For operations on a small area it is possible simply to inject local anaesthetic at the site of the operation. Injection and infiltration of local anaesthetic is uncomfortable, but only for a few seconds, and is bearable for the vast majority of patients, even children. The injection is carried out slowly to minimise any discomfort, and it is reassuring to know that it does work very quickly indeed. The injected area becomes numb within 30–40 seconds. You will feel no pain following the injection, but will continue to feel touch and temperature variations during the intervention.>
A general anaesthetic is not always necessary or advisable. Regional anaesthesia involves numbing of a targeted area in the body, without the need to put the patient to sleep. In Sonja’s practice this is commonly accomplished in patients undergoing wrist or hand surgery. Local anaesthetic is administered around large nerves in the armpit so that the whole of the upper limb becomes temporarily numb and floppy. Effects last for few hours, during which even very complicated and extensive operations can be completed without any discomfort to the patient.
Fasting is required for regional anaesthesia, in case conversion to general anaesthesia is required during the procedure.
The development of new, safer anaesthetic drugs and sophisticated monitoring equipment means that modern anaesthesia is very safe. Anaesthesia usually begins when the anaesthetist injects a drug through a fine plastic tube (cannula) inserted into a vein on the back of the hand. Within a few seconds, this sends you quickly and smoothly to sleep. It is also possible to induce anaesthesia with anaesthetic gases, inhaled through a mask. To maintain this unconsciousness, the anaesthetist gives you a mixture of oxygen and anaesthetic gases to breathe. This ensures you are unconscious throughout the operation and will not feel any pain or remember anything about it. The anaesthetist will monitor your condition throughout the operation.
Sometimes a combination of these can be used. We would normally discuss this in the clinic, depending on individual circumstances, and advise you what to expect well in advance.
If your operation is to be carried out under regional or general anaesthesia you must not eat any food including sweets and chewing gum or have any milky drinks for a minimum of 6 hours prior to the start of your operation. Milk counts as a food product as it takes longer than other fluids to digest. Fasting helps to prevent inhaling (breathing in) the stomach contents into the lungs while unconscious under general anaesthetic. You may safely continue to drink still water up to 2–3 hours prior to surgery. Research has shown that drinking fluids up to 2 hours before surgery helps recovery, and reduces postoperative nausea (sickness) and risk of vomiting.
Because the exact schedule of operations might change up until the last minute due to unpredicted medical circumstances, patients undergoing surgery in the morning are advised to eat only until midnight on the day prior to admission and to drink only still water up until 7am on the morning of surgery. For patients scheduled to have surgery in the afternoon, a light breakfast should be consumed up until 8am and a last water drink consumed by 11am.
You will be advised how long you will need to stay in hospital well in advance of surgery. After a general anaesthetic you must stay in hospital for at least 3–4 hours so that the effects can be monitored at regular intervals. Please be advised that you should not drive your car for at least 24 hours after surgery. We strongly recommend that you ask a friend or relative to collect you. Alternatively we can arrange a taxi or private ambulance for you. If you need to take any medication following your departure, this will be given to you when you leave.