Anaesthesia

Introduction

If you are planning to have an operation under general anaesthetic, the following section tells you about how the day of the operation will proceed.

Anaesthetist

Before the operation, you will meet the anaesthetist. This is the doctor specialised in the various forms of anaesthesia, pain control and intensive care relating to the operation. The anaesthetist may ask you about your health, what medication you take, or whether you are allergic to certain medicines. You may also be asked about previous operations and how you reacted to the anaesthetic. In this way, the anaesthetist gains an overview of your state of health, also gathering information from your case history and health survey. The anaesthetist may also sometimes make contact with you by telephone before your operation.

Different types of anaesthesia

There are several different types of anaesthesia or sedation. The best known type is general anaesthetic, where the whole body is sedated and you temporarily lose consciousness. Local anaesthetic is also generally known, where a small patch of skin is "locally" sedated, for example to stitch up a wound. With regional anaesthetic, a larger area of the body, for instance an arm, leg or the whole of the lower part of the body, is temporarily numbed. At the Boerhaave clinic, local anaesthetic is administered by the plastic surgeon. If your operation is not suitable for local anaesthetic, the anaesthetist will give you a general anaesthetic.

Preparing for the operation

If the operation is performed under general anaesthetic, your stomach must be empty to prevent vomiting during or after the operation. This often means you will no longer be allowed to eat anything as of midnight the night before your operation. You may of course swallow some water when taking pills or cleaning your teeth. If you are operated on later in the day, you will be allowed to drink clear drinks, such as water, tea and lemonade, up to two hours before the time of the operation. You may not drink any coffee, orange juice or milk products. It is recommended not to smoke before your operation. The airways of smokers are often irritated, making them more sensitive to inflammation. What’s more, it may hurt if you cough after the operation. You will sometimes be shaved in the area where you are being operated. Instead of pyjamas, you will be given a surgical gown to wear. Before the operation, you must take off any jewellery, such as watch, rings and bracelets. You will be asked not to wear any make-up or nail varnish. Glasses and false teeth must also be removed.

General anaesthetic

Before the anaesthetic agent is administered, you will be connected to the monitoring equipment. Sticky pads will be placed on your chest to monitor your heartbeat and a small clip on your finger to monitor oxygen content in your blood. Blood pressure is monitored via your arm. A needle will be inserted into your arm, to which a drip will be connected. The anaesthetist will inject the anaesthetic agent using this needle. You will fall into a deep sleep within half a minute. To be able to monitor your breathing while you are under anaesthetic, a small plastic tube is often inserted into your throat before the operation begins. You will not be aware of this as you will be anaesthetised at the time. The anaesthetist will be with you constantly during the operation. Where necessary, the anaesthetist can adjust the anaesthetic at any time. The anaesthetist will monitor and control your body functions throughout the operation. Thanks to the monitoring equipment, it is possible to accurately ascertain how your body is reacting to the operation. Respiration and circulation can be adjusted wherever necessary and medication administered to maintain your state of unconsciousness.

Coming to after the anaesthetic

Shortly after the operation, you may still feel sleepy and drift in and out of sleep. This is perfectly normal. As the anaesthetic wears off, you may feel pain in the area on which you have been operated. You may also feel nauseous as a result of the anaesthetic or the operation. Simply ask the nurse for a painkiller or anti-nausea drugs. If your throat feels rough or itchy, this will be because of the small tube inserted into your throat during the operation to regulate your breathing. This irritable feeling in your throat will disappear within a couple of days. Many people are thirsty after an operation. If you are allowed to drink, do so in moderation.

After the procedure

After the operation, you will be taken to the recovery room. This is a separate room close to the operating theatre. Specialist nurses will be there to make sure you gently come round after the operation. Here too you will be connected to the monitoring equipment. You will sometimes have a mask over your mouth to give you extra oxygen. If you are allowed to go home that same day, you should make sure you are accompanied by an adult and are not left alone at home. Arrange to be taken home by taxi or in your own car, but do not drive yourself! Take things easy at home for the first 24 hours after the operation. Do not operate any machinery. It is not a good time to make any important decisions. Eat and drink easily digestible food. It is quite normal not to feel 100% fit for a while after an operation. This is not only due to the anaesthetic, but also to the invasive procedure involved in the operation. The body has to repair itself at its own rate. And that takes time.

Is anaesthesia safe?

These days, anaesthesia is very safe thanks to improvements in monitoring equipment, the availability of modern drugs and the high level of expertise of the anaesthetist and his or her staff. However, despite the utmost care, complications cannot always be avoided. For instance, there may be an allergic reaction to the drugs. When the breathing tube is inserted, your teeth may be damaged. And if your body lies in an awkward position during the operation, a nerve may get trapped in the arm or leg, which may lead to a lasting tingling sensation or loss of power. If serious complications occur through the anaesthetic, this is nearly always due to a unforeseen circumstances or is linked to your state of health prior to the operation. Simply ask your anaesthetist if the anaesthetic entails specific risks in your case.

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