About anaesthesia

You will need anaesthesia for your operation, treatment, or examination. There are three types of anaesthesia:

• General anaesthesia
• Nerve block
• Spinal anaesthesia

Before most procedures, you will have a consultation with an anaesthesiologist. The anaesthesiologist will ask about your health and past medical history including any current medications, herbal medicines or supplements you are taking, as some of these may need discontinuing before your procedure. Please bring a list of your medications to the consultation. The anaesthesiologist will help you decide which type of anaesthesia is most suitable for you.

For minor procedures, you may not meet the anaesthesiologist until you are in the operating theatre. However, if you feel anxious about being sedated or have any questions, you can request a consultation with the anaesthesiologist ahead of time.

Types of anaesthesia

General anaesthesia

You will be asleep during the procedure. The anaesthetic medication will be administered through a needle in your arm or hand. To help you breathe, a plastic tube might be placed down your throat after you sleep. For some procedures, a plastic catheter will be placed in your back prior to anaesthesia to manage pain during and after the procedure.

Nerve block (local anaesthesia)

You will be awake during the procedure. A nerve block is used to numb a specific area of your body, such as an arm or foot. The anaesthesiologist will inject a local anaesthetic around the nerves using a thin needle. Most often, this is done using ultrasound. You will not feel pain during the procedure but may feel pressure or touch. The nerve block can relieve pain for up to 24 hours afterward. If you feel uncomfortable during the procedure, a small dose of sedative medication is given, so you can doze off during the procedure.

Spinal anaesthesia

You will be awake during the procedure. Spinal anaesthesia numbs your lower body or legs. The anaesthesiologist will inject a local anaesthetic in your back using a very thin needle while you are seated or lying on your side. Usually, this is quick and easy, but you can be given a sedative to help you relax. You will be awake during the procedure but may receive a small dose of sedative medication to help you doze off. In some cases, a catheter may be placed in your back to provide pain-relief during and after the procedure.

Important preparation

Fasting

You must fast before anaesthesia. This means:

• Stop eating six hours before your procedure.
• Stop drinking dairy products and juice containing fruit six hours before the procedure. Do not use milk in your coffee or tea. You can continue drinking clear liquids like water, sweetened and carbonated beverages, coffee, and tea.
• Stop drinking cold or hot liquids two hours before the procedure. We recommend a large glass of a sweet beverage as the last thing you drink, as the sugar may help counteract nausea and discomfort.

Your stomach must be empty to minimise the risk of any stomach content moving up through your food pipe (oesophagus) and into your lungs while you are under anaesthesia.

If you have diabetes, you will need to stop taking your diabetes medication ahead of the anaesthesia. During the consultation with the anaesthesiologist, we will let you know when to stop taking your diabetes medication. Most people will only need to stop taking medication on the day of the procedure. You will still need to fast. Before the procedure, we will measure your blood sugar and give you supplementary insulin if you need it.

Taking your medication

Unless otherwise directed by a doctor, you can continue taking any medication. You may drink a little water with the medication, even if you are fasting. You will need to take special precautions if you have diabetes. Contact the doctor or department that referred you to discuss what you need to do.

Shower or bath

On the day before the procedure, take a bath or shower and wash your hair. Put on clean clothes before leaving for the hospital. Wash your entire body, taking extra care to clean your navel. Use a cotton swab if necessary. Do not apply creams, deodorant, or perfume after the shower or bath as this increases the risk of infection.

Remove makeup, nail polish, and jewellery

Remove any nail polish or fake nails before the procedure. Do not put on makeup before leaving for the hospital. Take off your watch, jewellery, and piercings and leave them at home. The hospital does not replace lost or stolen items, so please be mindful of what you bring.

Bring only necessary items

You can bring dentures, hearing aids or glasses if you use them.

Be prepared for waiting

Bring a book, magazine or other entertainment to pass the time if there are delays.

At the hospital

Getting ready for the procedure

We will make sure you receive any necessary medication before the procedure, such as a sedative, pain reliever, or anti-nausea medicine.

Secure your valuables

Leave your belongings in a locked cupboard in your room during the procedure. You can bring glasses, hearing aids, and dentures with you to the surgery ward. Remove contact lenses before the procedure.

Anaesthesia process

The anaesthesia team will greet you when you arrive at the surgery ward. They will place a needle in your hand or arm for fluids and medication. To monitor your status during the procedure. we will place electrodes on your chest, a blood pressure cuff on your upper arm and a plastic probe on one of your fingers. The anaesthesiologist will then administer medication to make you sleep. While you are asleep, specially trained staff will be at your side and closely monitor you to ensure everything is going according to plan. When the procedure is done, the anesthetic medications are discontinued and you will wake up shortly after.

Recovery

Most patients will be taken to a recovery ward after the procedure. However, if you only been under anaesthesia briefly, you may be quickly awake and can safely go directly back to your room at the ward. In the recovery ward, you will be monitored and given pain-relieving and anti-nausea medication if needed. Likely, you will feel tired and need rest. Your family and loved ones are welcome for a brief visit in the recovery room. However, we ask you kindly to be considerate of other patients who may need quiet and privacy. The recovery ward staff may not have detailed knowledge of your specific procedure. The surgeon who performed the procedure will inform you once you are back in your ward.

Pain management

We use a pain scale to determine your pain level. Everyone experiences pain differently, so it is important to let us know if you are in pain. The pain should be manageable, allowing you to take deep breaths and move around in bed.

Important precautions for the first 24 hours

Take the following precautions during the first 24 hours after anaesthesia:

• do not drive any vehicle
• do not operate machinery
• do not drink alcohol.

If no one can stay with you, at least have someone available to call if you need help.

Possible side effects

Anaesthesia is very safe. Serious harm or side effects are extremely rare. Commonly, minor side effects are usually short-lived and treatable. Possible side effects include:

• Soreness in mouth and throat: If you had a tube inserted in your throat to help you breathe during general anaesthesia, your mouth and throat may feel sore afterwards. This is common and will go away on its own.
• Nausea: Some patients experience nausea and vomiting after anaesthesia. Medication can be provided to prevent this.
• Itching: Some pain-relieving medication may cause itching, though it rarely requires treatment.
• Problems urinating: In rare cases, you may have trouble urinating once home. Contact your general practitioner or dial 1813 for the medical helpline if this happens.
• Memory issues: Elderly patients may have trouble with memory just after anaesthesia. This usually improves within a few days or weeks.
• Headaches: Spinal anaesthesia can rarely cause headaches. This special kind of headache will appear when standing and disappear when lying down. These headaches are harmless but may require treatment. Contact the hospital if you develop a headache after returning home.
• Nerve damage: Rarely, local anaesthesia may cause nerve damage. If numbness, reduced muscle strength, or pain persists for 3-4 weeks, contact the department responsible for your procedure. Permanent nerve damage is extremely rare.
• Dental injuries: Loose or fragile teeth may be damaged by general anaesthesia.
• Blood accumulation or infection: In extremely rare cases, spinal anaesthesia can cause blood accumulation or infection in your spinal canal. This requires immediate treatment. Dial 1813 if you experience sensory disturbances, trouble urinating, or strong pain where the anaesthesia was placed. Inform the operator that you had spinal anaesthesia.