Preoperative assessment
The majority of patients will need to attend a preoperative assessment clinic. The assessment will be carried out by a specialist nurse. At this visit you will be asked questions regarding your general health. You will also need to bring a list of all your current medications. The assessment may involve examination of your heart and lungs. It may also be necessary for the pre-assessment nurse to perform some simple investigations such as a heart tracing (an ECG) or blood tests. If any major problems are identified this information will be forwarded to your anaesthetist. The intention of this visit is to ensure that we have all the necessary information to tailor our anaesthetic to your individual needs and to avoid any unnecessary cancellations on the day of surgery. The pre-assessment nurse will also be able to answer a lot of your questions relating to your anaesthetic. If however you still have unanswered questions please contact us via by phone or e-mail.
Meeting your Anaesthetist
Your anaesthetist will usually come to see you prior to your operation. During this preoperative visit, the anaesthetist will go through your pre-operative assessment health questionnaire with you and confirm your current medicines and allergies. They also may perform an examination by listening to your heart and lungs. The anaesthetist will then discuss with you the type of anaesthetic best suited for your operation and what to expect when you reach the anaesthetic room. If any special procedures such as an epidural or spinal block are indicated then your anaesthetist will also discuss this with you in full as well as options for your pain relief. This preoperative visit is the ideal opportunity for you to ask any questions regarding your anaesthetic that have not been answered by the pre-assessment nurse and hopefully will allay any anxieties you may have. Please see our Procedures Explained section for further information.
What happens when you are in the anaesthetic room?
Your anaesthetist is responsible for your well-being from the moment you enter the anaesthetic room. Your anaesthetist will be with you at all times, responding immediately to any changes that may occur during surgery.
In order to react to any changes, it is necessary for all patients to have monitoring applied before undergoing anaesthesia. This will include heart monitoring (ECG), oxygen level monitoring and a blood pressure cuff. You will also need a drip or cannula before your anaesthetic starts (the exception to this is in children).
Occasionally it may be necessary to place extra monitoring above that already mentioned. This may include an arterial line or central line. This will be inserted before or after you have gone to sleep, this is at the discretion of the anaesthetist. Please see Procedures Explained for more details.
If your anaesthetist has spoken to you about other procedures such as a spinal or epidural anaesthetic, these may also be performed whilst you are awake. Indeed some operations may be performed without the need for a general anaesthetic. Please see Procedures Explained for more details.
Starvation guidelines
For morning surgery:
No food, including chewing gum and sweets for 6 hours before surgery. This means nothing to eat after 2am.
Clear fluids, not milk or orange juice, can be consumed until 2 hours before surgery i.e. No clear fluids after 6 am.
For afternoon surgery:
No food, including chewing gum and sweets for 6 hours before surgery. This means nothing to eat after 7.30am.
Clear fluids, not milk or orange juice, can be consumed until 2 hours before surgery i.e. No clear fluids after 11.30am.
Bring with you adequate clothing etc for your expected length of stay and any particular items that we might not be able to provide e.g special cushions etc. Also bring with you all your current medications and ideally an easily readable list of these.
How we look after you during your surgery?
Your anaesthetist will be with you throughout your surgery reacting appropriately to the constantly changing theatre environment.
During surgery your anaesthetist will also be planning your pain relief for after surgery and other important elements to your recovery including anti-sickness medication, intravenous fluids and further monitoring.
What happens after your surgery?
You will be cared for in a purpose equipped recovery area where experienced recovery staff will ensure that any problems such as pain relief are managed swiftly. It may be necessary to continue some of the monitoring back on to the ward, this will be explained to you.
If you have had an epidural this will often be continued after your operation. The nurses on the ward will be monitoring the epidural whilst it is running.
If you are using patient controlled analgesia (PCA) this will be started for you in the recovery area and will be continued on the ward where the ward nurses will be monitoring you closely.