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Surgery Information
Information about anaesthesia

There are three main categories of anaesthesia: general, regional and local. Each has many forms and uses.


Are there different kinds of anaesthesia ?
There are three main categories of anaesthesia: general, regional and local. Each has many forms and uses.
In general anaesthesia, you are unconscious and have no awareness or other sensations. There are a number of general anaesthetic drugs. Some are gases or vapours inhaled through a breathing mask or tube and others are medications introduced through a vein. During anaesthesia, you are carefully monitored, controlled and treated by your anaesthesiologist, who uses sophisticated equipment to track all your major bodily functions. A breathing tube may be inserted through your mouth and frequently into the windpipe to maintain proper breathing during this period. The length and level of anaesthesia is calculated and constantly adjusted with great precision. At the conclusion of surgery, your anaesthesiologist will reverse the process and you will regain awareness in the recovery room.
In regional anaesthesia, your anaesthesiologist makes an injection near a cluster of nerves to numb the area of your body that requires surgery. You may remain awake, or you may be given a sedative. You do not see or feel the actual surgery take place. There are several kinds of regional anaesthesia. Two of the most frequently used are spinal anaesthesia and epidural anaesthesia, which are produced by injections made with great exactness in the appropriate areas of the back. They are frequently preferred for childbirth, lower abdomen and limb surgery.
In local anaesthesia, the anaesthetics drug is usually injected into the tissue to numb just the specific location of your body requiring minor surgery, for example, on the hand or foot.

Why are so many questions asked about my past and present medical conditions ?
Because anaesthesia and surgery affect your entire system it is important for your anaesthesiologist to know as much about you as possible.
You already realize that your anaesthesiologist is responsible for your anaesthesia to make you comfortable, but in addition, he or she is also responsible for your medical care during the entire course of surgery. Therefore, it is important to know exactly what medical problems you have and any medications you have been taking recently since they may affect your response to the anaesthesia. You also should inform your anaesthesiologist about your allergies, any hard drug or alcohol usage, and past anaesthetic experiences.
Your anaesthesiologist must be very familiar with your medical condition so that the best anaesthetic and medical care may be provided throughout your operation. This important knowledge will allow your anaesthesiologist, as a doctor, to continue your current medical management into surgery which will help prevent complications, and expedite diagnosis and treatment of any medical problems should they occur. Your continued medical management during surgery is necessary to help facilitate your speedy recovery.

What are the risks of anaesthesia ?
All operations and all anaesthesia have some small risks, and they are dependent upon many factors including the type of surgery and the medical condition of the patient. Fortunately, adverse events are very rare. Your anaesthesiologist takes precautions to prevent an accident from occurring just as you do when driving a car or crossing the street.
The specific risks of anaesthesia vary with the particular procedure and the condition of the patient. You should ask your anaesthesiologist about any risks that may be associated with your anaesthesia.

What are disadvantages and risks of general anaesthesia ?
• Nausea and vomiting at recovery may occur, however with recent improved techniques and new medications, this is now rare.
• Accidents because of reflux of gastric contents from the stomach to the lung rarely happen if the prior fasting instructions are strictly followed.
• Sore throat and hoarseness may occur; this is due to the fact that the patient has a plastic tube put into his throat or trachea to help respiration during anaesthesia.
• Dental trauma may happen. This can be prevented if you inform us of shaky milk teeth, decayed teeth or implanted teeth.
• Troubles with memory, concentration and behaviour may appear after the anaesthesia. They are only troublesome for a few hours.
• You may sometimes find some red irritated patches in the area where the anaesthesia was injected into the vein – these will disappear within a few days.
• It is necessary to pay attention when you first sit or stand up, as you may be weak and dizzy, and could fall.
• Some unforeseeable life-threatening complications may occur such as: severe allergy, excessively high temperature, asphyxia or cardiac arrest but these are extremely rare. Only a few cases have been described over millions of annually performed anaesthetic cases.

What are disadvantages and risks of loco-regional anaesthesia ?
• Headache may appear suddenly after spinal and peri-dural anaesthesia. The patient should rest for a few days or have specific treatment.
• Absence of urination may happen and a urinary catheter is sometimes inserted temporarily after the operation.
• Pain on the punctured site on the back may appear
• Sudden Itching may appear after administration of morphine or similar substances.
• Memory and concentration may be affected for a few hours after the anaesthesia in case of combination of general and loco-regional anaesthesia.
• Severe complications such as convulsion, cardiac arrest, permanent paralysis or few dysaesthesia parts of the arms or legs rarely occur. Some cases have been described over millions of annually performed anaesthetic cases

If I have an underlying medical problem, how will it be handled during surgery ?
Frequently, people requiring surgery may also have some underlying condition such as diabetes, asthma, heart problems, arthritis or others. Having taken your medical history prior to the operation, your anaesthesiologist has been alerted and will be well prepared to treat such conditions during surgery and immediately after. As doctors, anaesthesiologists are uniquely suited to treat not only sudden medical problems related to surgery itself, but also the chronic conditions that may need attention during the procedure, because their medical training involves a firm grounding in the principles of internal medicine and critical care.

Why are patients not allowed to eat or drink anything before surgery ?
For most procedures it is necessary for you to have an empty stomach so that the chances of regurgitating any undigested food or liquids are greatly reduced. Some anaesthetics suspend your normal reflexes so that your body’s automatic defences may not be working. For example, your lungs normally are protected from objects, such as undigested food, from entering them. However, this natural protection does not occur while you are anesthetized. So for your safety you may be told to fast (no food or liquids) before surgery. Your doctor will tell you specifically whether you can or cannot eat and drink and for how long. In addition, the anaesthesiologist may instruct you to take certain medications with a little water during your fasting time. For your own safety, it is very important that you follow these instructions carefully about fasting and medications; if not it may be necessary to postpone surgery.

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