ANAESTHESIA AND ANAESTHETISTS
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What is anaesthesia?
When you undergo a medical procedure, whether it be major or minor, it is important that you experience as little pain and discomfort as possible. Anaesthesia is used to ensure a patient does not experience any pain or sensation during a procedure. This is achieved by administering different medications that keep you asleep or relaxed. More information about specific types of anaesthesia can be found below.
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What are the different types of anaesthesia?
The type of anaesthesia used will depend on a number of factors including:
- The nature and duration of the procedure
- Your general medical condition
- Your care preferences
- The care recommendations of your anaesthetist and surgeon or other doctor performing the procedure
You are put into a state of carefully controlled unconsciousness for the duration of the operation. You have no awareness or sensation, and no memory of the surgery. For the duration of the surgery, the anaesthetist monitors your condition closely and constantly adjusts the level of anaesthesia.
SedationThe anaesthetist administers drugs to make you feel relaxed, drowsy and comfortable during certain procedures. This is sometimes called ‘twilight sleep’ or ‘intravenous sedation’. In addition to providing pain relief, sedation can provide relief from anxiety. Some forms of sedation use many of the same drugs as general anaesthesia, but in lesser quantities.
Regional AnaesthesiaA nerve block numbs the part of the body where the surgeon operates, and this avoids the need for general anaesthesia. During regional anaesthesia you may be awake or sedated. Examples of regional anaesthesia include epidurals for labour, spinal anaesthesia for caesarean section, ‘eye blocks’ for cataracts and peripheral nerve blocks that make a limb or part of a limb numb.
Local AnaesthesiaA targeted area of the body is injected with local anaesthetic drugs so that surgery can be performed on the numb area while you are awake. Light sedation is sometimes combined with local anaesthetic.
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What does an anaesthetist do?
While your surgeon focuses on the area of your body that they are operating on, your anaesthetist is making sure the rest of you is looked after by monitoring your wellbeing throughout the surgery. They will be with you from the commencement of your procedure, monitoring and caring for you, until you begin to wake up from your anaesthetic. They keep your heart beating, your lungs working, and make sure you are as comfortable as possible as you regain awareness following surgery.
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What training does my anaesthetist have?
An anaesthetist is a specialist doctor. This means they have completed their medical training to become a full medical doctor and have then undertaken further training and study to specialise in anaesthesia. All of our anaesthetists are Fellows of the Australian and New Zealand College of Anaesthetists, which is awarded to doctors only after significant amounts of experience and intensive training.
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Can I choose my anaesthetist?
Your surgeon may work with a number of different anaesthetists on a regular basis. On any particular day, your surgeon will generally work with the same anaesthetist for all patients.
If you would like to arrange a different anaesthetist for your surgery, you should discuss this with your surgeon. They may be able to reschedule your surgery to a date they are working with a different anaesthetist.
THE SURGERY PROCESS
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What do I need to do before surgery?
Good preparation for your anaesthesia can make a significant difference and ensure that the day runs smoothly. Prior to the day of surgery, you will be advised about specific details for when to stop eating and drinking (the fasting period). It is important that you follow these instructions as undigested food or liquid poses a significant risk during your procedure If you do not follow the fasting instructions, then there is a high chance that your procedure will need to be postponed. If you are going to be having a complex procedure, or if you have a significant medical history, then you may need to have a consult with your anaesthetist in the days leading up to your procedure. Your surgeon will advise if this is necessary, and we will get in touch to arrange a time for you to visit.
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What do I need to tell my anaesthetist before surgery?
Depending on your procedure, you may speak with your anaesthetist in the days prior to, or on the day of, your procedure. They will go over your medical history and general health status.
Your anaesthetist will ask questions regarding your medical history, medications (including over-the-counter and herbal remedies), previous experiences with anaesthesia, smoking status and alcohol and drug intake.
It is important that you are honest when answering all these questions as they are designed to ensure that you receive the most appropriate care.
It is also essential that you advise both your surgeon and anaesthetist if you are experiencing any new coughs, colds, sore throats, fever and gastrointestinal symptoms including diarrhoea and vomiting. Your surgeon, along with your anaesthetist, will weigh up your need for the procedure alongside the risks associated with these symptoms. If your surgery is delayed, then an optimal time for rescheduling will be suggested.
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What happens on the day of surgery?
Your surgeon’s rooms will be in touch to advise you of your admission time and give guidance on what to bring to the hospital. Depending on the facility you may be taken straight into the operating theatre or to a smaller room next to the theatre where the anaesthesia process can begin. Monitoring devices such as a blood pressure cuff will be placed, and an intravenous line may also be started.
Once you are taken into the operating theatre you will be given a combination of drugs intravenously or through your breathing mask in order to be put under anaesthetic. The combination of drugs is tailored to each patient and is based on several factors such as age and general health.
Your anaesthetist will remain by your side for the duration of the procedure to ensure you remain anaesthetised and unaware of what is going on around you.
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What happens after surgery?
Once the procedure has been completed, you will slowly regain consciousness as your anaesthetist stops the drugs that were keeping you under anaesthetic. If you needed a tube to allow you to breathe during your procedure, this will remain until you are able to breathe on your own.
You will be placed in a recovery area where a specialist nurse will look after you until you have fully regained consciousness. Please inform the nurse if you are experiencing any pain, nausea or discomfort.
You will need to arrange for a friend or family member to pick you up following your procedure. This is because it can take a little while for your reflexes to return to normal and it may be unsafe for you to drive or leave the hospital alone.
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What risks should I be aware of?
Although anaesthesia is generally very safe, any kind of medical intervention comes with some risk. These risks are usually temporary but some may cause long term impacts. Some procedures and medical conditions carry more risk than others and our anaesthetists will run through any risks they may foresee during your procedure.
Please make sure that if you have previously experienced any anaesthetic complications you flag this with your anaesthetist. If you have any other questions regarding specific risks, then please do not hesitate to get in touch.
For a more detailed explanation of risks associated with anaesthesia, please visit this link from the Australian Society of Anaesthetists.
SPECIFIC QUESTIONS
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Do I need to quit smoking?
There is strong research to prove that smoking significantly increases the risk of complications during anaesthesia. Quitting smoking at any point prior to your procedure can make your anaesthetic safer and your recovery faster. Surgery can be a great opportunity to quit smoking for good.
For further information and advice on this, please read this resource.
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Do I need to stop taking any of my medications?
This will depend on which medications you are currently taking. Some prescribed medications are safe to take right up until the time of your surgery and others, such as some diabetes medications and blood thinners, are not. Your medical team will advise you ahead of time how to manage your prescribed and over-the-counter medications, and any herbal supplements you might be taking.
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I take diabetes medication. Can I keep taking it?
Management of diabetes medication before surgery can be complicated. You will need to discuss with your anaesthetist the best way to manage your insulin or oral medications, and you will be given specific advice.
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What do I do if I have a sore throat or other cold symptoms?
It’s important to be as healthy as possible before an anaesthetic and you should contact your surgeon’s office if you feel unwell in the days leading up to your surgery. Your surgeon and anaesthetist will weigh up the need for your operation against how unwell you are feeling and they will make a decision on whether to proceed. Patient safety is always the guiding principle.
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I am breastfeeding – what do I need to do?
You will in most cases be able to breastfeed up until the time of surgery. And once you are conscious following surgery, breastfeeding is usually safe. Please discuss this with your surgeon and anaesthetist.
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Do I need to remove my acrylic nails?
Your acrylic nails and nail polish may interfere with the monitoring instruments. Depending on your anaesthetist, you may need to have them removed prior to your procedure. Please phone our office so we can advise you on your anaesthetist’s requirements.
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Can I drive home after my day procedure?
You cannot drive home following your procedure and will require an escort to take you home. It is not safe to drive after an anaesthetic for at least 24 hours, as it can take this long for some sedatives to leave your system. Some people can be affected for longer. The exception to this might be if your procedure only involved a local anaesthetic without sedation. In these cases, your doctor will advise you if it is safe to drive yourself home.
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I have a question that hasn’t been answered here. What should I do?
Contact our office on 07 3847 4255 and a team member will answer your query.