The word anaesthesia is derived from 2 Greek words:
an meaning without and aesthesis meaning sensation.
Anaesthesia refers to a state of no sensation and can be general, regional or local. General anaesthesia involves drugs which induce a deep sleep; regional anaesthesia (epidural / spinal) involves injecting drugs around the spine to numb the legs and abdomen; local anaesthesia involves injecting drugs into the skin to numb a small area. Sedation involves drugs that produce sleepiness or a light sleep but stop short of general anaesthesia.
All of these techniques can be used alone or in combination depending on the specific procedure. The decision as to which is best for your situation will be made by your consultant anaesthetist after discussion with you.
WHO IS AN ANAESTHETIST?
Anaesthetists are medical specialists, who are highly trained doctors that undergo five or more years training in anaesthesia, pain management, resuscitation and the management of medical emergencies after graduating from medical school and completing internship and residency years.
The Anaesthetist is responsible for ensuring your safety by monitoring and controlling all of your vital functions while you are under anaesthesia. They will stay with you for 100% of the time until you wake, and will also be involved with your post-operative pain management, your safety is their highest priority.
TYPES OF ANAESTHESIA
The anaesthetist administers anaesthetic medicine either by injection or by inhalation to produce a deep state of unconsciousness for the duration of the operation. The anaesthetic drugs administered through a cannula placed in a vein can eliminate all sensation including pain, thus allowing a painless surgical procedure. You are monitored throughout the whole procedure and the anaesthetist can adjust the level of anaesthesia according to your unconscious state.
Local anaesthetic medicine is administered to a specific location eg the tissue near the surgical site. This numbs the nerve/nerves of the site thus avoiding the need for general anaesthesia.
Local Anaesthetic medicine is injected around major nerve bundles supplying body areas eg spinal and epidural anaesthesia where the lower half of the body is made temporarily numb. Or nerve block where local anaesthetic is injected around a specific nerve or bundle of nerves supplying sensation to an area eg the shoulder.
The anaesthetist administers drugs to make you relaxed and drowsy. This is sometimes called ‘twilight sleep’ or ‘intravenous sedation’ and may be used for some eye surgery, some plastic surgery and for some gastroenterological procedures.
- Try and stay fit or get fit eg by walking swimming
- Eat well and stay rested
- Reduce alcohol consumption
- Stop smoking 6 weeks before
Before coming to hospital
Patients who are a high risk or who are preparing for major surgery may be required to have a preoperative appointment with their anaesthetist in their rooms.
- Bring a list of medication -dosage and strengths to the appointment
- Some medication may need to be stopped or varied eg blood thinners, diabetic medications upon instruction by your anaesthetist
- Know any allergies to what drugs that may have occurred
- Bring with you any relevant letters or test results from other doctors
Your anaesthetist will perform a health and fitness assessment to enable them to discuss your anaesthetic options with you and any concerns about anaesthesia you may have.
General fasting instructions
- No solid foods or dairy products should be consumed 6 hours before your surgery.
- You may continue to drink water up to 4 hours before your surgery. You may then continue to have sips of water up until 2 hours before your operation.
- Please note: Patients having a gastric sleeve or lap. band may be given specific fasting instructions.
Day of operation
Patients should arrive at the hospital/health care facility at their allocated time so that they can be admitted and health checks performed by the nursing staff prior to the scheduled surgery.
The hospital/health care facility will notify patients when they must arrive.
Your anaesthetist will also visit you for a preoperative check.
After your operation
Patients are taken to the recovery room where the anaesthetist and nursing staff will continue to monitor and keep them as comfortable as possible.
You will feel drowsy for a little while after you wake up. You may have some discomfort or pain, a sore or dry throat, feel nausea or have a headache. These are temporary and usually pass quickly.
Only when you are fully awake and comfortable will you be transferred back to your room/ward or be released.
- Make sure there is someone to accompany you home after day surgery and make sure they stay until the next day.
- Any medication required for your recovery at home will be supplied to you from the hospital pharmacy at your cost.
- You may eat and drink as you wish unless your surgeon instructs otherwise. Light food is best at first. On the day of surgery you must not drive a car, operate dangerous machinery, sign any legal documents or drink alcohol.
Nausea (feeling and being sick) has been reported to occur in up to 50% of patients following anaesthesia. We treat nausea very seriously because it is so unpleasant and is high on our patients’ list of concerns. We use a combination of medications and other techniques to reduce the incidence of nausea.
It is our aim to optimise pain relief while minimising the side effects of the painkillers. A variety of oral medications are used – often in combination – for minor surgery. Intermediate surgery often requires the addition of stronger pain killers which may be required as injections. Major surgery usually requires either strong painkillers in a drip or tablet form, and/or the use of a regional anaesthetic technique e.g. Epidural, major peripheral nerve block.