FREQUENTLY ASKED QUESTIONS
What do I need to do before my anaesthetic?
Fasting:
To optimise the safety of your anaesthetic you should be fasted. You will be notified by the surgeons rooms and/or the hospital about when you should stop eating and drinking.
Generally speaking, for adult patients undergoing elective surgery:
• You should not have anything to eat or drink for at least 6 hours prior to your surgery.
• You may continue to have small amounts of water until 2 hours prior to your surgery.
Smoking
Smokers have a higher risk of both anaesthetic and surgical complications. The longer you can abstain from smoking the safer it will be for your anaesthetic.
For maximum benefit you need to stop smoking at least 6 weeks prior to your surgery. Please do not smoke on the day of your surgery.
What about my current medications?
As a general rule you should continue to take all of your normal medications leading up to and including the day of surgery.
Some types of medication such as diabetic medications require special consideration and may need to be ceased or modified leading up to your surgery. Your surgeon and anaesthetist will need to know if you are taking diabetic medication or any 'blood thinning' medications such as aspirin, warfarin, clopidogrel (plavix), rivaroxaban (pradaxa)
Please contact our rooms on 9329 3100 if you have any questions regarding your medications.
What about herbal medicines, vitamins and other supplements?
Many patients are keen to continue these types of tablets throughout the time of their surgery.
Some herbal medicines are known to increase the risk of surgical bleeding and others are known to interact or interfere with some of the drugs given to you at the time of your anaesthetic.
It is difficult to be familiar with all herbal and alternative therapies: if in doubt it is advisable to cease taking them for a week prior to your surgery. It is important that you discuss these with your anaesthetist prior to your operation.
What does the anaesthetist do while I am asleep?
Your anaesthetist will be in the operating theatre looking after you and your safety for the entire duration of your procedure. His responsibilities include:
• Optimising your safety and ensuring you remain asleep throughout your surgery.
• Monitoring and managing your cardiovascular system (heart rate, blood pressure) and respiratory system (breathing rate, oxygen levels).
• Managing pain and nausea as well as making preparations to treat these side effects afterwards.
At the end of your procedure your anaesthetist will escort you to the recovery room where your ongoing care will be coordinated with the recovery room nursing staff.
What happens after the operation?
Your anaesthetist, along with recovery room staff, will continue to monitor your condition well after your surgery is finished to ensure your recovery is safe and as comfortable as possible.
As part of the recovery process, you will be given oxygen to breathe, usually by a clear plastic facemask, and encouraged to take deep breaths and to cough. You will be offered medication to treat any ongoing pain and nausea.
When you are fully awake and comfortable you will be transferred back to your hospital room or waiting area before returning home.
If you are having ‘day surgery’ you must have someone to accompany you home and remain with you for the first night after the operation.
You may feel tired and “washed out” for a day or two after the operation.
IMPORTANT - During the first 24 hours after your procedure you should not:
- drive a car
- use any dangerous equipment or tools
- sign any legal documents
- drink alcohol
What if I am breast feeding?
Please notify your anaesthetist if you are breast feeding. He will try to arrange that you be scheduled earlier on the operating list and may administer some intravenous fluids prior to your operation to ensure you maintain well hydrated.
Many mothers feel more at ease expressing and discarding their breast milk for the first feed after anaesthesia and substituting a bottle of previously expressed milk or formula. However in most cases it is very safe to continue breast feeding throughout the perioperative period. Some anaesthetic and analgesic drugs can make it in to the breast milk, however the actual amounts are very small and will not affect your baby.
Children
Anaesthesia can be given to children of all ages, including newborn babies.
Whilst there are dedicated children's hospitals which perform specialised paediatric procedures, many private hospitals and day-surgery units accept children for routine operations such as tonsillectomy, grommets (tubes in the ear to assist hearing) and dental surgery.
Children are often anaesthetised in a different way to adults. Whereas most adult patients are "put to sleep" by first placing an intravenous needle and then injecting a medication, most younger children are anaesthetised by breathing an anaesthetic gas through a face mask. The procedure is painless and it only takes a few minutes for the child to “fall asleep”.
Parents may be allowed to remain with their child as he or she is anaesthetised depending on the circumstances.
As the child falls asleep, don’t be alarmed if his or her eyes may assume strange positions, such as rolling back. This is normal. They may snore or move their arms or legs – this is a transient happening that occurs as the child moves through different stages of sleep.
After the child is anaesthetised, parents will be asked to leave the operating room or the anaesthetic bay.
Once the surgery is finished and the child is awake in the recovery room, parents may be called to be with them. Often the child may be irritable and teary upon waking from an anaesthetic. There are multiple causes for this, including waking in an unfamiliar environment, the residual effects of the anaesthetic gas as well as pain. The condition resolves and improves with time, but sometimes the anaesthetist may need to administer medication to settle the child.
What are the risks, side effects and complications of anaesthesia?
Anaesthetic risks are best described in terms of side effects which are relatively common and tend to be transient, and complications which are more serious but much less common.
Side effects
Side effects are unwanted secondary effects of drugs or treatment. They include nausea and vomiting, a sore throat which can persist for a few days, and bruising around the injection and drip sites.
Complications
Damage to teeth, lips or tongue: This is related to the fact that instruments are placed in your mouth as a part of the anaesthetic, in order to facilitate the placement of breathing tubes. This can be particularly difficult in patients with limited mouth opening, a small jaw or restricted neck movement.
Awareness. This refers to the situation where patients may become conscious during their operation. It has an overall risk of 1 in 1000 anaesthetics, but tends to be more common in particular circumstances. These include emergency operations and caesarean section procedures performed under general anaesthesia.
Serious allergy to drugs. Very rarely patients may have potentially serious allergic or anaphylactic reactions to drugs such as antibiotics and muscle relaxants.
Nerve damage (paralysis or numbness) may be occur as a complication of regional anaesthesia where needles have been inserted to facilitate local anesthetic inection around nerves. Nerve injury may also occur from inadvertent stretching of nerves which may occur during particularly long procedures. Most nerve damage is temporary and recovers within two to three months.
Death related to anaesthesia is extremely rare, although patients are often particularly anxious about the possibility that they may not wake up from the anaesthetic. If you consider that there are risks associated with normal day to day activities, the risk of dying from an anaesthetic is put in to context. For most people, having an anaesthetic is safer than travelling in a car even though most people would know that there is a very small risk of dying in a car accident. Just as people wear seat belts and obey speed limits to reduce the risk of traffic accidents, having your procedure in an accredited hospital with experienced and qualified medical staff optimises the safety of your procedure.