Anaesthesia

What does the anaesthetist do during the operation?

Throughout the operation your anaesthetist will be keeping a watchful eye on your breathing and the action on your heart using the monitors. He or she will see that the level of anaesthesia is kept just as deep as is necessary, that you are not feeling pain and that you are sufficiently relaxed for the surgeon to perform his task.

He will also be mindful of the shifts of your internal body fluids that occur during surgery and will ensure that you receive the correct amount of intravenous fluids. Should there be blood loss sufficient for you to be in danger of undue anaemia, blood may be administered. Your anaesthetist will remain with you throughout and will not leave the theatre.

Will I feel anything when I am under general anaesthetic?
No. Modern anaesthetic drugs have made the induction of anaesthesia a simple, stress-free and safe experience. Your anaesthetist will inject an intravenous induction agent into the drip and you will drift off to sleep within 30 seconds. Thereafter you will know and feel nothing until the operation is completed.

What is conscious sedation?
This is a very light form of anaesthesia where the patient does not even lose consciousness. It is used for procedures such as gastroscopies. Sedative drugs are used in very low doses so that the patient is rendered free of any anxiety and discomfort, but can communicate verbally throughout the procedure.

Why does a person experience muscle pains after an operation?

If the muscle relaxant scoline has been used this may cause you to have generalised aches and pains in your muscles for two to three days. This drug is not used routinely and is saved for special situations when the anaesthetist needs to intubate very quickly.

These pains, called scoline pains, are more prevalent in very muscular and fit patients.

What are the advantages of epidural and spinal anaesthesia?

This form of anaesthesia has a number of excellent advantages. Firstly your brain and heart are not affected to any extent so that you remain awake and there is very little danger of the strength of your heartbeat being diminished. When a Caesarean Section is done in this way the mother can hold and appreciate her baby within minutes of delivery, so that a strong bond is formed between the two.

Secondly, the effect on the nerve fibres that conduct pain and touch is greater than that on those which affect movement, so that during labour for example, the pain of the contractions can be controlled but the mother can still move about.

Thirdly, the duration of analgesia is long-lasting so that no other drugs are necessary for pain relief for up to many hours after the operation, thus avoiding the side effects of drugs such as morphine, which has the side effects of drowsiness and nausea.

Is anaesthesia really safe?
Modern anaesthesia has become a very safe procedure, considerably safer than travelling in your motorcar. It is, however, not entirely without some risk and one should not have an operation under anaesthetic unless it is really necessary. The main reasons for the ever-improving safety record are the expertise of your anaesthetist, the continually improving “cleaner” anaesthetics drugs, and the huge technological strides made in electronic devices used to measure your body’s response – the monitors. The risks associated with anaesthesia are that in addition to affecting the nervous system, anaesthetic drugs also affect other organ systems such as the heart.

Who will be involved in an operation?
There are quite a number of highly trained medical personnel who will be involved in your operation. The surgical team will include the surgeon himself, the doctor who will be the surgical assistant, a professional nursing sister, called the “scrub sister”, and her assistant, the floor nurse, who fetches and carries for her. The anaesthetic team consists of the anaesthetist, an anaesthetic assistant, and the recovery room sister.

Why is starvation important?

One of the risks of an anaesthetic is that stomach contents can be regurgitated or that there may be vomiting, and you lungs will be contaminated with stomach contents. This can have very serious consequences. For this reason your anaesthetist will instruct you not to take any fluid for at least two hours or solid food for four to six hours before your operation.

If your operation is been carried out as an emergency and there is not time to allow your stomach to empty, your anaesthetist has to use special techniques to minimise the risk of aspiration, as it is called. But it is always best to keep risks to an absolute minimum, and pre-operative starvation is the best way to do this.