Q. What training has my anaesthetist had?

An Anaesthetist is a doctor who has completed full medical training and then gone on to complete at least another five years of specialist training enabling him or her to perform the technical aspects of anaesthesia and fully manage all elements of patient care including responding to medical complications.

Q. Are there separate fees associated with my anaesthetic?

Yes, the anaesthetic is a separate service to your surgery as a different specialist provides it, so it is billed independently of the surgeon.

Depending on the type of health insurance you have the cost of the anaesthetic may be wholly covered by your insurance or may incur an additional (out-of-pocket) fee. You will be advised of this fee prior to your surgery. Please ask if you have any questions about fees.

Q. What different types of anaesthesia are there?

Local anaesthesia
The anaesthetic drug is usually injected into the tissue to numb the specific location of your body requiring minor surgery, for example, the skin on the face.
This allows patients to be comfortable during certain surgical or medical procedures. Sedation can provide pain relief as well as relief from anxiety that may accompany some treatments or diagnostic tests. During light or moderate sedation, patients are awake and able to respond appropriately to instructions. However, during deep sedation, patients are likely to sleep through a procedure with little or no memory. Breathing can slow and supplemental oxygen is often given during deep sedation.
Regional anaesthesia
Your anaesthetist makes an injection near a cluster of nerves to numb the part of your body that requires surgery. You might be awake, or you may be given something to help you relax, sometimes called a sedative. There are several kinds of regional anaesthesia. Two of the most frequently used are spinal and epidural anaesthesia, which are produced by injections made with great exactness in the appropriate areas of the back. They are frequently preferred for childbirth, or surgery in the lower part of the body including the legs.
General anaesthesia
You are unconscious and have no awareness or other sensations. There are a number of general anaesthetic drugs. Some are gases or vapours inhaled through a breathing mask or tube and others are medications introduced through a vein. During anaesthesia, you are carefully monitored, controlled and treated by your anaesthetist. A breathing tube may be inserted to maintain proper breathing during this period. The length and level of anaesthesia is calculated and constantly adjusted with great precision. At the conclusion of surgery, your anaesthetist will reverse the process and you will regain awareness in the recovery room where a nurse will look after you.

What does the anaesthetist do while I am asleep?

Your anaesthetist stays with you the entire time. He or she does not leave you until you are beginning to wake up, at which point you will be moved to the recovery room and into the care of a special nurse. While your operation is taking place, the anaesthetist monitors all of your vital functions to make sure you are safe and asleep. They will treat any situation that arises and if required will administer a blood transfusion. They will also give you painkillers and drugs to treat nausea and vomiting so that you wake up as comfortable as possible.

How long must I fast for before surgery and why do I need to fast at all? When can I eat and drink again?

Your surgeon and anaesthetist will advise you when to commence fasting. This will be different for various procedures and can also vary for children and babies. During the fasting period it is important to avoid all food and drink and also lollies and chewing gum. You will be advised whether to take regular medications or not.

It is very important that patients have an empty stomach before any surgery or procedure that needs anaesthesia. When anaesthesia is given all the normal reflexes relax making it easy for stomach contents to go backwards into the oesophagus and mouth or even the windpipe and lungs. Because the stomach contains acid, if any stomach contents enter the lungs it can cause pneumonia.

In many cases you can start drinking soon after you wake up and food can be started an hour or two after that. This can vary with the type of surgery and the staff caring for you will advise you.

Can I smoke before surgery?

You should avoid smoking for as long as you can before and after surgery. It is especially important not smoke the morning of surgery. This will help you achieve the best possible results from your surgery and also reduce the chance of anaesthetic complications. For example, quitting will reduce the chances of problems like a wound infection after the operation. Surgery can also be an excellent opportunity to quit smoking for good.

Should I take my regular medications on the day of my operation?

You should tell your surgeon and your anaesthetist about all of your medications, including non-prescription items. They will advise you on what to continue taking. Many medications should be taken as usual with a sip of water even during the fasting period. Others, such as aspirin and other blood thinners or diabetic treatments should be stopped or modified before the operation. Please contact your anaesthetist if there is any uncertainty about your medications.

Can herbal medicines, vitamins or other supplements affect my anaesthetic?

Yes, some herbal medicines and supplements can affect bleeding tendency or blood pressure control. Make sure you discuss any of these products with your anaesthetist.

Will I feel any pain during or after my operation?

No, your anaesthetist will ensure you are pain free during your procedure and will give you painkillers so that you are as comfortable as possible when your anaesthetic ends. While there is some discomfort associated with some types of surgery, you will always have access to appropriate pain relief in the immediate and ongoing post-operative period.

Is anaesthesia safe?

Yes, modern anaesthesia is very safe Advances in equipment, monitoring and drug therapy as well as the Australian standard practice of having an anaesthetist present throughout any anaesthetic all contribute to this safety. Some procedures and medical conditions carry more risks than others and your anaesthetist will discuss any pertaining specifically to you.

What are the side effects of the anaesthetic?

Sleepiness is common after an anaesthetic and usually lasts for the day of the procedure. It is important that patients do not drive or operate dangerous equipment at least until the day after their procedure.

Nausea and vomiting can occur and is more common after certain types of surgery. A variety of effective treatments are available if this occurs. A sore throat is also possible and can last a day or two after surgery.

Although these side effects are relatively common, none of them are dangerous. The more dangerous side effects are rare. Your anaesthetist is trained to deal with them and will discuss any that are relevant to you.