This leaflet provides information for patients due to have an operation or procedure with general anaesthetic and/or sedation.

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1 Page 1 of 5 Your anaesthetic Introduction This leaflet provides information for patients due to have an operation or procedure with general anaesthetic and/or sedation. Who is an anaesthetist? Anaesthetists are qualified doctors who have had specialist training to look after you before, during and after surgery. Who is in the anaesthetic team? The anaesthetist has an assistant who is a Nurse or an Operating Department Practitioner. They are trained to help the anaesthetist look after you during surgery. One of their jobs is to make sure the correct operation is performed and that you have signed the consent form. Also in the team is the Recovery Nurse who looks after you when you are waking up from your anaesthetic in the recovery area, until you are well enough to return to the ward. Will I see the anaesthetist before the operation? Yes. The anaesthetist will meet you and make an assessment of any medical problems that you may have and will talk about the preparation for your surgery. The anaesthetist will discuss the best type of anaesthetic for you, taking into account your condition and your surgery. What should I tell the anaesthetist? The anaesthetist will want to know how healthy you are and if there are any particular problems that may impact on this anaesthetic and surgery such as: Reference No. GHPI0005_09_15 Department Anaesthetics Review due September 2018 Any significant illnesses for example asthma, diabetes, heart disease, liver disease, kidney disease, high blood pressure, epilepsy Problems with previous anaesthetics or operations Problems that blood relatives may have had with anaesthetics Any allergies you have

2 Page 2 of 5 Anything else you might think relevant such as loose teeth or how much you smoke or drink Any medications that you are taking. Please bring all your tablets or inhalers into hospital with you to show the nurses and doctors looking after you. Are there different types of anaesthetic? Yes. With a general anaesthetic you will go to sleep before your surgery begins and wake up after it has finished. With local anaesthesia the area to be operated on is numbed with an injection and you will usually be awake. Epidural and spinal anaesthetics are given by an injection into your back (after first numbing your skin with local anaesthetic). For some operations this could allow you to be awake or alternatively the epidural or spinal can be combined with a general anaesthetic or sedation so that you are asleep throughout the operation. How will I go to sleep? Once in the anaesthetic room, various monitors are attached to you to measure your blood pressure and heart rate. Some oxygen may be given to you via a clear face mask before the anaesthetic starts. Usually the anaesthetic is given by an injection into a vein on the hand or arm. Occasionally anaesthetic gases given by via a facemask are used to induce anaesthesia instead of an injection. Will I wake up in the middle of the operation? If you are having a general anaesthetic this is extremely unlikely. The amount of anaesthetic gas in your breath is measured and monitored. When and where will I wake up? You will wake up after the anaesthetist turns off the anaesthetic once the operation has been completed. Most patients wake up in the recovery area though many do not remember anything until they are back on the ward. Occasionally with major operations patients may be taken to the intensive care unit when they are still asleep and woken up a few hours later. Wherever you are when waking up, there will be a doctor or nurse with you until you have fully regained consciousness.

3 Page 3 of 5 Will I have pain after my operation? This will depend on the extent of the surgery performed. Often the answer is yes, but it is controlled by drugs so that it is manageable. Everyone is given some kind of pain relief, often very strong pain relief into a vein during the anaesthetic. If needed, after the operation you may be given pain relief by injection, tablet or suppository (with your permission, if you are unable to take tablets by mouth). There are also other special techniques for relief of pain for some operations that you may be offered, these will explained by the anaesthetist beforehand. If you are in pain let your nurse know so that you can be given something to relieve it. You should not suffer in silence. Will I vomit or feel sick? Most patients do not vomit or feel sick. If you do feel sick let the nurse know so that you can be given something to treat it. If you were sick after any previous operations, let the anaesthetist know so that they can give you something to make sickness less likely this time. Will I need a blood transfusion? This depends on how much blood loss there is during the operation or how anaemic you become. You will only be given blood if the risks of being short of blood outweigh the risks of receiving it. The risks from a blood transfusion are very small. Should I stop drinking and eating before the operation? Yes. To make vomiting less likely and for your own safety we like to ensure that your stomach is empty before an anaesthetic. Please do not eat anything (including chewing gum, drink tea or coffee, or eat sweets) for at least 6 hours before your surgery, or drink clear fluids for at least 2 hours beforehand. You will be given instructions from the hospital about what time to stop eating or drinking. However, if you need a little water to take your tablets on the morning of your operation this is acceptable.

4 Page 4 of 5 Should I take my normal medication or tablets? Yes. Please take your normal medication on the morning of surgery unless you have been instructed not to by your consultant or preassessment team. The exception is that if you have tablets or insulin for diabetes; these should not be taken on the morning of surgery. If you are taking warfarin or other tablets to thin your blood you will need to discuss this with the surgeon prior to admission. Risks Anaesthetics are very safe. However there is a risk with any surgery or anaesthetic no matter how minor. We work hard on minimising the risks to you. Common side effects (about a 1 in 10 chance) Feeling sick or vomiting Dizziness Headache Sore throat Aches and pains. Uncommon but treatable complications (about a 1 in 1000 chance) Chest infection Medical problems getting worse Bladder problems Damage to your teeth Breathing problems. Rare complications (about a 1 in 10,000 chance) Serious but treatable allergy to a drug Nerve damage usually temporary Awareness (becoming conscious during your operation). Very rare complications (about a 1 in 100,000 chance) Infection from a blood transfusion Death. If anything in this leaflet worries you or you have questions that we have not answered please discuss it with your anaesthetist or your pre-assessment nurse

5 Page 5 of 5 Contact information Pre-Assessment/specialist nurse: Tel: Monday to Friday, 9:00am to 5:00pm Further information The Royal College of Anaesthetists Website: Content reviewed: September 2015

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