General Anaesthesia in an Operating Theatre: A guide for Patients
This page provides important information about undergoing general anaesthesia. It's important to note there are multiple ways of safely delivering general anaesthesia. Each method has benefits and downsides, but often no one way is better than another.
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Each and every anaesthetic delivered by an anaesthetist is bespoke and balanced. This means it is customised to you, taking in to account your medical background, your current medical condition, the operation being conducted, the body region on which the Team is operating, where we anticipate you going after the operation (home, ward, intensive care etc), and a multitude of other factors. As a result of this, the information here is generic in nature. Your anaesthetist is always best placed to provide you information about the anaesthetic care and technique specific to your surgery, as they will take all these factors into account.
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General anaesthesia is frequently paired with regional anaesthesia (commonly known as a 'block'), which helps provide excellent post-operative pain relief.
The Process
You will be brought into the anaesthetic room adjoining the operating theatre (OT), or sometimes directly in to the OT from the pre-operative waiting area.
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An intravenous cannula (a drip) will be placed, normally in the arm or the hand. Sometimes regional anaesthesia (a nerve block, if being used) may be performed in the anaesthetic room before going into the OT.
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You will then be taken in to the OT and positioned on the operating table. Your anaesthetist will be pedantic about your positioning, to ensure the optimum conditions for safety during the anaesthetic. Cables and attachments will be applied to your body to allow monitoring of your heart's electrical activity, blood pressure, and oxygen saturation level. Other specific monitoring may be applied such as a monitor for brain activity (to help determine how deeply asleep you are), and neuromuscular monitoring (to monitor how responsive your muscles are to electrical signals).
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You will be given pure oxygen to breathe for several minutes, before going to sleep. Once you are asleep, your anaesthetist will often take over your breathing, and insert an airway device through your mouth.
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Through the anaesthetic your anaesthetist will constantly and vigilantly monitor you, and adjust the anaesthetic drugs being administered in response to multiple factors. You will frequently also be given medication to relieve pain (analgesics), reduce the chance of post-operative nausea and vomiting, (anti-emetics), and antibiotics (as prophylaxis against infection).
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At the end of the operation your anaesthetist will wake you up, and transfer you to the recovery room.
Anaesthetic Risks
Almost all medical care and procedures carry some degree of risk of something not going according to plan, and it's important to be aware of this beforehand. Your anaesthetist is always best placed to provide information about the risks of anaesthesia specific to you and your upcoming surgery. The risks listed here are generic and not tailored to you and your circumstances. There are also multiple other less frequently encountered side effects/complications which are not listed here, to avoid providing an overwhelming list.
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1. Dental (+lip/gum) damage. During insertion (or removal) of an airway device, teeth rarely may be chipped or damaged. Teeth that are highest risk for this complication are those in the front and centre of your mouth on your upper jaw. Teeth which are capped or crowned are at higher risk of damage.
2. Pain. Some degree of pain or discomfort is to be expected after most operations, and is normal. Your anaesthetist is expert at managing pain, however.
3. Post-operative nausea and/or vomiting.
4. Sore throat is a common side effect, but normally resolves within 24hours with eating and drinking
5. Allergic reaction to any of the medications or skin preparations that we use
6. Heart issues for example heart attacks, strokes, or abnormal rhythms of the heart. Sometimes these can be life-threatening.
7. Breathing issues for example bronchospasm (like an asthma attack), post operative chest infection
8. DVT and/or PEs are blood clots in the leg (deep vein thrombosis) and lung (pulmonary embolus) respectively. The risk of these is raised with specific types of surgery, for example some orthopaedic surgery
9. Aspiration. This is inhalation of regurgitated or vomited stomach contents
10. Awareness under anaesthesia is when there is unintended awareness whilst anaesthetised, potentially with unintended memories about the procedure afterwards. This is incredibly rare. If you are under general anaesthesia your anaesthetist will be monitoring you closely for any signs of awareness