Delivering the safest anaesthesia guided by evidence-based medicine.
1. YOUR ANAESTHETIST.
Anaesthetists are medical specialists; all have qualified as medical doctors first, then completed another 5 years in a rigorous specialist training programme. This qualifies them as a specialist anaesthetist, with a Fellowship in Anaesthesia – often a Fellow of the Australian and New Zealand College of Anaesthetists, or FANZCA.
2. WHAT ARE THE DIFFERENT TYPES OF ANAESTHETIC?
Different types of surgery require different methods of anaesthesia. These include;
General anaesthesia, where you are completely unconscious. This is necessary for many operations, such as removal of the appendix, gallbladder or a bowel resection.
Regional anaesthesia, where a region of the body is anaesthetised. An example is a spinal anaesthetic, for a Caesarean section or some surgery on the leg, or an epidural for pain relief in labour.
Local anaesthesia, where local anaesthetic is injected to numb a particular area; an example is removal of small skin lesions.
Sedation, sometimes called “twilight anaesthesia”, where you are sedated to make you comfortable and deeply relaxed but not unconscious, and typically have little or no recall after the procedure. This is the usual technique for colonoscopy and endoscopy.
The most appropriate type of anaesthetic for you will depend on many factors, including the planned operation, your history, your health and medical conditions, and any medication you are taking. For your safety, tell your anaesthetist about previous operations and anaesthetics, particularly those relating to your heart and blood vessels, and your respiratory system.
DIABETICS: if you are taking any of these drugs THEY MUST BE STOPPED 3 DAYS BEFORE SURGERY: Forixga, Xigduo, Jardiance, Jardiamet, Glyxambi or Qtern. You MUST discuss this with your family doctor, and your surgeon or anaesthetist beforehand, otherwise it will not be possible to proceed with your operation.
Some ANTICOAGULANTS (“Blood thinners”) must be stopped some days prior to surgery; discuss this with your doctor beforehand.
3. BEFORE YOUR ANAESTHETIC.
Your anaesthetist will see you before your surgery. With day-of-surgery admission this may only be possible shortly before your operation, but you will have the opportunity to discuss things with your anaesthetist.
Modern anaesthesia is very safe, but there are things you should do beforehand to make your anaesthetic as safe as possible;
• Tell your anaesthetist about all major surgery and anaesthesia, and any problems you experienced.
• Tell the anaesthetist about any medical problems, medication, and any allergies – if possible, bring in a list of all of these.
• If you are on medication, make sure you know exactly which ones to take and when, and which to stop, particularly anticoagulants (“blood thinners”) and medication for diabetes.
• Stop all nonprescription medication at least 1 week beforehand; these can cause problems with bleeding. Do not take any “recreational” drugs; these make anaesthesia more difficult and increase risks to you.
• Stop smoking; smoking increases the risks of anaesthesia and surgery and of problems afterwards.
• If you are overweight, try to lose weight; being overweight is a significant risk factor.
• Follow the fasting guidelines given to you by the hospital. You may brush your teeth and rinse your mouth, but not swallow water.
• “Nil by Mouth” means exactly that; do not eat or drink anything after the time you are told. Do not drink or sip water, do not chew gum, do not suck lollies. Food or liquid in the stomach mixes with acid; under anaesthesia this can come up the throat and enter the lungs. This is potentially lethal.
• Complete our “pre-operative questionnaire” and e-mail it back to Northside Anaesthesia.
• Discuss any issues of concern with your anaesthetist.
4. AFTER YOUR OPERATION.
• Seek advice about your normal medication, and also about pain killing medication, antibiotics and anticoagulants (“blood thinners”).
• You must be accompanied home, and have someone stay with you at home for the rest of that day and night.
• Spend the rest of the day quietly at home; catch up on your fluid intake and sleep
• Within the first 24 hours,
Do not perform potentially harmful tasks – like cutting and cooking
Do not drive a car
Do not sign any documents – they can be easily discredited
Do not take any recreational drugs
• Follow the instructions you were given before discharge.