FAQs FOR DR JARRETT BARKER-WHITTLE
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What time will my operation start?
The hospital will contact you the day before your operation (or on Friday for Monday cases) and advise your admission time to hospital. Often they do not make this phone call till late into the afternoon. If you do not receive a time, please call your hospital.
What does an anaesthetist do?
An anaesthetist is a specialist doctor who has completed a medical degree at university and then undertaken further training specifically in anaesthesia. The anaesthetist monitors your condition carefully until you have safely awoken in the recovery room.
Your anaesthetist looks after your safety and comfort during and immediately after your surgery.
They do this by:
- Considering your medical history before the operation and make sure it is okay for your surgery to proceed.
- Commencing and maintaining the anaesthetic during your procedure.
- Monitoring you throughout the surgery. This includes your breathing, the action of your heart, the depth of your anaesthetic and your fluid levels during the procedure.
- Giving you medications to control pain and nausea and keep your body relaxed.
- Managing problems if they arise.
What are the risks of Anaesthesia?
The information presented here is a general guide only. Specific risks vary form patient to patient and you are encouraged at all times to ask questions and to gather information from relevant sources.
Physical injuries
Damage to teeth occurs in fewer than 1 in 100 general anesthetic cases. This usually occurs when a breathing tube is inserted in your airway while you are asleep or if a plastic sucker has to be used to clear fluid in your mouth.
Sore throat
Sore throat may occur in up to 45 per cent of patients having anaesthesia requiring a breathing tube. More rarely damage to the voice box can occur and even more rarely this may result in permanent voice changes
Nerve injuries
Nerve injury (damage to nerve fibres) following nerve blocks (regional anaesthesia) occurs in approximately 0.02 per cent or 1 in 500 cases. More commonly this is temporary nerve damage , however permanent nerve damage or paralysis resulting in the loss of function of limbs, breathing control, bladder or bowel function can also occur.
Death
Death related to anaesthesia is extremely rare. Type of surgery (in particular if the surgery is an emergency such as for major trauma), underlying medical condition, physical status, and age all impact on the rate of death.
For a healthy patient undergoing surgery the incidence of death is about one in 100,000. For all patients with all different physical conditions, including those that are not expected to survive with or without the operation, the incidence is about one in 50,000.
Allergy
It is possible to have an allergic reaction to medications given as part of anaesthesia. The reaction varies from a mild allergic reaction, such as a rash, to a life-threatening reaction called anaphylaxis, which is a severe life-threatening allergic reaction. The incidence of anaphylaxis reactions to anaesthetic agents in Australia is 1 in 10,000. It is important that you tell your anaesthetist if you have experienced an allergic reaction to any medications in the past.
Nausea and Vomiting
In the past, nausea or vomiting were relatively common after general anaesthesia however with new and improved anaesthesia medication and delivery systems, and appropriate use of anti-nausea medication, there has been a reduction in the number of patients experiencing these symptoms. Postoperative nausea and vomiting (PONV) occurs in 20 to 30 per cent of the general surgical population and in up to 70 to 80 per cent of high-risk surgical patients.
Other risks
Awareness
Heart attack, stroke, brain damage, kidney or liver failure may occur
Infection from blood transfusion by bacteria, hepatitis or HIV/Aids
The anaesthetic may affect your judgment. For 24 hours you must not: Drive; Operate machinery; Cook; Sign any legal documents.
What types of anesthetics are there?
Sedation
This is also often called "twighlight' sedation. Sedation allows patients to be comfortable during certain surgical or medical procedures. Sedation can provide pain relief as well as relief of 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.
Local and Regional anaesthesia
Local anaesthesia involves the injection of local anaesthetic into the tissues near the surgical site. It is usually used for minor surgery, such as toenail repair, skin lesion or a cut to remove something. It is often supplement with sedation.
Regional anaesthesia involves the injection of local anaesthetic around major nerve bundles supplying body areas, such as the thigh, ankle, forearm, hand, shoulder or abdomen. Regional anaesthesia is sometimes achieved by using a nerve-locating device, such as ultrasound. This device helps to locate the selected nerve(s) so that local anaesthetic can be delivered with improved accuracy. Regional anaesthesia may be used on its own or combined with general anaesthesia.
The duration of the anaesthesia depends on which local anaesthetic is used, the region into which it is injected and whether it is maintained by continual doses or repeated injections. Typically numbness can last several hours but may last up to several days. Generally, the "heaviness" wears off within a few hours but the numbness and tingling may persist much longer. As the local anaesthetic effect wears off, numbness will diminish and surgical pain may return, in which case alternate methods of pain relief, including injections or tablets, will be prescribed.
General Anaesthesia
General Anaesthesia (GA) produces a drug-induced state where the patient is unconscious and will not respond to any stimuli, including pain. It is usually associated with changes in breathing, circulation and muscular function as well as other direct and indirect affects which can alter biological functions in the body.
ANZCA College Resources
The Australian and New Zealand College of Anaesthetists (ANZCA) is the professional organisation for about 6400 specialist anaesthetists (Fellows).
One of Australasia's largest specialist medical colleges, ANZCA, along with its Faculty of Pain Medicine, is responsible for the training, examination and specialist accreditation of anaesthetists and pain medicine specialists and for the standards of clinical practice in Australia and New Zealand.
General anaesthetic agents in young children
Modern anaesthesia and surgery is safe for children and infants. The risks of cardiac arrest, allergic reactions, kidney and liver failure are now extremely low. Recently, the chance that anaesthesia (and other sedative drugs) may cause long term effects on brain development has been raised. The Australian TGA released a safety advisory in October 2018 which tried to address some of these issues. The link to this alert can be found here. Three of Australia's leading Children's Hospitals have published a fact sheet for parents and carers about this potential concern. This sheet can be downloaded by clicking the button below.