Your anaesthetic is designed to keep you comfortable, safe, and free from pain during your operation or procedure so that the operation is as easy and beneficial as possible, for both you and your surgeon.
The choice of anaesthetic type depends on the nature of your surgery, your general health status, and your personal preference. Your anaesthesiologist will offer you the best anaesthetic suited to your wishes and circumstances, as long as it places you at the lowest risk possible
Modern anaesthesia is safe but it may still have side effects and complications. The risk of experiencing a complication is affected by the patient’s general state of health, specific medical conditions and the complexity of the procedure. The information below aims to place these risks in context. Please discuss any queries/concerns with the anaesthesiologist before your procedure.
Common Complications ( 1 - 10% of cases) |
Rare Complications (Less than 1 in 1000 cases) |
Very rare complications (1 in 10 000 to 1 in 200 000 cases) |
Extremely rare (Less than 1 in 250 000 cases) |
|---|---|---|---|
|
Equivalent to someone in your family |
Equivalent to someone in a |
Equivalent to someone in a |
|
|
Minimal treatment is usually required |
May require further |
May be serious with long- |
Often serious with long- |
|
• Nausea and vomiting |
• Injuries to teeth, crowns, tongue, lips, mouth |
• Eye injuries |
• Death as a direct result of the anaesthetic |
Complications that may occur due to procedures that may be performed during your anaesthetic:
Procedure |
Complication |
|---|---|
|
Intravenous line (IV) |
Pain, swelling, bleeding, inflammation, infection, clots,
repeated insertions if IV not working adequately |
|
Arterial line for specialised monitoring (A-line) |
Pain, swelling, bleeding, inflammation, infection, repeated insertions, loss of |
|
Airway management |
Damage to lips, teeth, tongue, palate, throat, vocal cords, hoarseness, |
|
Nerve blocks, spinal or epidural injection |
Back pain, non-resolving headache, nerve damage, paralysis, headache, |
South African Society of Anaesthesiologists “For patients”:
Peripheral Nerve Blocks:
Peripheral Nerve Blocks:
Paediatric Anaesthesia:
Royal College of Anaesthetists: Anaesthesia explained – Information for Patients
Royal College of Anaesthetists: You and your anaesthetic – Information to help patients prepare for anaesthetic
PRE-OPERATIVELY
MEDICAL HISTORY
Your anaesthesiologist must be aware of any medical conditions you have, and any problems you previously had with anaesthesia.
- Dr Steyl would like to encourage her patients to make use of the Perioperative Shared Health Record (PSHR) to record their medical history for her to review in advance of their hospital admission.
- Alternatively, patients can complete the green Anaesthetic Record which is usually available in the hospital ward and
can be completed after admission. If you have any medical reports, feel free to bring them with you when you are admitted.
Dr Steyl endeavours to see her patients in the ward before the start of a list, but please note that if the surgeon offers you an admission time after the starting time of a list, you may only see Dr Steyl in the theatre waiting area shortly before the procedure. This is because once an anaesthesiologist starts a case in theatre, they cannot leave that patient unattended.
MEDICAL EQUIPMENT
- If you use a home CPAP mask, please bring your mask and device to the hospital with you so that you can use it after the operation.
WHAT YOU MAY EAT AND DRINK
- All patients must fast before any anaesthetic or sedation is given. This prevents stomach contents from being aspirated and causing lung damage.
- In general, the fasting guidelines are as follows:
Adults |
|
|---|---|
|
Meat and fried foods |
Up to 8 hours before the planned procedure. |
|
Light meal |
Up to 6 hours before the planned procedure. |
|
Clear fluids |
Up to 2 hours before the planned procedure. |
Children |
|
|---|---|
|
Solid food Cow’s milk Formula milk Fortified milk |
Up to 8 hours before the planned procedure. |
|
Light meal |
Up to 6 hours before the planned procedure. |
|
Clear fluids |
Up to 2 hours before the planned procedure. |
PLEASE NOTE
- You are strongly advised not to drive, operate dangerous machinery or make important decisions in the 24 hours following your anaesthetic.
- Please do not post anything on social media in the 24 hours after your anaesthesia.
- If you are likely to be discharged home within 24 hours of your procedure, please arrange for a family member or friend to collect you and take you home.
- Do not consume alcohol in the 24 hours after your anaesthetic, or while taking medication prescribed after your procedure (especially painkillers and antibiotics).
- Female patients, please note that some agents used in anaesthesia may render oral contraceptives ineffective. If you have received such an agent or are unsure, please use additional contraceptive measures for the remainder of your cycle.
ADVICE FOR PREGNANT AND BREASTFEEDING PATIENTS
Please make sure to use only the prescribed medication in the postoperative period. If you are unsure whether a medication is safe to use in pregnancy, please consult your surgeon, anaesthesiologist or gynaecologist.
General anaesthesia does not normally affect breastfed babies. It is recommended that you breastfeed up until the operation, and continue breastfeeding as soon as you are awake and feel ready to do so after the procedure. Very small amounts of anaesthetic medication may pass into breast milk, however, there is no need to “pump and dump”.
Please ensure that you have help to look after your child for the first 24 hours after surgery. Ideally, you should not be the primary caregiver for your child for the first 24 hours after anaesthesia.
If you are likely to be discharged home within 24 hours of your procedure, please arrange for a family member or friend to collect you and take you home.
- Do not consume alcohol in the 24 hours after your anaesthetic, or while taking medication prescribed after your procedure (especially painkillers and antibiotics).
- Female patients, please note that some agents used in anaesthesia may render oral contraceptives ineffective. If you have received such an agent or are unsure, please use additional contraceptive measures for the remainder of your cycle.
INTRA-OPERATIVELY
Different types of anaesthesia techniques can be used individually or in combination. Each patient will have an anaesthetic treatment plan based on their medical background and risk profile. The aim is to achieve the safest anaesthetic for each patient.
GENERAL ANAESTHESIA (GA)
This is when the anaesthesiologist puts you into a state of controlled unconsciousness. You are not aware of anything during the procedure.
This is usually achieved by injecting induction medication into a vein, but sometimes anaesthesia is induced by inhalation of anaesthetic vapours (gases).
Patients can be kept asleep with either anaesthetic vapours that are inhaled through an airway device (inhalational anaesthesia), or with intravenous agents that are slowly infused into a vein for the duration of the procedure (total intravenous anaesthesia).
REGIONAL ANAESTHESIA (RA)
- Local anaesthetic agents are injected near specific nerves. This can be with a spinal injection, an epidural injection, a nerve plexus block, or a peripheral nerve block.
Whole body parts can be made numb in this way.
- Depending on the procedure and your preference, you may be awake or lightly sedated, but you will not have any sensation or pain in the area that has been blocked.
- A spinal injection is a once-off injection into the lower back, to temporarily paralyse the nerves of the spinal cord. This produces numbness in the lower half of the body. A spinal injection is quick to insert and can give pain relief for anything from 4 – 12 hours, depending on the medications injected.
- An epidural injection can be into either the lumbar or thoracic spine and usually involves leaving a small catheter in place for up to 3 days to give continuous local anaesthetic medication. An epidural catheter takes a bit more time to insert than a spinal injection, but the benefit is a longer duration of pain relief.
- Plexus or peripheral nerve blocks target specific nerves or specific areas of the body
PROCEDURAL SEDATION AND ANALGESIA (PSA)
- Oral medication, injectable agents or anaesthetic vapours are used to keep you calm and drowsy, but you are still breathing on your own and you can be easily woken up.
The depth of your sedation will depend on the procedure you are coming for, and on your baseline condition.
- Gastroscopies and colonoscopies are often done under sedation.
- It is still important to follow the fasting rules, even if you are only having sedation.
- Not all patients are candidates for sedation.
POST-OPERATIVELY
Different types of anaesthesia techniques can be used individually or in combination. Each patient will have an anaesthetic treatment plan based on their medical background and risk profile. The aim is to achieve the safest anaesthetic for each patient.
PAIN RELIEF
Dr Steyl will discuss possible strategies and medications for pain relief with you.
It is usually best to use a combination of agents that target different receptors responsible for pain sensation. Not all medications agree with all patients; if you know that some medications give you side effects, please discuss this with Dr Steyl in advance.
PREVENTION OF NAUSEA AND VOMITING
Dr Steyl usually prescribes medication to prevent nausea and vomiting to her patients based on their risk profile.
If you know that you have had previous postoperative nausea and vomiting, please discuss this with Dr Steyl in advance that she may plan appropriately.
FOLLOW-UP
The surgeon remains primarily responsible for your post-operative care. In some cases, Dr Steyl may also follow up with you, especially if you had an epidural catheter placed, or if you were admitted to the intensive care unit.
PLEASE NOTE
- You are strongly advised not to drive, operate dangerous machinery or make important decisions in the 24 hours following your anaesthetic.
- Please do not post anything on social media in the 24 hours after your anaesthesia.
- If you are likely to be discharged home within 24 hours of your procedure, please arrange for a family member or friend to collect you and take you home.
- Do not consume alcohol in the 24 hours after your anaesthetic, or while taking medication prescribed after your procedure (especially painkillers and antibiotics).
- Female patients, please note that some agents used in anaesthesia may render oral contraceptives ineffective. If you have received such an agent or are unsure, please use additional contraceptive measures for the remainder of your cycle.
ADVICE FOR PREGNANT AND BREASTFEEDING PATIENTS
Please make sure to use only the prescribed medication in the postoperative period. If you are unsure whether a medication is safe to use in pregnancy, please consult your surgeon, anaesthesiologist or gynaecologist.
General anaesthesia does not normally affect breastfed babies. It is recommended that you breastfeed up until the operation, and continue breastfeeding as soon as you are awake and feel ready to do so after the procedure. Very small amounts of anaesthetic medication may pass into breast milk, however, there is no need to “pump and dump”.
Please ensure that you have help to look after your child for the first 24 hours after surgery. Ideally, you should not be the primary caregiver for your child for the first 24 hours after anaesthesia.
