YOUR ANAESTHETIC

General Anaesthesia

General Anaesthesia (GA) is when you are ‘put to sleep’ using a combination of drugs and anaesthetic agents.   A state of unconsciousness is induced, usually intravenously via a needle which is placed in a vein in your arm.  The anaesthetic is then maintained by breathing anaesthetic gases through a breathing mask.  The length of surgery and level of anaesthetic required is calculated and this will be constantly adjusted. Your anaesthetist will be with you throughout your operation and will be monitoring your wellbeing.  At the end of your procedure the process will be reversed and you will wake up in the recovery room where you will be looked after by a trained recovery nurse.

Sedation

Sedation is used for some procedures that only require a light anaesthetic.  Your anaesthetist will give you a combination of drugs so that you feel drowsy and relaxed.  It is often used for patients requiring pain relieving injections and can be used in combination with regional blocks i.e. spinal epidurals for Hip and Knee replacements.  Smaller procedures, such as colonoscopy and endoscopy are usually performed under sedation.

Regional Anaesthesia

This is where a region of the body is numbed.  As mentioned above, regional anaesthesia can be used to operate on shoulders, arms, hips and legs and is often used in conjunction with sedation, so that you will be awake but drowsy and free of pain.  The anaesthetist performs a nerve block to that particular part of the body to achieve the numbness.  Regional anaesthetics or blocks are commonly used for cataract surgery and spinal blocks for knee and hip replacements.

Local Anaesthesia

A small part of the body is numbed with an injection and this is often combined with light sedation, so that surgery can be performed with the patient awake.  Many minor skin operations are performed this way, as well as removal of some skin cancers.

General Anaesthesia – Risks and Complications

Anaesthesia is usually very safe but all general anaesthetics carry a risk of complications.  These are increased depending upon your overall health and the type of procedure.

Some of the relatively common side effects include drowsiness, sore throat and mild nausea.  If you have had an anaesthetic in the past and suffered with nausea, inform your anaesthetist who can take steps to try and prevent this.
Less common side effects include temporary breathing difficulties such as wheezing, headaches and lip and tongue injuries.  Occasionally there will be temporary voice changes or nerve injury.   Care is taken not to damage teeth, caps, crowns or bridges but this does very occasionally happen during the placement of the airway tube in the patient’s mouth once the patient is asleep.  Very infrequently a patient may bite on the tube involuntarily.
Very rare side effects include serious complications of heart attack, stroke, severe allergic reactions to anaesthetic drugs, liver or kidney failure, lung damage and permanent nerve damage.  There is a possibility of death but this is very remote.

To minimise your anaesthetic risk, please ensure you inform your anaesthetist of the following:

• Heart problems, including hypertension (high blood pressure), angina, palpitations
• Breathing problems such as asthma or bronchitis
• Whether you have suffered a stroke or mini-stroke
• Neck or back problems
• Ulcers or reflux problems
• Past problems with anaesthetic
• Prescribed medication and any allergies, including reactions to pain killers
• Your weekly alcohol consumption and whether you smoke or use recreational drugs
• Whether you have dentures, crowns, caps, plates or loose teeth.
• Recent illnesses or a bad cold

You will receive a pre-assessment appointment with the nurse prior to your procedure and the above questions will be asked of you.  It is important you answer them as accurately as possible.
Your anaesthetist will have this information when they visit you in your room prior to your surgery and it is important you inform them of any changes.
If your surgery is planned, there are some things you can do that will make your anaesthetic safer.

•  Give up smoking 2 to 3 months before your operation.  Surgery is an ideal opportunity to quit smoking altogether. If however you can’t stop, cut down but don’t give up the day before, as this will only make you agitated.
•  Drink less alcohol and none in the days leading up to your procedure.
•  Take gentle exercise.
•  Observe fasting guidelines

Fasting

To minimise the risk of food or fluid in your stomach being inhaled into your lungs while you are unconscious, it is very important that you follow the fasting guidelines.
For a morning procedure, no food should be consumed after midnight.   Small amounts of water can be drunk up to 2 hours before surgery.  Orange juice, tea and coffee with milk MUST NOT be consumed.  Nor chewing gum.
For an afternoon procedure a light breakfast of tea and toast can be eaten no later than 7am. Water can be drunk until 11am.  Orange juice, tea and coffee with milk MUST NOT be consumed.  Nor chewing gum.

Medication

You should take your medication as usual apart from some blood thinning drugs such as Warfarin and Clopidegrel.  You will be advised by the pre-assessment nurse when you should stop taking them.  If you are in any doubt, please telephone 01494 513964 and our secretaries will check with the anaesthetist concerned.  If you are diabetic, the hospital’s pre-assessment nurse will give you advice, but again if you wish to check please call the office number and we will liaise with your anaesthetist.

Post-Operative Care

After your procedure, your condition will continue to be monitored in the recovery room and pain relieving drugs given as necessary.  You may be given or will have already received it in the operating room, a nerve block or epidural.  These are very effective in controlling post-operative pain.  You will be given further pain relieving medication on the ward should you require it and drugs written up for you by the anaesthetist.  If you are an in-patient, your anaesthetist is only a phone call away and will be contacted by the ward should you require further pain assistance.

Telephone: 01494 513964   /  E-mail: info@csas.uk.com