Anaesthesia and you
I hope this information will ease your mind. Please read it carefully — I want you to be well informed. I will be happy to answer any questions you have about the anaesthetic before your operation.
You're in good hands
Anaesthetists in Australia are highly trained medical specialists, having spent at least five years, after medical school and residency, undergoing training in anaesthesia, intensive care medicine, pain control, resuscitation and the management of medical emergencies. I will meet you before your operation to discuss your anaesthetic and to perform a relevant examination. This may not occur until immediately before your operation.
General, regional or local anaesthesia?
This question relates to the type of anaesthetic you will receive. This will depend on the nature and duration of the surgery. Regional or local anaesthesia may often be used with or without general anaesthesia.
You are put into a state on unconsciousness for the duration of the operation. This is usually achieved by injecting drugs through a cannula placed in a vein and maintained with intravenous drugs or a mixture of gases which you will breathe. While you remain unaware of what is happening around you, I will monitor your condition closely and constantly adjust the level of anaesthesia. You will often be asked to breathe oxygen through a mask just before your anaesthesia starts.
A nerve block numbs the part of the body where the surgeon operates and this avoids a general anaesthetic. You may be awake or sedated (see below). Examples of regional anaesthetic include epidurals for labour, spinal anaesthesia for caesarean section and "eye blocks" for cataracts.
A local anaesthetic is injected at the site of the surgery to cause numbness. An obvious example of a "local anaesthetic" is numbing an area of skin before having a cut stitched.
Is fasting really necessary?
We know that being hungry can be uncomfortable but no food or drink for a period before the operation is a MUST. Not even water. Food or fluid in the stomach may be vomited and enter your lungs while you are unconscious. If you don't follow this rule of fasting, the operation may be postponed in the interests of your safety. Your surgeon, anaesthetist or the hospital will advise you how long to fast.
After the operation
Along with recovery room staff, I will continue to monitor your condition carefully well after the surgery is finished to ensure your recovery is as smooth and trouble-free as possible. You will feel drowsy for a little while after you wake up from the anaesthetic. You may have a sore or dry throat, feel sick or have a headache. These are temporary and usually soon pass. To help the recovery process, you will be given oxygen to breathe, usually by a clear plastic facemask, and encouraged to take deep breaths and to cough. Only when you're fully awake and comfortable will you be transferred either back to your room, ward or a waiting area before returning home. Don't worry if there is some dizziness, blurred vision or short-term memory loss. It usually passes quite quickly. If you experience any worrying after effects, you should contact my rooms.
With modern surgery the requirements for blood transfusions are now uncommon. All blood collected today from donors is carefully screened and tested but a very small risk of complications or cross infection still remains. I am aware of these risks and only use blood transfusions when absolutely necessary.
'Day of surgery' admission and 'day surgery'
It is likely that you will be asked to come into hospital only a few hours before your operation. Hospitals are very busy places and you may only see me just before your anaesthetic. If you have any concerns or questions please contact my rooms prior to coming to hospital.
The best part is that most people now go home on the day of surgery. If you are having 'day surgery' make sure there is someone to accompany you home. For at least 24 hours do not:
- Drive a car
- Make important decision
- Use any dangerous equipment or tools
- Sign any legal documents
- Drink alcohol
Anaesthesia — the risks and complications
Firstly, let's put this into perspective, Australia is one of the safest places in the world to have an anaesthetic. Nevertheless, some patients are at an increased risk of complications because of their own health problems e.g. heart disease and/or because of the type of surgery they are undergoing. Some infrequent complications include: bruising, pain or injury at the site on injections, temporary breathing difficulties, temporary nerve damage, muscle pains, asthmatic reactions, headaches, the possibility of some sensation during the operation (especially with caesarean section and some emergency procedures), damage to teeth and dental prostheses, lip and tongue injuries, and temporary difficulty in speaking. There can also be some very rare, serious complications including: heart attack, stroke, seizure, severe allergic or sensitivity reactions, brain damage, kidney or liver failure, lung damage paraplegia or quadriplegia, permanent nerve or blood vessel damage, eye injury, damage to the larynx (voice box) and vocal cords, pneumonia and infection from blood transfusion. Remember, the possibility of these more serious complications including death is quite remote, but it does exist. The risk of death related to anaesthesia is about as likely as your dying in a car accident in the next twelve months. This is not likely but not a zero risk either. I will be happy to answer any questions and discuss how to work with you for the best possible outcome.