Most patients, on booking surgery with me as their anaesthetist, will be directed to this website were hopefully they will understand the expected process and general consent issues as highlighted in the linked documents from The Royal College and Association of Anaesthetists.
On the day of surgery, I will meet with each patient and check the most essential information prior to finalising the plan for anaesthesia. I will also have met with the operating Surgeon and will take into consideration their needs for optimising your surgery. This is the final opportunity to ask questions and raise any issues before heading to theatre.
The patient will be transferred to the anaesthetic room where final checks will be made before monitoring equipment is attached. As a minimum this will consist of a blood pressure cuff, ECG heartbeat, and blood oxygen monitoring.
A "drip" (cannula) will be inserted into a vein, usually on the back of the hand. Through this all medication can be given throughout the duration of your hospital stay.
For a General Anaesthetic, just before drifting off to sleep you will be given oxygen to breathe via a face mask. This is an essential part of the anaesthetic process.
Once asleep an airway device needs to be inserted into the patients mouth to lift the tongue forward so that they can carry on breathing. Because of this many patients will wake with a temporary sore throat that should only last a few minutes. On exceedingly rare occasions patients have been known to develop inflammation of the uvulae. This is exceedingly rare and may result in a very sore throat which eventually settles but can take 2 weeks or longer. Another complication of airway management is dental damage which can include loss of teeth, dislodged crowns or broken veneers. Fortunately, this is rare and not necessarily due to negligence. The overriding need in securing a safe airway is to keep the patient oxygenated and alive.
If a nerve block is to be performed for optimum analgesia, I will normally perform this with the patient asleep, after I have secured their airway.
After surgery, the patient will be woken in theatre or sometimes in a recovery room. The airway device will be removed once the patient is breathing well by themselves. In recovery the patient will be monitored and kept warm. Analgesia and anti-sickness treatments may be administered as needed before the patient is discharged back to their room.
Prior to hospital discharge the patient will be advised on the optimum analgesia regimen for their recovery. They will often receive 3-4 different painkillers to take at home, in a regular, by the clock fashion. This may entail waking in the middle of the night to take the prescribed painkillers.