GENERAL PATIENT INFORMATION
What is Anaesthesia?
Anaesthesia is the loss of sensation of the body for surgery through the administration of special medication. There are two broad types of anaesthesia that I administer, depending on the type of surgery and the individual patient’s needs.
General anaesthesia renders you unconscious for the duration of your procedure. Patients are given medications through an intravenous cannula (‘drip’) and/or a breathing tube. You will require placement of this breathing tube shortly after you are put to sleep.
Regional anaesthesia is the loss of sensation of part of your body (usually the arms or legs). This is achieved by administering a local anaesthetic drug (via a tiny needle) around the nerve supplying that body part. You can be awake and completely comfortable with this kind of anaesthesia.
I can use either type of anaesthesia or a combination of both, to provide safe and comfortable anaesthesia for your procedure.
What is an anaesthetist?
An anaesthetist is a fully qualified medical doctor who has spent at least three general training years in the public hospital system before completing a further five years of specialty training in anaesthesia.
The anaesthetist’s role encompasses all aspects of medicine related to care of patients before, during and after surgery. This includes:
the management of medical emergencies.
Surgery puts significant stress on the body, and without modern anaesthesia the majority of these procedures would not be possible.
Additionally, anaesthetists are often the primary care providers in resuscitating critically ill patients, and in providing pain relief for women in labour.
The training to become a Specialist Anaesthetist is equal in length to that of other specialists, including Surgeons. Anaesthetists must continue to update their skills by regularly attending professional development sessions.
What can you expect from me as your anaesthetist?
I will review your responses in the pre-anaesthesia questionnaire. This will help me plan a safe and effective anaesthetic for your operation.
On the day of surgery
I will meet you in the pre-operative area for further assessment before we move into the operating theatre. Here, I will insert an intravenous cannula (‘drip’) in your arm to give you fluids and any necessary medications.
My team will attach monitors (for blood pressure, ECG and oxygen) and administer oxygen through a comfortable mask. I will then administer the appropriate intravenous anaesthetic. I will be present throughout your anaesthesia to monitor your vitals and administer any necessary medication.
At the end of the operation, I will remove the breathing tube (if you had a general anaesthetic) and then wake you up. I will then transport you to a recovery area where my team will monitor and facilitate your recovery.
Is general anaesthesia safe?
Anaesthesia in Australia is very safe today and most healthy people don’t have any problems with it. However, nothing is risk-free.
Anaesthesia carries 2 types of risks. Firstly, there are common risks which usually have no permanent effects on your body:
Nausea and vomiting: up to 1 in 5 people may experience this, but the rate is decreasing due to improved anaesthetic techniques.
Sore throat: This can be due to the breathing tube and usually settles within 2 days
Bruising: due to the intravenous cannula and nerve blocks, and this usually settles within 2 days.
Secondly, there are very rare but serious risks (such as severe allergy, heart attack, stroke or even death) which can have a lasting impact on your body:
Damage to teeth: if you need general anaesthesia, I have to carefully inserting a breathing tube to help you breathe. Insertion of this tube has the potential to cause damage to teeth.
Aspiration: this is where stomach contents are brought back up into the throat and then inhaled into the lungs. This is a risk during a general anaesthetic and can lead to serious lung damage. This is the reason that I place great importance on adequately fasting prior to your procedure.
Allergy: It is possible to have an adverse reaction to an anaesthetic drug or other materials in the operating theatre, even without a prior history of allergies. It is vital that you inform me of any known allergies to medications or rubber/latex products.
Awareness: Being conscious of the things going on around you whilst anaesthetised is exceedingly rare. It is generally associated with ‘high risk cases’ where lower medication doses are used (when the use of normal doses could be life-threatening to the patient). In these cases, I use a special ‘awareness’ monitor which minimises this risk.
Life-threatening events (heart attacks, strokes) related to anaesthesia are rare and can usually be managed appropriately in the hospital setting. Death is extremely rare.
In general, the risk of complications is more closely related to the type of procedure you are undergoing, and your general physical health, than to the anaesthesia itself. Patients with heart, or lung disease who have previously had a stroke, are diabetic, or smokers are in a higher risk category.
I am always available to outline these risks to you over the phone in greater detail, should you want to discuss them.
Will I be in pain?
While pain is a common concern after surgery, there are very good methods of minimising pain. This includes the use of drugs (intravenous medication, tablets), procedures (nerve blocks), and/or non-drug methods. Most patients have their pain well-controlled following surgery.
I will always be available to manage any issues with pain following your surgery.
How do I prepare for my surgery?
Prior to your surgery
Hydrate yourself well with water the day prior to your procedure (unless you are given medical instructions to do otherwise);
Stop smoking as soon as possible (ideally at least 6 weeks prior to your treatment);
Reduce alcohol consumption. Please refrain from alcohol intake for 24 hours prior to your procedure.
On the day of surgery
Fasting: please strictly follow the hospital’s instructions on fasting. If your stomach is not empty during surgery, there is a significant risk of stomach contents entering into your lungs, which can be fatal.
If your operation is in the morning, you must not have anything to eat after 12 midnight (ensuring a 6-hour fast). You may drink water up to 2 hours prior to the time you have been asked to attend the hospital.
If your operation is in the afternoon, please have a light breakfast (e.g. toast or muesli and milk) prior to 7.00 am (ensuring a 6 hour fast). Do not eat or drink anything after this time except for water, which you may continue to drink up to 2 hours prior to the time you have been asked to attend the hospital.
Sometimes your procedure will have specific fasting instructions given by your surgeon (e.g. colonoscopy). These instructions take priority over my above general fasting instructions.
Medications: Please bring all medications to hospital. You should take all your regular medications up to and including the day of your surgery (with a small sip of water). If you are on diabetes medications, blood thinners or blood pressure medications, please contact me for specific advice - these medications may be exceptions to the above instructions.
What can I expect after surgery?
Immediately after surgery
You will feel drowsy for a short period (usually < 1 hour) after you wake up. Most people wake up comfortable, but side effects can infrequently occur. It is important that you let myself or your recovery nurse know about these, as most are treatable and/or temporary. These include: pain, sore throat, nausea, dizziness or itchiness.
Most people will experience some discomfort from their surgery. Unfortunately, medication cannot completely remove surgical pain, but they can usually effectively control it. I will ensure you are comfortable when you wake up.
Most patients are able to go home on the same day of surgery. Please ensure you have someone to accompany you home. For at least 24 hours after coming out of anaesthesia, do not:
drive a car;
make important decisions;
use any dangerous equipment or tools;
sign any legal documents; or
I will discuss a plan to manage your pain from home. This will usually consist of some over-the-counter medications. Should you need stronger medications, I will provide a prescription for you.