Your Anaesthetic

As you will probably only see your Anaesthesiologist on the day of your operation, the following information explains our role in ensuring the safe conduct of your anaesthetic and operation.

Medical history

You will be required to complete a medical questionnaire to highlight potential problems while you are undergoing surgery and anaesthesia. Please bring information on any medical conditions you may have to the hospital when you are admitted for your operation. 

Medication

  • Bring your current medication to the hospital if there is any chance that you will be staying overnight or need to take this medication while in the hospital. Bring your CPAP mask if you use one. 
  • Bring a list of any medication that you are currently on, or have taken in the past 3 months (including homeopathic and natural products). 
  • Bring a list of any allergies you may have. 
  • Take your routine medication as normal. (If you are taking Warfarin, Aspirin, Plavix or any other blood thinners or any diabetic drugs please ask the surgeon when you should stop these before the operation.)

Eating before an anaesthetic or sedation

YOU NEED TO BE STARVED FOR ALL ANAESTHETICS AND SEDATION. 

All patients including children must have no food or milk products from 6 hours before admission, but may have clear fluids (water, black tea or clear apple juice) up to 2 hours before you report to the hospital on the day of your operation. 

  • Morning surgery – no food or milk products after midnight. Clear fluids up to 5am. 
  • Afternoon surgery – May have an early light breakfast before 7am, and then no further food or milk products. Clear fluids up to 10am. 

Timing of surgery

Although an operating list is scheduled to start at a particular time, only one patient can be anaesthetised and operated on at a time. This means that your surgery may be hours after the scheduled start time of the list. You will be given a rough estimate of the start time for your procedure. If the surgeon offers you an admission time after the start of a list, you may only see the Anaesthesiologist in the theatre waiting area. If you have a medical condition or anything else to discuss with the Anaesthesiologist please either make contact before the day of surgery or ensure you are admitted to the ward at least one hour before the start of the list. 

 

After an anaesthetic or sedation

You will not be allowed to drive (arrange for a lift home), operate dangerous machinery or make important decisions for 24 hours after your anaesthesia. DO NOT CONSUME ALCOHOL post anaesthesia and until you have stopped all post-operative prescribed medication (i.e. pain killers, anti-inflammatories, antibiotics etc).  If in doubt, please consult your treating surgeon or anaesthesiologist. 

Complications during anaesthesia

Anaesthesia is not without risk.  Adverse events can occur during any anaesthetic, which can range from trivial to brain damage or death.  These events may occur due to a reaction to drugs, underlying medical diseases, complications with procedures that have to be performed or due to the surgery itself.  Anaesthesiologists have been trained to manage these complications which may incur further medical expenses.  If a complication persists for more than 48 hours, please inform your anaesthesiologist or surgeon.

Below is a list covering some of the complications that may occur under anaesthesia or after an operation. Many of these risks are more likely to occur or more severe if you smoke, are overweight or have medical conditions such as diabetes or heart disease.

Common complications
(1-10% of cases). Minimal treatment usually needed.
  • Nausea and vomiting
  • Sore throat
  • Shivering or feeling cold
  • Headache
  • Dizziness
  • Itching
  • Pain from drug injection
  • Swelling/bruising at drip site
  • Confusion or memory loss (more common in elderly patients)

Rare complications
(less than 1 in 1000 cases). May require further treatment.
  • Injuries to teeth, crowns, lips, tongue and mouth
  • Hoarse voice
  • Vocal cord injuries
  • Painful muscles
  • Difficulty breathing
  • Visual disturbances
  • Worsening of underlying medical conditions like diabetes, asthma or heart disease

Very rare complications
(1 in 10 000 to 1 in 200 000 cases). Often serious with long-term damage.
  • Eye injuries
  • Lung infection
  • Nerve injuries causing paralysis
  • Awareness of the operation
  • Bleeding
  • Stroke
  • Allergic reactions
  • Unexpected reactions to drugs
  • Inherited reactions to drugs (malignant hyperthermia, scoline apnoea, porphyria)
Brain damage or death
(less than 1 in 250 000 cases).
  • Due to complication getting more severe
  • Heart attack
  • Emboli (clots)
  • Lack of oxygen

When you grant permission for a procedure to be performed under anaesthesia, it is accepted that you are familiar with the information provided and the risks involved.  Should you have any further questions or concerns, please feel free to ask the anaesthesiologist.

General anaesthesia

Expected result Total unconscious state, possible placement of a tube into the windpipe
Technique Drugs injected into the bloodsteam via an intravenous line (a drip), or gases breathed into the lungs
Risks Damage to lips, teeth, tongue, palate, vocal cords, hoarseness, inhalation of stomach contents (aspiration), pneumonia, obstruction of breathing, failure to manage the airway which may require an emergency operative procedure. Awareness under anaesthesia

Spinal/epidural analgesia (with/without sedation)

Expected result

Temporary decreased or loss of feeling and/or movement to lower part of the body

Technique

Drug injected through a needle/catheter placed either directly into the spinal canal or immediately outside the spinal canal

Risks

Headache, backache, nausea/vomiting, decreased blood pressure, itching, infection, injury to blood vessels, temporary or permanent nerve damage persistent weakness/paralysis, high spinal block/’total spinal’

Nerve block

Expected result

Temporary loss of feeling and/or movement of a specific limb or area

Technique

Drug injected near nerves providing loss of sensation to the area of the operation

Risks

Infection, convulsions, weakness, persistent numbness, residual pain, injury to blood vessels

Monitored anaesthesia care (with/without sedation)

Expected result

Measurement of vital signs, availability of anaesthesia provider for further intervention should it become necessary

Reduced anxiety and pain, partial or total anxiety

Technique

Application of full monitoring

Drug injected into the bloodstream, via ‘a drip’, producing a semi-conscious state

Risks

Increased awareness, anxiety or discomfort.