol, use dangerous equipment or sign any important documents for 24 hours after an anaesthetic.

If you have an increase in pain or are feeling sick when you get home, please contact the hospital for advice.

Side Effects

One of the aims of a modern anaesthetic is a pleasant painfree awakening. However, some of the side effects are unpleasant:

• Nausea and vomiting occur in approximately 20% of patients.
• A sore throat is common
• A headache may occur
• Some patients may get muscle aches

Most side effects can be easily treated with medication.

Major complications

Your Anaesthetist will plan the safest anaesthetic for you, and is specially trained to deal with any problems that arise, but always remember an anaesthetic is a major medical procedure. Like any other medical procedures, there may be major complications including the risk of dying. Risks are greater in the elderly and very young but nobody is free from risk.

• The chance of dying unexpectedly during anaesthesia, if your age is less than 60 years and you are fit and well, is about 1 in 200,000.
• If you are over 60 years, the risk is greater, approximately 1 in 60,000. This may be higher if you have serious heart or lung conditions.

Apart from causing death there is the possibility of a heart attack, stroke, major nerve or brain damage, organ failure or allergy or awareness during a procedure. These are very rare complications. Each type of anaesthesia has different risks and benefits and every patient reacts to and tolerates anaesthesia differently. The risk you face will depend on your health and the operation you are having.

If you have any questions, please do not hesitate to ask.