Before anaesthesia, surgery was very much a final attempt to save life. A limited number of procedures were possible and surgeons were judged by their speed. The development of safe and controllable anaesthesia allowed surgeons to take more time, be more accurate and undertake more complex procedures. Today, consultant anaesthetists are highly trained and skilled physicians who provide a wide range of patient care. Anaesthesia is now very safe, with mortality of less than 1 in 250,000 directly related to anaesthesia.
Spire Norwich Hospital and Norfolk and Norwich University Hospital Consultant Anaesthetist Dr David Spackman answers some common concerns raised by patients prior to a general anaesthetic.
What is general anaesthesia?
General anaesthesia helps doctors put patients to sleep and keep them asleep for surgery or other medical procedures. When you have a general anaesthetic you will not feel or remember the operation.
What happens before my operation?
For certain operations you may be asked to attend a pre-admission clinic, where you may meet your anaesthetist. Otherwise you will meet your anaesthetist on the day of your operation. You will be asked about your health and about any hospital treatment you have previously undergone. It's important you tell your anaesthetist about any allergies you may have and about any medication you are taking (whether prescribed, herbal, or over-the-counter).
Is a general anaesthetic more dangerous for smokers?
If you smoke, you should aim to give up a few weeks before surgery. This will significantly reduce your risk of breathing problems during and after general anaesthesia.
Can I eat or drink before my operation?
You should always follow the fasting instructions given in your admission letter. Typically, you must not eat or drink for about six hours before general anaesthesia.
How do you ‘knock me out’?
Whilst in the anaesthetic room you will have a narrow plastic tube (called a cannula) inserted into a vein, usually on the back of your hand or in your arm. This may cause a scratch sensation, like an injection, but passes quickly. With the cannula in place, the anaesthetist can administer the various medications that put you to sleep and control pain and nausea, without repeat injections.
Just because I’m asleep, why don’t I feel pain?
To help control pain during and after surgery, your anaesthetist may give you pain relief which can be injected through the cannula. They may also use a variety of local anaesthetic injections. These will all be explained to you before you are put under a general anaesthetic.
How do you know if I’m safe during the operation?
Your anaesthetist will remain with you throughout the operation. You will be connected to machines that closely monitor the activity of your heart and other body systems. As well as making sure you are asleep your anaesthetist will keep a close check on your heart rate, blood pressure, and the amount of oxygen in your bloodstream.
How do you wake me up?
The anaesthetic drugs will be topped up constantly throughout the operation to keep you asleep. When the anaesthetic drugs are stopped, by the anaesthetist, you will begin to wake up or “recover” quite quickly. Generally, you will then be moved to the recovery room where a specialist nurse will provide your post-operative care. It is routine to be given oxygen to breathe through a face mask at this stage so do not worry if you wake up with an oxygen mask on. Your nurse will continue to monitor your heart rate, blood pressure and other vital body functions until you are well enough to return to the ward.
How will you control any pain after my operation?
Depending on the type of operation you may need pain relief. There are a wide range of medications for pain control available which will be tailored to suit your individual needs. There are also many types of local anaesthetic injections that can be used together with a general anaesthetic and these can help greatly with the control of pain after an operation. Your anaesthetist will talk to you about this if they think it is suitable for you.
Controlling pain after an operation is very important as pain may interfere with your recovery, so please discuss any discomfort with your nurse, anaesthetist or consultant.
When can I go home?
If your operation is not a “day-case” you will be advised by your consultant surgeon how long your recovery in hospital is likely to take. For day-case surgery, you will need to rest on your bed for a few hours before going home. Modern anaesthetics are quickly flushed out of your system. Where possible you should try to arrange for somebody to stay with you at home for the first 24 hours. You will need to get someone to drive you home and should not drive for 48 hours after a general anaesthetic. However, depending on your operation, your consultant may recommend you do not drive for a longer period.
So, it is safe to have a general anaesthetic?
The use of modern anaesthetic technology has made many types of surgery possible. However, there is still the risk of side-effects and complications. Side-effects are the unwanted but mostly temporary effects of successful treatment. After having a general anaesthetic, you may have a sore throat, a headache, or feel tired and confused for a couple of days but the long term benefits of successful anaesthesia and surgery far outweigh the side-effects.
For further information regarding the Norwich Anaesthetists Group visit ww.norwichanaesthetists.co.uk.
All surgery carries an element of risk and the content of this page is provided for general information only. It should not be treated as a substitute for the professional medical advice of your doctor or other healthcare professional.