Dr. Damon Sutton

MB BS FANZCA PGDipEcho

Guidelines Before Surgery:



Your Role

  1. What the Anaesthetist needs to know
  2. Fasting
  3. General Anaesthesia, Regional Anaesthesia or Sedation
  4. After the Operation
  5. Risks & Complications

Your Role:

There are some things you can do which will make your anaesthetic safer;

  1. Get a little fitter - even a regular walk can do wonders.
  2. Don't smoke - ideally stop 6 weeks before surgery
  3. Drink less alcohol
  4. If you are taking aspirin or other blood thinners, you should contact your surgeon as these may need to be stopped up to 10 days before the date of surgery.
  5. Observe fasting guidelines.
  6. On the day of surgery continue to take all prescribed drugs with a sip of water. One exception are tablets for diabetes which should not be taken. Patients who take insulin should contact their specialist or myself at my office for specific advice.
  7. If you are being admitted on the day of surgery, I would like to meet you before the commencement of the operating list so that I can review your medical history and discuss any questions with you. For morning surgery which starts at 7.45am, this means that you need to arrive before 7.00am to get through the hospital paperwork. For afternoon surgery which starts at 1.00pm, this means that you need to arrive before midday.

What the Anaesthetist Needs to Know:

To minimise the risk to you and plan the most suitable anaesthetic I need to know how fit you are. I am interested to know, for instance, if you get short of breath doing normal activities such as showering, walking on the flat or going upstairs.

I also need to know if you have any history of medical problems. Examples include:

  1. Breathing problems like asthma or bronchitis
  2. Heart problems like hypertension, angina, palpitations, blackouts
  3. Nerve problems like strokes, mini-strokes
  4. Neck problems or back problems such as sciatica
  5. Gland problems like diabetes or thyroid disease
  6. Severe reflux, indigestion or ulcer problems
  7. Recent illnesses such as a bad cold

Other important information includes:

  1. Past problems with anaesthesia or surgery
  2. Any loose teeth, dentures, caps or plates
  3. Heavy smoking, alcohol, or recreational drug use
  4. Any prescribed medications
  5. Any allergies
  6. Bad reactions to pain killers

Fasting:

To minimise the risk of food or fluid in the stomach being inhaled into your lungs while you are unconscious, it is important that you follow the fasting guidelines. For a morning procedure, no food or fluid should be taken after midnight. For an afternoon procedure, no food or fluid should be taken after an early light breakfast.

General Anaesthesia, Regional Anaesthesia Or Sedation:

Depending on the type of procedure, you may have a general anaesthetic, a regional anaesthetic or intravenous sedation associated with local anaesthesia. I will discuss the various anaesthetic and post-operative pain control options available to you at the pre-operative assessment.

General anaesthesia involves placing you in a state of controlled unconsciousness for the period of the operation. This is achieved by administering drugs by a small needle into a vein or by inhalation. All your bodily functions are carefully monitored. As well as adjusting the ananesthetic as required, I will also administer pain killers, fluids, drugs to change the contraction fo the heart and medications to prevent nausea.

Regional anaesthesia refers to numbing an area by injecting local ananesthetic near major nerves. Examples of this include spinal, epidural and shoulder/arm blocks. Usually you will receive light general anaesthesia as well, so that you are totally unaware of what is going on. The blocks are also often very helpful in controlling post-operative pain.

Intravenous sedation for shorter procedures in association with local anaesthesia may not make you completely unconscious, but you will not have any discomfort.

After the Operation:

To ensure that your recovery is as smooth and trouble-free as possible, I will continue to monitor your condition in the recovery area. More pain medication will be adminsitered if you are not comfortable, and maybe continued in the ward.

Relatively common side effects are feeling drowsy, dizziness, sore throat, blurred vision and mild nausea. These are temporary and usually pass quickly. Please contact me if you have worrying after effects.

If you are having day surgery, make sure there is someone to accompany you home. It is not wise to drive, make important decisions, usa any dangerous equipment, sign legal documents or drink alcohol on the day of surgery. A prescription for strong pain killers will be given to you if you undergo a painful procedure.

Risks & Complications:

As stated previously, the risks of anaesthesia in Australia are very low. Some patients are, however, at increased risk of complications due to their health status and type of surgery they are undergoing.

Infrequent complications include: bruising at the injection site, temporary breathing difficulties such as asthma, muscle pains, headaches, damage to teeth and dental prostheses, lip and tongue injury, temporary voice changes and temporary nerve injury. Waking up in the middle of an operation (more likely during emergency surgery or Caesarean section) is very unusal.

There can also be some very rare and serious complications including: seizures, heart attack, stroke, severe allergic reactions. liver or kidny failure, lung damage such as pneumonia, paraplegia or quadriplegia, damge to voice box, infection from blood transfusion and permanent nerve injury from epidural injections. The possibility of death is remote but does exist. For healthy patients the risk of death is approximately 1/200,000.