Your visit to theatre Information for you about your anaesthetic and your visit to the operating theatre This leaflet provides information about coming into hospital for your operation It explains anaesthetic and some of the important risks of having an anaesthetic It is advised that you read this leaflet and raise any questions with your anaesthetist when you come in for your surgery Theatres and Anaesthesia Page 1 of 10
When to stop Eating and Drinking Food You must stop eating about 6 hours before your operation. For patients arriving in hospital before/at 7.30 am or soon after Last food/milky drinks at 12 midnight (including sweets) For patients arriving in hospital after 11.00/11.30 am Last food/milky drinks at 7.00 am (including sweets) Please stop chewing gum before you arrive at the hospital Drinks You should continue to drink up to about 2 hours before your operation. Allowed drinks are: Still water Clear fruit juice no pulp/bits Diluting juice Tea or coffee with a small amount of milk You must have a last drink at home before you come to hospital. The ward staff will then tell you what time you can drink up to before your operation. If you have not followed the instructions about eating and drinking then your operation may be cancelled Medicines On the morning of your operation you should take all your normal tablets, except the ones listed in the table below. This applies even if you are in the final 2 hours of fasting please take tablets with your final drink. Page 2 of 10
Medications that you should stop before surgery Medicine Stop days before or on the day of surgery If you have not followed these instructions then your operation may be cancelled Day of admission Admission: You may be admitted via the Theatre Admission Suite (TAS) at Ninewells Hospital. TAS is situated on Level 6, one floor down from the main hospital reception and is signposted. There is a pick up/drop off zone in the main hospital car park that is free for 20 minutes. Your relative, friend or partner will be given the phone number of the ward you will be returning to. If you are a day case patient returning to the Day Surgery Unit, please be aware that we do not have room for visiting. There are cafe facilities on Level 5 and Level 7 where your relatives can wait until you are ready to leave. If you are not going to TAS, go directly to the hospital/ward named in your letter. What to bring with you: Bring in all your normal medicines with you including tablets, inhalers, eye drops, etc Bring in your dressing gown, slippers or comfortable shoes Bring your glasses, hearing aids if you need them Bring an audio player with headphones, book or tablet to keep yourself occupied while waiting Remove all nail varnish and make up Page 3 of 10
Remove any jewellery (you can keep your wedding ring on) Remove any piercings (if able) Do not bring valuables or large sums of money, as we cannot accept responsibility for the loss or damage of any property. If you require an interpreter, you or your relative/friend/ carer should use the contact details noted in your admission letter so that we can make arrangements as soon as possible. Driving: It is an offence to drive for 24 48 hours following a general anesthetic, sedation or taking strong pain medication. In addition, your driving insurance may not be valid during this time. Please arrange for someone to collect you to take you home or arrange alternative transport, for example a taxi. If you do not arrange this then your operation may be cancelled If you are only having a local anesthetic you may be able to drive yourself home as long your driving is not affected by your procedure: for example: after hand/foot surgery where you are advised not to drive until you are able to make an emergency stop/ have full control of the car or after eye surgery where your sight may be affected Getting ready to go to theatre Staff in the ward will help you get ready for theatre. Please be patient as this is a busy process. You will be seen by different members of the hospital team, such as nurses, pharmacist, anaesthetist and the surgeon. You will be given a theatre gown to wear. These gowns tie at the back and you may keep your underwear on if you wish to. You will be asked to put on your dressing gown and slippers/comfortable shoes to go the theatre. Contact lenses may be worn for short operations otherwise it is best to remove these. Page 4 of 10
If you have a hearing aid or dentures, please do not remove these as we can do this in the anaesthetic room. All your belongings will be secured in a sealed bag and kept safely while you have your operation. Theatre ticket Before your operation you will be asked to fill in a Theatre Ticket to ensure you are ready to go to theatre. The Theatre Ticket is a safety checklist to confirm important information, such as: Your name and date of birth When you last had anything to eat or drink Have you signed a consent form Confirm the operation you are having If you have any questions we can ask a member of the team to speak to you. Pregnancy For female patients, it is important we check that you are not pregnant before you are given an anaesthetic. Having surgery in early pregnancy carries risks, so we normally perform a pregnancy test on all females aged 12 55 years old. You may be asked to provide a sample of urine for this test and the ward staff will let you know the result. Getting to theatre Ward staff should be able to tell you where you are placed on the theatre list and roughly what time you are expected to be called. Sometimes other peoples operations on the list can take more or less time than expected, so your predicted theatre time slot may not always be right. It is a good idea to visit the toilet before you leave the ward. Most patients can walk to theatre with a nurse or clinical support worker, but if you cannot walk easily you will be taken in a wheelchair, trolley or sometimes a bed. Theatre Reception When you arrive in the theatre suite you will usually wait in the reception area before you are taken to the anaesthetic room. Sometimes your wait here can take some time, so if there is anything we can provide for you such as extra blankets, please let us know. Your anaesthetic nurse will introduce themselves to you here and re-check your details. Page 5 of 10
Your anaesthetic There are several different types of anaesthetic and your anaesthetist will discuss the options with you. You can discuss your questions and worries with them. Meeting your anaesthetist Your anaesthetist will meet you on the day of your surgery, shortly before your operation. Anaesthetists are highly trained specialist doctors who are responsible for giving your anaesthetic and taking care of you throughout your surgery. They will: Ask about your general health Discuss the type of anaesthetic Discuss any risks Decide with you what anaesthetic would suit you best Types of anaesthetic Anaesthesia is very safe thanks to the very high level of training that all anaesthetists have. They use technologically advanced machines to deliver your anaesthetic and monitor you continuously throughout your operation and during your recovery. General anaesthetic (GA) This is where you are asleep and you feel nothing. The anaesthetic will be injected into a vein through a cannula (small plastic tube) in your hand. Once you are asleep the anaesthetist will stay with you and closely monitor you throughout. Once the operation is finished, the drugs will be stopped and you will wake up soon after. You will wake up either in the operating theatre or in the recovery room close by. Side effects Common Side effects of General Anaesthetic: Feeling sick or vomiting Headache Sore throat/cough Minor damage to teeth/lips Mild confusion All these side effects will usually disappear in a few hours and can be treated easily. Page 6 of 10
Rare complications of General Anaesthetic: Confusion lasting longer than a few hours Kidney damage Allergic reaction Nerve damage (1 in 1,000) Awareness you become aware of what is happening during your operation You are more at risk of these if you are older, have multiple medical conditions, or are having a long, complicated operation. Most people make a full recovery within a few hours, days or weeks and permanent damage is rare. Serious complications of General Anaesthetic: Heart attack Stroke Severe allergic reaction Death These risks become greater if your general health is poor, especially if you have serious heart or lung disease and you are having complicated major surgery. If you are at risk of any of these complications, your anaesthetist will speak to you about this when they meet you before your operation. Spinal/Epidural/Nerve Block This involves an injection that numbs larger areas of the body such as your legs or an arm whilst you have your operation. You can choose to stay awake or, if you prefer, you can be given drugs into a vein through a cannula in your hand that make you sleepy and relaxed. The area will remain numb for a few hours afterwards but this will wear off. Side effects Common side effects of Spinal/Epidural/Nerve Block Numbness Pins and needles Temporary muscle weakness Wetting yourself All these side effects will usually disappear in a few hours. Page 7 of 10
Rare complications of Spinal/Epidural/Nerve Block Temporary nerve damage (1 in 1,000) Permanent nerve damage (1 in 5,000) Local anaesthetic This is where you are given an injection(s) that numbs a small area of your body whilst you have your operation. You will be awake but feel no pain. Side effects Common side effects of Local Anaesthetic Pain when medicines are injected Infection Bruising around the skin where you have been give a local anaesthetic Very rare complications of Local Anaesthetic Severe allergic reaction Where you will receive your care The anaesthetic room: The anaesthetic room is next to the operating theatre that you will be going to and is where you will usually be prepared for your operation. In this room there will be an anaesthetist and an anaesthetic nurse. You will be attached to machines that monitor your heart, blood pressure and how much oxygen is in your blood. The anaesthetist will put a cannula (small plastic tube) into a vein in your hand or arm, to give your anaesthetic drugs through. Surgery will not start until you are fully anaesthetised and the anaesthetist is happy to proceed. If you are just having a local anaesthetic you may go straight into the operating theatre itself. Everything will be explained to you as it is being done Theatre recovery room: Following your operation you will be taken to the theatre recovery room until you are ready to return to your ward. There will be a specialist recovery nurse looking after you who can give you painkillers and medication for sickness if you need it. When you are ready, a nurse will collect you and you will be taken back on a trolley or in a chair, depending on the type of anaesthetic you have had. If you have had a local anaesthetic you may go straight back to the ward Page 8 of 10
After your operation You will be encouraged to start eating and drinking soon after your operation, unless you have had surgery on your throat, bowels or stomach as this may take longer. It is important for you to get out of bed and start walking as soon as possible after the anaesthetic has worn off or any numbness (if you have a spinal/epidural) has gone, unless the medical team tells you not to. Your team will be aiming for you to be able to leave hospital as soon as you are able. Your home circumstances will be taken into consideration when planning your hospital discharge. It is a good idea to have some simple painkillers for when you go home Paracetamol and Ibuprofen (unless you can t take anti-inflammatory drugs) are useful to have available Concerns We hope that this leaflet has helped answer questions you had regarding your anaesthetic. If you are particularly worried about anything related to your anaesthetic, please phone the Anaesthetic Pre-assessment Clinic and we will put you in contact with a specialist doctor or nurse who can answer your questions. For contact details and further information, please see our Tayside Pre-Assessment Clinic (PAC) website at: https://www.nhstayside.scot.nhs.uk/ourservicesa-z/pre- AssessmentClinicPAC/index.htm More information is available on the Royal College of Anaesthetists website at http://www.rcoa.ac.uk/patientinfo Feedback We are committed to providing high quality care and to supporting you through your journey to theatre. We would appreciate it if you could give us feedback on what we have done well on your visit to theatre and whether there is anything you feel we could improve upon, so that we can continue to improve the care we provide. Please contact us by email on: theatrefeedback.tayside@nhs.net Page 9 of 10
Revised: 09/2018 Review: 09/2020 LN0544 Page 10 of 10