Different procedures can be performed with different types of anaesthetic. These may include local anaesthetic, when part of the body will be made numb or general anaesthesia, where you will be asleep for the procedure. The best and most appropriate technique can be tailored specifically for you. This will depend on the surgery & upon your own health.
There are 4 main types of anaesthetics:
A general anaesthetic may appear like a deep sleep but it's quite different. It is often referred to in such terms for comparison & can be an initially similar feeling when it is starting.
During general anaesthesia, your anaesthetist keeps you in a state of carefully controlled unconsciousness. When the procedure has finished this state of anaesthesia is reversed to allow you to regain consciousness in a controlled & comfortable manner.
A regional anaesthetic produces numbness in a region of your body, like your arm or leg. These procedures leave you comfortable but awake & can often be combined with sedation
A local anaesthetic numbs a part of your body. It can be produced with injections, creams or sprays depending on the desired effect & intended procedure. You stay conscious but comfortable.
For a surgical procedure this usually entails applying the anaesthetic on the operating table with a needle & syringe, just under the skin. This can initially sting slightly but then the area will go numb, not unlike a visit to the dentist but usually less unpleasant. You can often talk to your surgeon or anaesthetist during the procedure. You may be aware that something is going on but will feel no pain.
Often the surgeon will apply this type of anaesthetic without the need for an anaesthetist. You may wish to feel slightly sleepy during the procedure & sedative techniques can be provided. Please ask the team about these options.
This is a state between fully awake & unconscious, often referred to as feeling slightly sleepy. It can be produced with a number of techniques, usually achieved with tablets or injections.
Sedation is often combined with local or regional anaesthetic techniques. You remain awake for the procedure although often remember very little of this time
An Anaesthetist in the UK is a fully trained doctor who specialised in taking care of you & your body for a procedure that requires an anaesthetic. Their specialist training & skills allows them to provide the best care for you, not only during your operation but also in the time before and afterwards.
They are extensively trained in human physiology (how the body works), particularly the brain, heart, lungs, kidneys and liver. They are experts not only in anaesthesia but also resuscitation, intensive care and pain control.
They work closely with the surgeons to provide the best possible result from your procedure. This is vitally important in plastic & aesthetic surgery, to provide the area of your body with exactly the correct blood supply & conditions to get the best tissue results from surgery.
Assesses your fitness for surgery.
Decides with you & the surgeon the best type of anaesthetic.
Discuss with you postoperative options including any pain relief required.
Checks all the equipment vital for your safety in the theatre suite.
Organises the anaesthetic team in theatres; to provide you with the best & safest anaesthetic.
Check your vital functions are stable
Ensure you are as comfortable as possible
Ensure you will not be dehydrated
Look after you medically until you are discharged
Organise with the team & ward staff when you can be discharged
Advise on pain killing drugs to take & take home
Yes they are. Millions of anaesthetics are administered every year. With modern techniques, state of the art equipment & anaesthetic expertise serious problems are extremely rare.
Any operation and anaesthetic carries a slight risk. If you are generally healthy this is very low. In a recent survey of operations in the United Kingdom, death due to anaesthesia occurred in about 5 in every million anaesthetics given. To put this in perspective you are hundreds of times more likely to have a crash on the way to the procedure than have a significant one during it.
The fitter you are the better your heart and lungs can tolerate anaesthesia. Your Anaesthetist may ask you about your physical fitness. If you have any significant medical problems you may require a preoperative consultation with the anaesthetist, to optimise your state of health.
8 hours before your procedure.
It is important to adhere to the advice given to you by the team & the institution where your procedure is to be organised.
Normally this advice will be that you should not eat or drink any fluids 8 hours before your procedure. In certain circumstances this may change but confirmation should be sought from the team & anaesthetist dealing with your procedure.
It is sometimes permissible to have clear fluid, water, up to 3 hours before a procedure. However be careful as any problem may cause your procedure to be cancelled for your safety. Please check with the team.
Inhaling stomach contents into your lungs is called "aspiration", and can be dangerous. Fortunately your body has an effective mechanism to stop this from happening. Unfortunately when you are unconscious this mechanism does not work, so it's best that your stomach is empty when you have a general anaesthetic.
Even if you are booked to have a local anaesthetic, it is important to follow the instructions about not eating and drinking.
It is vitally important, for your own safety, not to eat or drink anything before your procedure. Times will vary according to the institution where you are having your procedure & you should check with the team.
Yes it is important to continue with most medications up to and including the day of surgery. There are one or two exceptions & it is best to discuss these with the team by informing them of all the types of drugs you have used recently.
When you talk to the Anaesthetist before surgery, show them all the medications you're taking, including over-the-counter pills, supplements & any other substances. This will reduce the chance of unexpected interactions between anaesthetics and other drugs present in your system.
Providing you are not feeling unwell there is usually no cause for concern. If you suffer from chest problems, such as asthma or bronchitis it would be wise to discuss this with the team before your operation.
If your child is having an anaesthetic and has had a cold in the last 2 weeks you should discuss this with the team.
Smoking can have an adverse effect on many operations. If you are considering stopping smoking, you should allow six weeks for the effects of smoking to wear off.
Any past family history should be discussed with your Anaesthetist before surgery. Knowing exactly what happened during this anaesthetic can assist the Anaesthetist to prepare for your anaesthetic.
Please tell the team of any loose teeth, crowns, bridges, veneers or dentures to avoid damage. Special instruments used to place breathing tubes in a very exact position can press on teeth & could damage loose ones or crowns. It is possible to bite on teeth or crowns when you wake up & this could lead to damage. We know how important teeth & dental implants are to you. All the staff take special care of dental implants but very occasionally these may be damaged during a procedure but this is a rare.
Most general anaesthetics start with an intravenous injection. If you do not like needles then please talk to the team & other technique such as local anaesthetic creams at the site of injection or mask anaesthetics can be used.
Your Anaesthetist will insert a needle (intravenous cannula) into your hand or arm before the procedure. You will then be given anaesthetic and pain relief medication through this cannula. Intravenous cannulas can 'sting/hurt' when being inserted but only for a second. The anaesthetists are experts in placing cannulas quickly & with as little discomfort as possible.
Yes. We can provide local anaesthetic (magic) creams to reduce the sensation. It is possible to be put off to sleep without having an injection. To do this your anaesthetist can use an inhaled anaesthetic agent which you breath through a facemask. However, the Anaesthetist will prefer to have venous access in case you require any medications during your induction.
During most general anaesthetics you will be attached to a bag of fluid containing a balanced salt solution, tailored to replace exactly the constituent of your body fluids. This will replace any fluid loosed by not drinking before & any fluids lost during the operation. These are often used after you operation & a bag of balanced solution will be infused through your cannula whilst you rest afterwards.
This is a very rare event & not usually a problem with this type of surgery.
Specialised monitoring is employed to keep second to second observations on your heart, blood pressure, oxygen saturation & breathing. Some patients may require more extensive monitoring depending on the type of surgery & their health. The most valuable monitoring in theatre is the anaesthetist & surgeon who will be with you throughout the procedure.
Some people are prone to nausea following anaesthetics. However this can often be treated successfully with appropriate medication. Sore throat associated with breathing tube placement is common, but usually only lasts a day or so. Of course, there are a number of infrequent, less serious complications, such as pain and bruising at the site of injections, headaches, and dental damage. These are usually easily treatable, get better quickly, and are also quite rare.
There is a risk but we make every attempt to prevent this. If you have been sick with previous anaesthetic please advise the team. Our record of anti-emetic anaesthesia is very good. We can tailor your anaesthetic & analgesic (painkillers) requirement to prevent this.
Often people undergoing certain procedures can notice a slight sore throat afterwards. This usually goes after one or two days & can often be eased by sucking some types of cough lozenge. Please ask the team.
Please inform the medical team of any allergies you have. Even if you are not sure you are allergic to a certain substances, it is best to discuss these beforehand.
It is possible for a patient to have an allergic reaction to a drug during anaesthesia, but the chance of this occurring is extremely low. If it did happen it is unlikely that you would suffer any permanent harm, as anaesthetists are experts in the recognition and prompt treatment of allergic reactions, particularly those occurring during anaesthesia.
Sometimes patients may think, or be told, that they are 'allergic to anaesthesia' because they have an unpleasant experience that they associate with anaesthesia, for example nausea and vomiting. These are side effects of drug administration, not allergic reactions.
A true allergic reaction to a drug usually produces hives or wheals on the skin, wheezing in the lungs, swelling of the mouth, throat or eyes, and sometimes a drop in blood pressure. Although this can occur with anaesthetics it is extremely rare. Please discuss this with the team.
Yes, many latex / rubber products are used in the theatre setting. Latex allergy is an increasingly common allergy to rubber, which is usually not serious. If you think you have it, you should tell your surgeon and your anaesthetists, so they can avoid using rubber products. Informing the medical team & Anaesthetist at the earliest possible time will allow latex products to be removed from the theatre reducing your exposure to these products.
Please inform the ward staff & medical team if you wear contact lens. For your own safety these should ordinarily be removed prior to any procedure.
It may be possible for some one close to you to accompany you to the start of the procedure. If this is a general anaesthetics until you are asleep. Please ask the staff.
This too will depend on the surgery. After some operations it may be all right for you to eat and drink straight away. Again the team and nurses will let you know what to expect. You should not eat and drink a large amount straight away or you may feel sick.
This will depend on your procedure. Everyone needs some time to recover form surgery & anaesthesia. There may certain activities you should avoid for a period of time. Please ask the team about these.