If you are having a heart operation you will be taken to the operating room after having a “premed” to help relax you. If you are having a chest operation then you may not have a premed. Some drips are placed in the operating room. Your “premed” is topped up during this phase. The drips are inserted into a vein, artery and a special catheter is passed through the heart via a drip placed in the neck. It is unusual to remember any of these procedures. At this stage you are put into a state of unconsciousness for the duration of the operation. This is achieved and maintained by injecting drugs through a cannula placed into a vein, combined with a mixture of gases which you will breathe. if you are having a heart operation once you are asleep a special ultrasound probe is passed into the gullet. It provides additional information regarding heart function whilst you are asleep. Whilst you remain unaware of what is happening around you, I will be monitoring your condition closely and constantly adjusting the level of anaesthesia. Once the operation is completed, you will be transferred to the Intensive Care Unit the Recovery Room. This is where you will be observed closely until you have sufficiently recovered. You will have a special breathing tube in which will be removed when you are sufficiently awake and the heart and lung function are satisfactory.
What happens during my Anaesthetic ?
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 or heart operations this is unusual. Nausea and vomiting after cardiac surgery is unusual.
This can be due to a breathing tube or ultrasound probe that has been inserted into your throat during the anaesthetic. 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 relatively common to need a blood transfusion when having cardiac surgery. It is probably in the order of 30 to 50%. 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. The ultrasound probe which is inserted has a complication rate of about 0.2% (1 in 500). These may be minor complications like a hoarse voice through or a serious problem like a tear in the gullet.
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.