Elective surgery involves three stages once the decision to operate has been made at a surgical outpatient appointment; pre anaesthesia assessment and preparation, the surgery itself and postoperative care.
Our staff will help prepare you for your surgery and will also provide you with a professional level of care before, during and after your operation.
PRE ANAESTHESIA ASSESSMENT
HEALTH QUESTIONNAIRE SCREENING
Once you and your surgeon decide on surgery you will be asked to complete a Patient Health Questionnaire. This will be screened to decide on what type of appointment you will require. It is essential you complete and return this questionnaire as soon as possible.
You may be asked to attend an anaesthetic appointment or be available for a conversation on the phone. We will let you know when this appointment will occur with a letter in the post, so please be sure we have your correct address. This is where we assess whether you are fit enough to have an operation, any preparation that may need to be done, and how long you will need to stay in hospital.
You may see a Specialist Anaesthetist, Medical Officer or a Nurse depending on your overall health and the type of operation you are having. This will also reflect the amount of time your appointment will take. Some operations may require you to stay in the anaesthetic clinic for most of the day; this allows you plenty of time to ask questions and us to ensure we are well prepared for your operation.
At your appointment, we will:
- ask you about your health and medical history
- check your pulse and blood pressure
- weigh you and measure your height
- arrange any blood, heart tracing (ECG) or other tests as needed
- answer any questions you may have about your operation and anaesthetic
- arrange any support services you may require.
You may also be given brochures about your operation. In some cases we will be able to provide you with a date for your surgery, however this will often be arranged later on, with confirmation mailed to you in the post.
You will need to call Surgical Admissions the day before your surgery between 4.00 - 5.00pm, if your surgery is on a Monday you need to phone in on the Friday before. We will give you an approximate time for your operation and instructions on when to stop eating and drinking. It is very important that you follow the instructions provided to you.
Eating or drinking before your surgery can cause delay or even cancellation of your surgery. This is a safety precaution to ensure that there is a very low risk of you vomiting or regurgitating stomach contents whilst under anaesthetic. This can potentially damage your lungs.
Generally, you will have to arrive at Surgical Admissions several hours before your operation is scheduled. This allows the staff time to ensure all of your paper work is completed and correct. Your surgery will be in the order of a list, not on a first come first serve basis. In the unlikely event we need to perform emergency surgery on another patient or the operation before yours takes longer than expected, your operation may be delayed or may need to be postponed to another date.
Your safety is our highest priority, so we will not start your operation unless we have ample time, equipment and appropriately skilled staff available. We appreciate that having your operation delayed or postponed is frustrating, as you will likely be struggling with a disability and have made many arrangements.
Once you have checked in at reception, you will be asked to fill in a personal information form. A surgeon and anaesthetist will usually come and see you, and will give you a request and consent form to read and sign. A nurse will then use a checklist to ensure you are well prepared and will be available for any further questions. If you or your child is a female between the ages of 11 to 60 we will ask if there is any chance you could be pregnant, and when your last menstrual period was. If there is any doubt we will ask you to provide a urine sample so we can check. After this we will ask that you wait in the lounge area until you are called to go into the operating theatre.
Once we are ready to bring you into the theatre, you will be changed into a gown, paper underpants, socks and hat, and a warm dressing gown. If you are comfortable walking, a nurse will escort you into the operating theatre; please let the nurses know if you would prefer to be wheeled in on a bed or wheelchair.
There will be a lot of staff in the theatre who all have different jobs to do. Once you are on the operating table, the staff in the theatre will perform some safety procedures which will involve asking you your name and date of birth, what operation is planned, if all the needed equipment is present, and if blood for transfusion or breathing difficulty is expected. While many of these questions may have already been asked before you enter the theatre, we ask them again as a final check for your safety.
Do not be alarmed that you will be asked a lot of the same questions by several different staff, this is to ensure your safety.
Below are listed different types of anaesthetic. You can discuss these options and any preferences you may have with your anaesthetist.
- LOCAL: a local anaesthetic numbs the part of your body being operated on with an injection to prevent you feeling pain. A local anaesthetic is often used for small, less extensive procedures.
With a local anaesthetic you remain awake for the operation and free from pain.
- REGIONAL: an injection is used to numb the nerve pathways on the part of your body being operated on. It is often used for surgery on the hand, arm, knee etc. A larger section of your body can also be numbed this way, using an epidural or spinal anaesthetic. You may receive medication to make you feel relaxed and sleepy.
With a regional anaesthetic you may remain awake for the operation and will be free from pain.
- GENERAL: an anaesthetic is injected into a vein or anaesthetic gases breathed into the lungs and your whole body is put to sleep. You may have a tube in your mouth and throat when you are asleep to help you breathe.
With general anaesthetic, you are asleep and feel nothing.
Anaesthetists are highly trained doctors. They will meet with you before your operation to discuss the best anaesthetic for your needs and then they will stay with you constantly throughout the operation. Their sole role is to look after you.
Immediately after your surgery, if you were anaesthetised or sedated you will be taken to a Post Anaesthesia Care Unit (also known as the Recovery Room) where you will receive care while waking up from your anaesthetic. The nurses in this area are specially trained to ensure you are kept safe and comfortable as the anaesthetic wears off.
Family members or friends are not usually permitted in recovery; however the nurse taking care of you after your surgery or your surgeon will notify your family or significant other of your progress.
If you are to stay overnight or longer, you will be moved from the recovery area directly to your room/ward where your family or significant other can rejoin you.
If you are to go home the same day, you will be taken to second stage recovery from the Recovery Room, where you will rest for a few hours before going home.
You will be given a pamphlet that describes what you can expect as you recover at home, and what you should do if you have concerns. You may also be given a prescription you will need to take to a pharmacy. Most operations will require you take some time off school or work, so please ask one of the nurses if you require a medical certificate.
The effects of anaesthesia can last for some time. You may be drowsy for a while after your operation.
You MUST have someone drive you home and stay with you for the 24 hours after your operation. You must also have access to a working telephone.
You MUST NOT drive a car, drink alcohol, use dangerous machinery/equipment (including cooking) or sign any important documents for 24 hours after an anaesthetic.
If you have an increase in pain or are feeling sick when you get home please contact the hospital for advice.