Dr Girish Dhond is the anaesthetist at The Endometriosis Clinic. He has been working together with Peter Barton-Smith as far back as 2004. Here he explains, for Endometriosis Clinic women undergoing surgery, what to expect.
YOUR ANAESTHETIC EXPLAINED
I've written this to help you prepare for your operation and anaesthetic and to address some of the questions and concerns that you may have. Modern anaesthesia is very safe and can be tailored to your individual needs and to the type of surgery you are having.
Your anaesthetist will normally visit you shortly before your operation. They will look at the results of your health check and may ask you more questions about your health and previous anaesthetic experiences. They may also need to listen to your chest with a stethoscope, examine your neck and jaw and may look in your mouth. They will discuss with you the choice of anaesthetic methods that are appropriate for your surgical procedure, highlighting the benefits and risks associated with each of them, in order to agree with you the best and safest anaesthetic option. Please feel free to ask questions and you may sometimes be able to make choices about the type of anaesthetic you can have. Together you and your anaesthetist will work together to make your experience in hospital as safe and comfortable as possible.
Your anaesthetist will :
- look after your wellbeing and safety throughout your surgery
- agree a plan with you for your anaesthetic
- administer the anaesthetic to you
- plan your after-surgery pain control regime with you
Depending on the type of operation you are having, the anaesthetist may use a regional anaesthetic, such as a caudal epidural, in addition to the general anaesthetic. This is often done to make you more comfortable after surgery by numbing the parts of the body that are affected by the surgery.
The anaesthetist will also discuss the various medications that you may receive to help with relieving pain after the operation. They will discuss these options in detail with you in your room prior to surgery.
WHEN IT IS TIME FOR YOUR OPERATION
A member of the nursing staff will go with you to the anaesthetic room which is next to the operating theatre. If you are anxious you may bring a friend or family member with you.
The Anaesthetic Room
Once in the anaesthetic room, you will need to lie on a theatre trolley for your anaesthetic. This trolley is narrower and higher than a hospital bed and may feel quite cold and hard. A member of staff will help you onto it.
Theatre staff will then go through a safety checklist with you, checking your identification bracelet, consent form and identifying any known allergies.
To monitor you during your operation the anaesthetist will now attach you to the monitors. Three small sticky patches will be placed on your chest to monitor your heart ECG. A blood pressure cuff will be placed on your arm and will inflate and deflate occasionally to check your blood pressure. A soft clip will placed on your finger to monitor the oxygen level in your blood.
Starting the anaesthetic
To send you off to sleep your anaesthetist will need to put a small cannula into a vein in your hand or arm. The anaesthetist will give you the anaesthetic drugs through this cannula and you will become unconscious within a minute.
During the operation you will also receive pain-relieving drugs, antibiotics and anti-sickness drugs. The anaesthetist will stay with you throughout surgery, monitor your condition and look after your wellbeing.
Waking up from a general anaesthetic
At the end of the operation, your anaesthetist will stop giving the anaesthetic drugs and you will gradually wake up. Nowadays, with modern anaesthetic agents, patients normally wake up within a few minutes after surgery, even after a prolonged operation. When your anaesthetist is sure that you are recovering normally, you will be taken to the Recovery Room. A designated recovery nurse will be looking after you and will continue to monitor you closely. You will be given oxygen to breathe through a lightweight clear plastic mask. If necessary, the nurse may give you more pain-relieving or anti-sickness drugs.
You may temporarily need a urinary catheter after your surgical procedure, usually until the next morning at least. This is a thin soft tube put into your bladder while you are asleep, to drain the urine during and after your surgical procedure.
Returning to the ward
The recovery staff must be totally satisfied that you have safely recovered from your anaesthetic, you are comfortable, and all your observations are stable, before you are taken back to the ward.
The type of operation you have had will affect how long it will be before you can drink or eat. However, even after quite major surgery you may feel like sitting up and having something to eat or drink within a couple of hours of waking up.
Risk of Side effects
Most people have no problems after their operation and anaesthetic. How you feel will depend on the type of anaesthetic used, the operation you have had, how much pain-relieving medicine you need and on you general health before surgery.
However, you may suffer from side effects of some sort and almost all treatments, including anaesthetics, have side effects of some kind. Unpleasant side effects do not usually last long. Some are best left to wear off and others can be treated.
Common side effects
- Feeling sick and vomiting - this can be treated with anti-sickness drugs, but it may last from a few hours to several days.
- Sore throat – if you have had a tube in your airway during the operation, it may give you a sore throat. This discomfort may last from a few hours to a few days.
- Dizziness and feeling faint – your anaesthetic may lower your blood pressure and you may be a little dehydrated after surgery. Fluids and/or drugs will be given to you through your cannula to treat this.
- Shivering – care is taken to keep you warm during and after your operation, however shivering may happen due to the effects of the anaesthetic drugs.
- Headache – there are many causes of headache such as the operation, anaesthetic, dehydration and feeling anxious. Most headaches get better in a few hours.
- Aches, pains and backache – this may be from lying still for a long time or from the operation itself.
- Bruising and soreness – this may develop around injection and drip sites as well as the area that has been operated on. It normally settles without treatment.
We hope this information about your anaesthetic has been helpful. Please feel free to discuss any concerns that you may have about your operation with the surgeon, the anaesthetist or any member of the hospital team.