Anaesthesia: What, Who, Why and How
What is General Anaesthesia?
General anaesthesia is a state of controlled unconsciousness achieved through medicines that are administered by an anaesthesiologist through a mask or an IV cannula placed in the vein. A general anaesthetic is required for most major operations involving the heart, lungs, or in the abdomen, brain or major arteries and transplants.
There are two ways to induce general anaesthesia:
- Via an IV cannula- Anaesthetic drugs are injected through the IV cannula.
- Via a mask: you are given anaesthetic drugs through a tight-fitting mask & oxygen to breathe in. Very useful for kids as they remember the pain of an IV cannulation.
How does a general anaesthetic work?
Anaesthetic drugs stop the brain from responding to sensory messages travelling from the nerves in the body. While the anaesthesia is working, you will be unconscious, feel nothing and many of your body’s functions will slow down or need help to work effectively. A tube may be placed in your throat to help you breathe. You will have no memory of what happened while you are anaesthetised. You will not be “aware” of what is going on.
Anaesthetic unconsciousness is different from a natural sleep. You cannot be woken from an anaesthetic until the drugs are stopped and their effects wear off.
Your care while under a General Anaesthetic
Our anaesthetic team will treat you with immense care while you are unconscious. We will monitor your heart rate, blood pressure, breathing and other vital signs to make sure they are normal and steady while you remain unconscious and free of pain. Your anaesthesiologist will stay near to you throughout the time you are anaesthetized.
Once your surgery is complete, your anaesthesiologist will either stop or reverse the medications and remove the breathing tube. They will be with you as you return to consciousness, continually monitoring your breathing, circulation, and oxygen levels.
After your General Anaesthetic
You will be observed in the Anaesthesia Recovery Room by trained staff while the effects of the general anaesthetic slowly wear off & you wake up.
Some patients feel fine as they wake up; others experience symptoms such as nausea, vomiting, or chills. Your throat may be sore from the breathing tube. These symptoms are managed by the anaesthesiologist.
You will be observed for an hour or so in the recovery room & then return to the ward/room.
If you require more intense monitoring, (either due to a pre-existing severe medical condition or as a consequence of the severity of your procedure) you will be shifted to an intensive care area like the ICU (Intensive Care Unit). We try to anticipate this circumstance and let you know about it beforehand, as much as is feasible.
Controlling your pain after the surgery
You will, probably, experience some pain and discomfort as you recover, which may worsen as the effects of the anaesthetic wear off. Your anaesthesiologist will manage your pain during recovery.
Going home the same day after a General Anaesthetic
If you are discharged home on the day of surgery, you will not be able to drive after having a general anaesthetic — so please make sure you have someone with you who can take you home. It may take a day or two for the anaesthesia medication to completely leave your system, so you may be sleepy, and your reflexes and judgment may be affected.
Caring for a Loved One who has Undergone a General Anaesthetic or Sedation
What should you expect?
The sedation & anaesthetic medication can make the patient slightly confused and unsteady. Their judgement maybe affected, so they may not be able to think clearly. The patients will not be able to drive for 24 hours following a general anaesthetic. This may last up to 24 hours or so until the next day. They should not be left unattended during this period.
When can you take your relative or friend home?
Patients will be discharged home from the hospital only when the medical team are satisfied that they have recovered well from the procedure and you are there to accompany them home. Therefore, you should be a capable adult over 18 years old and be able to take them home by a car or a taxi. It is better to avoid public transport like buses and the metro.
The nurse will take your phone number to contact you. The exact time of discharge is difficult to predict as the response of patients to the anaesthetic varies in each patient.
What will you need to do?
You will be given a discharge summary which will include instructions regarding medications and concerns for patient care. These may include, among others,
- Instructions about eating, drinking & taking their medication
- Anything of concern to look out for & a number to contact at the hospital if you or they have any questions or if they do not feel well
- Things they can & cannot do after their procedure
- Information about any additional medication they may need to take
- Information about washing and care of wounds.
- You should read these instructions with your friend or relative and help ensure that they are followed.
- Please ask for explanations wherever you need them.
What should my relative or friend do at home?
This depends on the procedure that they’ve had and the instructions they have received from their physician. In general, they should
- Get plenty of rest to help them recover from the procedure.
- Not walk unaided if they are unsteady, and ideally, avoid stairs.
- Carefully follow instructions from the hospital about taking their usual medication and any additional pain relief
- Follow the instructions they have been given by the hospital about eating, drinking and washing.
What should they not do?
They may not be able to think clearly and their judgement may be affected for up to 24 hours after an anaesthetic or sedation. During this time, they should NOT:
- Be responsible for children or other people in their care
- Drive a vehicle or ride a bicycle
- Cook or use any machinery
- Drink alcohol and preferably not restart smoking
- Make any important decisions, even if they think they feel okay
- Post on social media/public forums.
