You will normally meet your anaesthetist on the ward before your operation. Your anaesthetist will look at the information from your health check or pre-operative assessment and ask further questions about your health. They may listen to your chest and look in your mouth. You will be able to ask questions and discuss any concerns you may have as well as discussing the choices of anaesthetic for your operation. 

Sometimes there is a choice about which kind of anaesthetic and pain relief is best for you. Having talked about the benefits, risks, and your preferences, you and your anaesthetist will decide together which anaesthetic you will have if there are any choices to be made. Nothing will happen to you until you understand and consent to what has been planned. You can refuse the treatment or ask for more information, or more time to decide.  

Types of Anaesthesia 

• General anaesthesia
• A local anaesthetic
• A regional anaesthetic
• Spinals and epidurals
• Other types of regional anaesthetics
• Sedation
• Combination anaesthetic
• A 'pre-med' (pre-medication)  
  

Can my operation be cancelled at the last minute?

Unfortunately, cancellations do happen at the last minute if time runs out in theatre or there is no bed available. Occasionally, your anaesthetist or surgeon may find something about your health which is not expected. They might recommend that your operation is delayed until the problem has been investigated, reviewed, or treated. This will be discussed with you and your surgeon. 

Monitors 

The ODP or anaesthetic nurse will attach you to monitoring equipment, which allows the team to closely follow your wellbeing during your operation.  

• Heart monitor
  Sticky patches will be placed on your chest that give a heart tracing on the monitoring screen. Sticky pads connect wires to the chest for monitoring the heart.
• Blood pressure
  A cuff is placed around your arm, attached to a blood pressure monitor. The monitor is usually set to read your blood pressure every five minutes or less.
• Oxygen levels
  A peg with a red light inside it is placed on your finger or other places such as your ears or toes. This continuously measures your oxygen level.

Setting up your cannula  

Your anaesthetist will need to give you drugs into your blood stream. They will do this through a small plastic tube placed in the vein. This tube is called a cannula. A needle is used to put the cannula into a vein on the back of your hand or in your arm. If you have any concerns about this, please talk to your anaesthetist. 

Intravenous fluids - ‘a drip’

You need to receive fluids during most operations to prevent dehydration. This may be continued after surgery until the time that you can drink normally. Your anaesthetist can give you sterile fluid through a drip into your cannula to keep the fluids in your body at the right level. Any blood you need will also be given through the cannula.  

Cannulas for children and those who find needles difficult  

Local anaesthetic cream can be used to reduce the sensation when the needle is inserted. The cream is used routinely for children. Adults can ask their anaesthetist about it if they have particular worries about the cannula. 

Having a general anaesthetic

You now have a cannula in place and the monitoring equipment is attached. The anaesthetist will usually ask you to breathe pure oxygen from a light plastic face mask before the anaesthetic begins. If you are worried about using a face mask, please tell your anaesthetist.

Two ways of starting a general anaesthetic: -

1. Anaesthetic drugs are given through your cannula. This is the usual way of starting the anaesthetic if you are an adult or older child. Some people report a light-headed feeling first, and most people become unconscious within one minute, or
2. You can breathe a mixture of anaesthetic gases and oxygen through the light plastic face mask. The gases smell quite strong, and it usually takes two or three minutes to become unconscious. After you are unconscious, your anaesthetist will insert the cannula. 

Having a regional or local anaesthetic

These anaesthetics are started in the anaesthetic room or in the operating theatre. There are many kinds of regional or local anaesthetic. All types involve an injection of local anaesthetic drug. You will be awake for the injection unless you have asked to have sedation. Regional anaesthesia provides pain relief on its own for operations such as caesarean section, hip, or prostate surgery. Alternatively, you may have a regional as well as a general anaesthetic to help with pain relief after an operation. For example, this may be helpful in major bowel surgery.  

Spinal or epidural anaesthetic  

These are used for operations on the lower half of your body. They both involve an injection in the back.  

• A spinal anaesthetic is a single injection which makes you numb for up to two hours. Strong pain killers can be added to the local anaesthetic.
• An epidural is a fine, flexible tube placed in the back near the nerves coming from the spinal cord, through which pain-killing drugs can be given to give pain relief.

Other types of regional anaesthetic

Other regional anaesthetics often involve an injection placed near to a nerve or group of nerves. This is called a ‘nerve block’. This can allow you to have the operation without a general anaesthetic. Or, you can have a nerve block as well as a general anaesthetic for longer-lasting pain relief. A nerve block is useful for: 

• operations on the arm or lower leg
• operations on the artery in the neck, 
• operations on the abdomen, where a nerve block can be used for extra pain relief, alongside a general anaesthetic.