What is Anaesthesia?
Anaesthesia stops you feeling pain and other sensations. It can be given in various ways and does not always make you unconscious.
Local anaesthesia involves injections that numb a small part of your body. You stay conscious but free from pain.
Regional anaesthesia involves injections that numb a larger or deeper part of the body. You stay conscious but free from pain.
General anaesthesia gives a state of controlled unconsciousness. It is essential for some operations. You are unconscious and feel nothing.
- discuss the type or types of anaesthetic that are suitable for your operation. If there are choices available, your anaesthetist will help you choose what is best for you
- discuss the risks of anaesthesia with you
- agree a plan with you for your anaesthetic and pain control
- are responsible for giving your anaesthetic and for your wellbeing and safety throughout your surgery
- make your experience as calm and pain free as possible.
On the day of your operation
- Nothing to eat or drink – (‘nil by mouth’)
This is because if there is food or liquid in your stomach during your anaesthetic, it could come up into your throat and damage your lungs.
- The usual period for not consuming solid food or milky liquids is 6 hours. Clear fluids can be drunk up to 2 hours prior to surgery but not fizzy drinks.
- If you are a smoker you should not smoke on the day of your operation.
- If you are taking medicines: most medicines should be continued before an operation, but there are some important exceptions. This should be discussed with your surgeon or anaesthetist prior to admission.
- If you feel unwell when you are due to come into hospital, please telephone the ward for advice.
Meeting your anaesthetist
Your anaesthetist will meet you before your operation.
They will discuss the anaesthetic options with you, including benefits, risks and your preferences.
If there is a choice of anaesthetic, this will depend on:
- the operation you are having and your physical condition
- your preferences and the reasons for them
- the recommendation of the anaesthetist, based on experience
Pre-medication (a ‘pre-med’) is sometimes given before some anaesthetics.
Premeds prepare your body for surgery – they may start off the pain relief, reduce acid in the stomach or help you relax. Some pre-meds make you more drowsy after the operation. If you think a pre-med would help you, please ask your anaesthetist.
A needle is used to start most anaesthetics in adults. If you are very worried about this, please talk to your anaesthetist.
Sedation. This is the use of small amounts of anaesthetic or similar drugs to produce a ‘sleep like’ state. If you are having a local or regional anaesthetic, you will need to decide whether you would prefer to:
- be fully alert
- be relaxed and sleepy (sedation) but not unconscious
- have a general anaesthetic as well.
When you are called for your operation
- A member of staff will go with you to the theatre.
- You can wear your glasses, hearing aids and dentures until you are in the anaesthetic room. You may be able to keep them on if you are having a local or regional anaesthetic.
- Jewellery and/or any decorative piercing should ideally be removed. If you cannot remove it, the nurses will cover it with tape to prevent damage to it or to your skin.
- If you are having a local or regional anaesthetic, you can take your own electronic device, with headphones to listen to music.
- You may walk to theatre, accompanied by a member of staff, or you may go in a wheelchair or on a bed or trolley. If you are walking, you can wear your own dressing gown and slippers.
- Final checks will be done as you arrive in the operating department, before the anaesthetic starts. You will be asked to confirm your name, the operation you are having, whether left or right side (if applicable), when you last ate or drank and your allergies. These routine checks are normal in all hospitals.
Starting the anaesthetic
Your anaesthetic may start in the anaesthetic room or in the operating theatre. Your anaesthetist will be working with a trained assistant. The anaesthetist or the assistant will attach machines that measure your heart rate, blood pressure and oxygen levels.
Almost all anaesthetics, including some kinds of local anaesthetic, start with a needle being used to put a cannula (thin plastic tube) into a vein in the back of your hand or arm. If needles worry you, please tell your anaesthetist.
Local and regional anaesthetics
If you are having a local or regional anaesthetic:
- your operation will only go ahead when you and your anaesthetist are sure that the area is numb
- you will remain alert and aware of your surroundings, unless you are having sedation. A screen shields the operating site, so you will not see the operation unless you want to
- if you are having sedation, you will be sleepy and relaxed. However, you may be aware of events around you
- for regional anaesthetics, your anaesthetist is always near to you and you can speak to him or her whenever you want to. For local anaesthetics, other theatre staff may be looking after you.
There are two ways of starting a general anaesthetic:
- anaesthetic drugs may be injected into a vein through the cannula. This is generally used for adults
- you can breathe anaesthetic gases and oxygen through a mask, which you may hold if you prefer.
- Once you are unconscious, an anaesthetist stays with you at all times and continues to give you drugs to keep you anaesthetised.
The Recovery room
After the operation, you will usually be taken to the recovery room. Recovery staff will make sure you are as comfortable and free of nausea as possible. When they are satisfied that you have recovered safely from your anaesthetic you will be taken back to the ward.
Pain relief afterwards
Good pain relief is important and some people need more pain relief than others. It is much easier to relieve pain if it is dealt with before it gets bad. Pain relief can be increased, given more often, or given in different combinations.
Here are some ways of giving pain relief:
Pills, tablets or liquids to swallow These are used for all types of tpain. They take at least half an hour to work. You need to be able to eat, drink and not feel sick, for these drugs to work.
These are often needed, and may be intravenous (through your cannula into a vein for a quicker effect) or intramuscular (into your leg or buttock muscle using a needle, taking about 20 minutes to work).
These waxy pellets are put in your rectum (back passage). The pellet dissolves and the drug passes into the body. They are useful if you cannot swallow or if you might vomit.
Patient-controlled analgesia (PCA)
A machine allows you to control your pain relief yourself. The medicine enters your body through your cannula.
Local anaesthetics and regional blocks
these types of anaesthesia can be very useful for relieving pain after surgery.
In modern anaesthesia, serious problems are uncommon. Risk cannot be removed completely, but modern equipment, training and drugs have made it a much safer procedure in recent years.
To understand a risk, you must know:
- how likely it is to happen
- how serious it could be
- how it can be treated.
The risk to you as an individual will depend on many factors including:
- whether you have any other illness
- personal factors, such as smoking or being overweight
- surgery that is complicated, long or done in an emergency.
Side Effects and Complications
Very common (1 in 10 Someone in your family) and Common side effects – (1 in 100 Someone in the street)
Feeling sick and vomiting after surgery
Dizziness, blurred vision
Damage to the lips or tongue (usually minor)
Aches, pains and backache
Pain during injection of drugs
Bruising and soreness
Confusion or memory loss
Uncommon side effects and complications (1 in 1,000 Someone in a village)
Slow breathing (depressed respiration)
Damage to teeth
An existing medical condition getting worse
Rare (1 in 10,000 Someone in a small town) or very rare complications (1 in 100,000 Someone in a large town)
Damage to eyes
Heart attack or stroke
Serious allergy to drugs
Awareness (becoming conscious during your operation)