Your Anaesthetic
Information about your Anaesthetic
Many people will be anxious or concerned before coming to hospital for an operation. This page explains the process of having an anaesthetic and tries to answer common questions.
Who needs an anaesthetic?
If you are having an operation you will need some form of anaesthetic. Some patients will be unconscious (general anaesthetic), while others stay awake for surgery but are kept pain free with a special injection (local anaesthetic). You may be given drugs to ensure you are comfortable and drowsy (sedation) if your surgical procedure is under local anaesthetic.
What happens to you individually will depend on exactly what operation you are having. This website does not replace individual discussions with your anaesthetist prior to surgery but provides general information.
Is anaesthesia safe?
Anaesthetics are very safe. However, no medical intervention is without risk. In anaesthesia, perhaps more than in any other field of medicine, training and practice is centred on patient safety. The risk of serious complications from an anaesthetic for a healthy patient is minimal. For patients who are less healthy, surgery and anaesthesia may be associated with greater risks. For more information on risk of anaesthesia, The Royal College of Anaesthetists has produced infographics and leaflets detailing specific risks, side effects or complications that can occur.
Please click below for more information:
Before the Operation
Who will give the anaesthetic?
Your anaesthetic care is provided by a Consultant Anaesthetist. All anaesthetists are qualified doctors who have completed a long period of training and examinations after medical school in a process identical to other hospital doctors and surgeons.
Meeting the Anaesthetist
Your Consultant Anaesthetist will visit you before your surgery. The Consultant Anaesthetist will ask you questions and explain what happens to you during your time in theatre and may also examine you. This is the best opportunity for you to ask any questions you may have. Please make sure you raise any concerns you have about anaesthesia at this time.
Not eating before your operation
You will not be allowed to eat or drink for several hours before your operation. This is purely for safety reasons. It is important that your stomach is empty before you are anaesthetised.
As a general rule you should not eat for six hours before anaesthesia.
- Do not eat any solid food, milky drinks, fizzy drinks, or sweets (including chewing gum) 6 hours before your surgery.
- You may drink unlimited amounts of clear fluids until 2 hours before the intended start time of your operation. Clear fluids include water, black coffee, black tea, diluted squash, or fruit juice without bits.
- After that, you will be encouraged to sip up to 1 glass (170mls) of clear fluids every hour.
Normal medicines before your operation
You should continue to take your medicines up to and including the day of the operation unless you are told not to.
Please follow carefully the instructions you have been given in the preoperative assessment clinic. Please look out for specific instructions if you take:
- drugs to thin your blood (for example, warfarin, dabigatran, rivaroxaban, clopidogrel, aspirin)
- diabetes medication
- blood pressure medication
- all herbal remedies
‘Pre-meds’
You may be given drugs before surgery (a ‘pre-med’). This most frequently includes a pain relief medication, or a drug to reduce sickness. Sometimes it also includes a drug to reduce anxiety. If you would like something to relax you before your operation please discuss it with your anaesthetist at your preoperative visit.
Leaving the ward
When ready you will walk to theatre or be taken on a trolley. You will be asked to confirm who you are and what operation you are having. These careful checks ensure the right person arrives for the right operation.
In Theatre
Arriving in the anaesthetic room
In the anaesthetic room you will be asked some questions to confirm your name, date of birth and what surgery you are expecting to have. Although repetitive, this ‘checklist’ system is carried out to protect you, as it ensures safety. We use the World Health Organisation approved safety checklist for this purpose.
Getting ready for your anaesthetic
The Consultant Anaesthetist will insert a small tube into a vein, usually in your hand. You may find this uncomfortable for a few seconds. All the anaesthetic drugs go through this tube without the need for more needles. You may feel light-headed, dizzy or sleepy as you are taken into theatre.
Having a general anaesthetic
Once you are on the operating table and safe, the anaesthetic will start. You will be asked to breathe some oxygen from a facemask, which you may hold. The Consultant Anaesthetist’s assistant will put monitors (to measure oxygen levels, heart rate and blood pressure) on you. You may feel light-headed. You may have an odd taste in your mouth. Your hand or arm may feel cold or occasionally sore. These feelings will last only a few seconds as the anaesthetic starts to work. Once anaesthetised, you will not be aware of anything until after your operation has finished when you will be woken up.
What exactly is a general anaesthetic?
A general anaesthetic is the use of a combination of drugs to make you temporarily unconscious. You will be given several drugs to make you unconscious (send you to sleep) followed by other drugs to keep you unconscious and safe.
What happens after I’m anaesthetised?
Your anaesthetist stays with you throughout your operation and keeps you safe. The Consultant Anaesthetist carefully adjusts the anaesthetic in response to the surgery. The Consultant Anaesthetist controls your breathing and cardiovascular system, and gives painkillers, other drugs and fluids as necessary. The details vary widely according to the type of operation. The Consultant Anaesthetist takes overall care of your wellbeing and safety while the Consultant Surgeon concentrates on the surgery. At the end of surgery the Consultant Anaesthetist ensures you wake up safely and that your recovery is safe and comfortable.
Local anaesthetic techniques
Some operations may take place using a local anaesthetic rather than a general anaesthetic. Local anaesthetic methods include spinal and epidural blocks, which involve an injection into the back. For shoulder and arm operations the anaesthetic will often include a nerve block combined with general anaesthesia or sedation.
Sedation
The Consultant Anaesthetist may use sedation during your operation; generally combined with a local anaesthetic technique. During sedation you are not unconscious but are given drugs that make sensations less clear and more comfortable. Perhaps the best description is of ‘dozing’. You may fall into a natural sleep during sedation. Some patients have some recall of events while sedated, but many do not. Your Consultant Anaesthetist will adjust the sedation to your needs.
Immediately after your operation
You will be transferred to a recovery room where you will be cared for by a specialist nurse whilst waking up and recovering from the operation. You may not remember waking up until you reach the recovery room or even the ward. This nurse will ensure you are safe, and if you have any pain or feel sick this will be treated. You will also routinely be given oxygen through a face-mask.
After the Operation
Will I be visited by the Consultant Anaesthetist?
The Consultant Anaesthetist will try and see all patients postoperatively. However, some patients having ‘day surgery’ procedures may be able to leave the hospital before the operating list has finished. In this case, the Consultant Anaesthetist will still be busy in the operating theatre. You may wait if you have specific questions you wish to ask.
Pain relief
Operations may cause pain. Pain relief medication will effectively control this and you should usually have little more than mild pain. If you do have pain after your operation, please inform your nurse looking after you who will give you medication to keep you comfortable.
Nausea and vomiting
Some people feel sick after operations which may be due to the operation, the anaesthetic, pain relief medication or other factors such as antibiotics. If you do feel sick after your operation, please inform the nurse looking after you who will give you medication to relieve the nausea and vomiting.
Going Home
You will be allowed to leave hospital when you are safe and well. As anaesthetic drugs disappear rapidly from your body, these are likely to have little effect on your recovery. However you are advised to take things easy for the first 24 hours after an anaesthetic.
- A responsible adult must accompany you during this time.
- You must not return to work, operate machinery or drink alcohol for 24 hours after an anaesthetic.
- You must not make important decisions or sign legal documents during this period.
- You must not drive for at least 36 hours after an anaesthetic. Your insurance may not be valid due to your anaesthetic and surgery. Insurers vary in their rules regarding how soon you can drive, please check with your own insurer.
- If you are taking opioid painkillers (e.g. codeine, dihydrocodeine, tramadol, morphine or oxycodone) or any other drugs that might make you sleepy, you should not drive.
You will usually be given some painkillers to take home with you, and you will receive instructions on how to take them. If you normally take painkillers at home, please inform your anaesthetist so that they may advise you on when to restart these.
It may take you considerably longer to recover from surgery than anaesthesia. Your recovery will be helped by getting the right balance between rest and activity. Taking the painkillers you have been prescribed will assist you in doing this.
