| Having a general anaesthetic
|
| |
When you have a general
anaesthetic, you will be asleep before your operation begins and
will wake up afterwards with no memory of the procedure.
Your anaesthetist is present throughout your time in the operating
theatre and will give various drugs so that you are comfortably
asleep during the operation and wake up promptly when it is over,
feeling the minimum amount of pain.
The anaesthetist is also in charge of monitoring and controlling
your breathing, heart beat and other vital body functions during
the operation so that the surgeon can concentrate on the surgery.
All anaesthetists are doctors and have additional specialist qualifications.
|
| |
| Getting ready for surgery
|
| |
| Your anaesthetist will visit
you in your room before the operation starts. He or she will ask
you about your health and about any previous experience you've
had of operations or anaesthesia. It's particularly important
that you tell the anaesthetist about any medicines, prescribed
or over-the-counter, that you're taking. Also tell the anaesthetist
about any caps, crowns or dentures you have so that extra care
can be taken to protect these when masks and tubes are fitted.
|
| |
| Eating and drinking |
| |
You'll be given specific
advice about this from the hospital. In general, you shouldn't
eat for about six hours before surgery so that your stomach is
empty. This reduces the chance of complications caused by being
sick during the operation. Sipping clear fluids up to two hours
before your operation is usually allowed.
To get ready for surgery, you may be asked to put on a surgical
gown and some elastic stockings. These are worn from the knee
down and help to maintain the circulation in the veins of your
lower legs, so helping to prevent blood clots from forming.
Lastly, many people may be nervous before an operation and you
may be offered a pre-medication. This is a drug given as tablets,
liquid or by injection. It relieves anxiety and makes you feel
relaxed. It can also make you feel quite sedated or even 'out
of it'.
Modern anaesthetics are so safe, rapidly acting and effective
that most people don't need pre-medication, especially for procedures
that don't require an overnight stay. You can discuss this with
your anaesthetist. |
| |
| The operating theatre |
| |
The operating theatres are
usually in a separate area of the hospital - the theatre suite
or operating block. You will normally travel from your room to
the theatre on a bed or trolley.
At the entrance to this area, you will be handed over to a theatre
nurse or theatre technician. At this point in the journey you
will be awake. |
| |
| The anaesthetic room |
| |
From the entrance to the
theatre suite, you will be taken to the anaesthetic room. This
connects with the operating theatre. A technician or a nurse will
help the anaesthetist prepare you for the operation.
The anaesthetist will insert a narrow plastic tube - called a
cannula - into a vein on the back of one of your hands. This is
a sharp sensation, like an injection, that passes quickly. With
the cannula in place, the anaesthetist can give the various drugs
that put you to sleep and control pain and nausea, without repeated
injections. For certain operations, you will also be given a water-based
drip into another vein to help prevent you becoming dehydrated.
For most operations, the anaesthesia is started with a drug injected
through the cannula. Within seconds of having this, you will fall
asleep and won't wake up again until after the operation is complete.
Read the box on the back page if you are interested in more information
about what happens during general anaesthesia. |
| |
| Recovery |
| |
When the operation is finished,
you will be moved to the recovery room where a nurse provides
one-to-one care. This is where you will wake up from the anaesthetic.
The care includes constant monitoring of your heart rate, breathing,
blood pressure and other vital body functions. It's routine to
be given oxygen through a face mask.
It's normal to feel sleepy or disorientated in the first 15 minutes
or so after you first come round. You may also have a sore throat
caused by the tube that was placed there to keep your airway open.
You may feel sick, although preventive medicines are now given
routinely for many procedures. You should not experience serious
pain. |
| |
| Returning to your room
|
| |
Once you have recovered
from the anaesthetic, and the anaesthetist is happy with your
progress, the connections to the monitoring equipment will be
taken off. You will then be able to return to your room on the
trolley or bed.
When you no longer need intravenous medicines or fluids, the cannula
or drip will be removed.
After complex operations you may need further close monitoring.
This takes place in a 'high dependency' ward where one nurse looks
after no more than two patients at a time. Attachment to the monitoring
machines and connection to a drip will be continued. |
| |
| Pain relief |
| |
This is also known as 'analgesia'.
Depending on the type of operation you've had, you may need pain
relief medication which will be tailored to the expected amount
of pain you may experience. This is often simple painkillers such
as paracetamol, but for more severe pain, there are other drugs
available.
Controlling pain after an operation is very important as pain
can interfere with your recovery. |
| |
| Patient-controlled analgesia
(PCA) |
| |
PCA is used for some but
not all procedures. It consists of a pump connected to a vein
in your hand or arm that allows you to regulate how much medication
you receive. Patients who are in control in this way tend to use
a smaller amount of pain relief medicine than if it's administered
in set doses at regular intervals.
You will be shown how to use the pump, which is usually operated
by a simple button. It's designed so that you cannot take a harmful
amount of the painkiller. |
| |
| Going home |
| |
If your operation has been
planned as a 'day case', you will need to rest on your bed for
a couple of hours or so before going home.
Modern anaesthetics are quickly flushed out of your system. However,
you should follow the advice of the nurses about how much activity
you should do and this will depend on the type of operation you
have had.
Get someone to drive you home and avoid operating machinery or
making important decisions in the 24 hours after your operation.
Once you get home, you can ring the hospital for information or
advice at any time. |
| |
| Benefits and risks of anaesthesia
|
| |
Anaesthesia has made surgery
much safer. The routine use of high technology, such as equipment
that constantly measures the amount of oxygen in the blood, has
made it safer still.
However, there are still some risks. These can be divided into
the risk of side-effects and the risk of complications. |
| |
| Side-effects |
| |
| These are unwanted but mostly
temporary effects of successful treatment. You may feel tired
for a day or so after a general anaesthetic, but this may also
be part of the body's normal response to surgery. You may also
find your memory and concentration are worse than usual for a
while. |
| |
| Complications |
| |
| Serious complications, and
death, as a result of anaesthesia do occur, but they are very
rare. Older people in good health are not necessarily at higher
risk than younger people. Your anaesthetist will be willing to
discuss how these risks affect you. |
| |
| During the operation |
| |
The exact type of anaesthesia
you are given depends on the procedure you are having. After you
have been put off to sleep, general anaesthesia typically includes
an inhaled gas that is a modern form of ether, plus a strong painkiller.
Depending on the site of the operation you may also get a drug
that relaxes your muscles.
Once you are asleep, a flexible tube may be put into your throat
to allow oxygen and anaesthetic gas to flow freely into your lungs.
Throughout the procedure, the anaesthetist will use electronic
monitoring equipment to constantly check the amount of oxygen
reaching your bloodstream. The amounts of other gases in the air
you breathe in and out, including the anaesthetic and carbon dioxide,
are also measured.
Your blood pressure and pulse rate will be constantly supervised.
As well as the gas that keeps you asleep, the anaesthetist may
give you a number of other drugs. These ensure that when you wake
up any pain is controlled. Other drugs help avoid the nausea (feeling
sick), or vomiting, that can be caused by some anaesthetics or
surgery.
When the surgery is complete, the anaesthetist will start your
wake up from anaesthesia. This is known as 'recovery' and begins
when the anaesthetic gases or drugs are stopped. You will also
be given a drug to reverse the effects of any muscle relaxant.
If you have a tube in your throat this will be taken out as you
wake up and a mask will be put over your face to provide oxygen.
|
| |
| Further Information |
| |
American Society of Anesthesiologists
http://www.asahq.org/patientEducation/
The Association of Anaesthetists
http://www.aagbi.org/ |
| |
Healthwise (Health Information Resource
Centre)
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email : info@healthwise.org.hk
Homepage : http://www.healthwise.org.hk/
This leaflet is for information only. For a detailed
opinion or personal advice, please consult with your own
doctor |
|
| |
| |
|
|