What happens during my Anaesthetic ?
Prior to your surgery you will be brought to the operating room from the ward area. During this phase you will be asked questions to confirm your identity and confirm the procedure you are going to have. These questions may seem repetitive but these processes are in place for your safety.
In the preoperative holding area I will place an intravenous drip into a vein in the arm and sometimes another drip into the artery at the wrist. This is done with local anaesthetic and causes minimal discomfort. At this stage you may wait for a period of time in the preoperative holding area. At the appropriate time we will move you into the operating room. We will connect some addition monitoring to you and ask you to breathe on a mask with oxygen. This is the beginning of a general anaesthetic. This is where you are put into a state of unconsciousness for the duration of the operation. This is achieved and maintained by injecting drugs through the drip placed into the vein, combined with a mixture of gases which you will breathe. Whilst you remain unaware of what is happening around you, I will be monitoring and preserving your life support systems closely, as well as constantly adjusting the level of anaesthesia. Once the operation is completed, I will stop giving you the anaesthetic drugs which means you will wake up over the next 10 or so minutes.
If you are having an angiogram (dye test of the blood vessels of the brain) we usually do this procedure with light sedation only.
Common side effects
All operations hurt to some degree. However it can be managed. Most anaesthetics involve the administration of pain-killers during the procedure. In general a combination of medications is prescribed to manage the post operative pain. Most pain can be managed by strong pain killers taken orally. Pain after cardiac surgery is usually easily managed.
There are many reasons for feeling “sick”, nauseated or actually vomiting, including the type of operation, your pre-existing condition, use of pain-killers, and the drugs used during Anaesthesia. In general people having back, brain, heart and vascular operations nausea and vomiting is unusual.
This can be due to a breathing tube. At least 95% of patients having a general anaesthetic have some type of breathing tube inserted. You may occasionally be aware of this tube. It does not mean anything has gone wrong during the operation. This is removed in the intensive care unit after the operation. Rarely the insertion of this breathing tube can lead to damage to your teeth, especially if you have caps, crowns or bridgework.
It is unusual to need to have a blood transfusion having brain or spine surgery. If you do need a blood transfusion, be assured that the Australian Red Cross blood is currently safer than it has ever been and probably the safest blood in the world. New tests to detect viruses in blood have reduced the risk of viral transmission to a very low level. During the 2-year period from July 2000 through June 2002 the risk of transmitting HIV was 1 in 4 million, Hepatitis C 1 in 3 million and Hepatitis B 1 in 900,000 per unit of blood transfused.
Other minor problems that can occur include itching, bruising, or soreness at the site of the injection; rashes either due to adhesive tapes or some medications; dry mouth/temporary breathing problems; sore neck, sore/dry eyes; and some discomfort of the arms, legs, or back (that can be due to positioning for the operation). You may also feel cold and shivery.
Rare side effects
There are rare serious problems that can occur, which may or may not be due to the Anaesthesia. These include severe allergic reactions, heart attacks, major blood loss (which may require transfusion), blood clots & pulmonary embolism, stroke, severe asthmatic attacks and other cardio-respiratory problems). The special drips which are placed are invasive and have risks but they are small.
Patients are often worried about waking up DURING their anaesthetic. Although this is possible, it is extremely uncommon with modern anaesthesia and if you are at higher risk of this complication, it will be discussed with you at the preoperative visit. Overall, the risk of one of these major problems occurring is remote. If you wish to know more about these problems, please do not hesitate to ask.