Is my anaesthetist a doctor, what training has s/he done
Yes, all our Anaesthetists are doctors and specialists who have completed a medical degree and at least a further five years of specialist training in anaesthesia, intensive care, resuscitation and pain management.
Our practice is actively involved in continuing medical education with all partners regularly attending local, national and international conferences and workshops.
What does the anaesthetist do while I am asleep?
Your anaesthetist stays with you the entire time. He or she does not leave you until you are beginning to wake up, at which point you will be moved to the recovery room and into the care of a special nurse. While your operation is taking place, the anaesthetist monitors all your vital functions to make sure you are safe and asleep.
They will treat any situation that arises and if required will administer a blood transfusion. They will also give you painkillers and drugs to treat nausea and vomiting so that you wake up as comfortable as possible.
Can I come with my child/partner into surgery?
If your child or dependent requires an anaesthetic we encourage one parent or guardian to be present until we are able to insert an IV and give some sedation or your child falls asleep breathing gas. We then ask you to say goodbye and leave the theatre while we do the surgery required. Unfortunately, it is not safe for you or your child to remain in the theatre during surgery.
We will usually call you back to your child in the recovery room just as they start to wake up.
During Caesarean section, the mother’s partner is encouraged to be present during the entire procedure. Unfortunately only one partner can attend as increasing numbers put the mum, partners and staff at higher risk.
For all other surgeries, current practices suggest that having other family members present during a procedure poses increased risks.
I want to complain about my anaesthetic
We take your satisfaction very seriously and would like to hear from you if you are dissatisfied in any way. The best option is to contact our rooms and speak to either our Practice Manager or our Practice Nurse on
(03) 5331 4888.
Hopefully they can answer any questions you may have and refer the matter on to the anaesthetist who looked after you or, if you prefer, one of our other partners
I would prefer a female anaesthetist
Our practice will try to accommodate any request for particular anaesthetists for your procedure. Unfortunately the reality is that few female anaesthetists want to work in rural private practice. It is also often difficult to accommodate specific requests as all our partners work at several hospitals and have many other commitments.
The best results will be obtained if you can nominate 2 or 3 anaesthetists that you have been happy with (or those you would prefer not to look after you).
I would like to know more about the drugs you use
Traditionally, a patient who was to receive an anaesthetic was given a "premed" 1-2 hours before their anaesthetic. This premed was designed to sedate patients and relieve their anxiety. Unfortunately, it also tended to increase the amount of nausea after an operation and increase the time until patients could go home. These days, most of our patients come in just before their operation and go home within a few hours. Rarely, if someone is particularly anxious, the anaesthetist will prescribe a mild sedative such as temazepam before the case. More commonly, the anaesthetist will use a similar drug called midazolam intravenously when you arrive in the theatre.
This drug also affects memories and is the reason many people don't remember much about their theatre experience.
Other drugs are sometimes given before your operation to assist with pain relief postoperatively (eg Panadol or anti-inflammatories) or make your anaesthetic safer (eg antacids such as ranitidine). If you are particularly worried about needles, you can request cream be applied before coming to theatre which will numb the skin. This is routinely used with children but takes 1 hour to work well.
These days we use what is called 'balanced anaesthesia'. This means that we use a mixture of drugs with similar actions so that we don't have to use a large amount of one drug increasing the risk of side effects. When anaesthesia started, ether was used by itself (drops onto a cloth over the mouth!) - things have come a long way since then.
To send you to sleep we usually use a drug called propofol (the one that looks like milk) injected in to your IV or “drip”. To keep you asleep we either keep giving more Propofol or, get you to breathe a gas such as Sevoflurane, an improved version of Ether. To wake you up, we stop giving these drugs and they wear off very quickly.
We also often give drugs such as Midazolam (see above) and opiate pain killing drugs such as morphine or newer versions such as Fentanyl or Alfentanil.
For some operations we need to paralyse the muscles and we then use drugs based on curare, for example Rocuronium.
Using these drugs is a highly specialised field taking many years of training. If used incorrectly they can have dangerous consequences. Part of this training is also the ability to use drugs that may be necessary to keep your breathing and circulation stable while you are asleep.
Local anaesthetics are drugs that 'block' the ability of pain nerves to send messages back to the brain. The local anaesthetic is usually injected next to the nerves which can be small, such as in the skin or teeth; or large, such as near your spinal cord. These injections can be painful so sedation is sometimes used as well.
There are many types of local anaesthetic drugs (cocaine was one of the earliest!) and the choice usually depends on safety and how long we want the numbness to last - common drugs are Lignocaine, Bupivicaine and Ropivicaine.
If large nerves are 'blocked', then nerve impulses from the brain to the muscles are blocked and temporary weakness or paralysis will develop. It is important that when you have had a local anaesthetic, care is taken with the affected area to avoid damage until it wears off.
Sedation is commonly used for minor procedures such as gastroscopy and colonoscopy. In reality, sedation is just a light form of general anaesthesia and the drugs used are usually the same as above but in lower doses, for example midazolam, propofol and fentanyl. Great care is required in the use of these agents though to ensure that there is no interference with the breathing or blood pressure.
What are the risks of blood transfusion?
Certain types of operations are associated with a greater chance of the patient requiring a blood transfusion, including major cancer surgery, prolonged orthopaediac (bone) operations (eg revision hip surgery), caesarean section in patients with placenta attachment difficulties.
There are a number of possible risks and adverse reactions to blood transfusions. Some of them are the result of interaction of the body's immune system with components of blood and some are due to factors including the transmission of infectious diseases. Having a blood transfusion is very safe because the Australian Red Cross Blood Service conducts routine screening tests on all donor blood.
If you would like to know more, please visit the Australian Red Cross Blood Service website. http://www.donateblood.com.au/
What effect does obesity have on anaesthesia?
Obesity is defined as body mass index (BMI) greater than 30kg/m2 and poses a number of problems for anaesthesia.
For these and other reasons, it is advisable for patients who are overweight or obese to lose weight prior to elective surgery.
If significant weight loss is not possible, even small weight loss is beneficial. Where patients are able to do so, light exercise, such as a 30 minute walk each day before surgery, will be helpful and make postoperative recovery easier for the patient. You can start with walking 10 minutes each day and increase to 20 minutes per day and then achieve 30 minutes per day.