​FREQUENTLY ASKED QUESTIONS

What is an Anaesthesiologist?


An Anaesthesiologist is a qualified medical doctor who has a further specialist degree or degrees in his/ her chosen field. Anaesthesiologists are thus medical specialists qualified in delivering anaesthesia, intensive care and pain management. The standard of training in South Africa is very high.

What does "informed consent" mean?


Before consenting to any treatment or procedure you should be informed about the relevant options regarding the treatment or procedure, the pro's and cons of being treated or not and the general and more serious risks and complications that are possible. You should also be given the opportunity to ask any questions. Written consent is usually required from the patient personally, except in extreme emergencies.

What should my Anaesthesiologist know?


It is important to answer all questions honestly and truthfully. These questions are related to your health and any medical condition that may pose a risk. You will be asked questions about your medical, surgical and family history, your medication, smoking habits, drug habits, previous anaesthetics etc.

Why is a pre-operative examination necessary?


The effect of anaesthetic drugs is influenced by numerous factors. Personal details including family history, previous medical and surgical history, allergies, social habits, drug use and abuse are all taken into account in planning the anaesthetic management of a patient undergoing a specific procedure. Many medical conditions increase the risk of anaesthesia therefore it is vitally important that the Anaesthesiologist should be informed of all medical conditions you may have.

Should I inform my Anaesthesiologist if I am taking any herbal/ natural medication?


Some of these products are very potent and can be dangerous, especially if the Anaesthesiologist is unaware that you are taking them. Some herbal medications prolong the effect of anaesthetics while others may tend to cause bleeding or induce palpitations and high blood pressure. The use of herbal medication should ideally be stopped 2 weeks pre-operatively. If this is not possible, the product should be taken to hospital in its original packaging so that the Anaesthesiologist can familiarize him/ herself with the contents of the product.

Do I have to inform the Anaesthesiologist about smoking and alcohol consumption?


Tobacco and alcohol sometimes affect the body more than medication. Due to their effect on organs such as the heart, lungs, liver and blood, they influence the way anaesthetics work. This is especially important with regard to "street drugs" e.g. marijuana, cocaine, amphetamine, heroin etc. Patients are sometimes embarrassed to reveal this information, but it is worthwhile to remember that all information is strictly confidential. It is important for the Anaesthesiologist to be well informed in this regard.

Do I have to stop smoking before my operation?


Tobacco has an influence on your heart, lungs, blood and other aspects of the body. You should stop smoking 6 weeks prior to your operation. If not possible, stop the moment you are scheduled for the operation.

Why am I not allowed eating or drinking before my operation?


Aspiration is the inhaling of food particles into the lungs and can be extremely dangerous. The body has an effective mechanism to prevent this, but when you are unconscious, this mechanism is also "unconscious". It is therefore important for the stomach to be empty when you are receiving anaesthetics. In emergencies where the patient has been eating and/or drinking less than 6 hours previously, the Anaesthesiologist will take special precautionary measures to minimize the risk of aspiration. This rule of no eating and drinking 6 hours prior to anaesthesia, should also be applied when regional anaesthesia is administered because the possibility that general anaesthesia might become necessary cannot be ruled out. It is also not advisable to chew gum or suck sweets, as these enhance the acid secretion in the stomach.

Will I need a blood transfusion?


There are many factors determining the need of a blood transfusion. The most important is the type of operation you will be undergoing and the condition of your own blood prior to the operation. During some procedures the loss of blood is unavoidable regardless of the skills of the Surgeon. Most blood transfusions are given directly after or just before an operation. All fluids given in the operating theatre are administered by the Anaesthesiologist. Blood is only given when absolutely necessary and the benefit of giving blood exceeds the risk of not giving it. Anaesthesiologists are qualified to make these decisions which are not taken lightly.

What are the most common side-effects of anaesthesia?


Sore throat: This is due to the breathing tube placed in your throat during anaesthesia. At least 95% of all patients have some or other tube in the throat during anaesthesia. This causes friction during breathing, hence the sore throat. Please note – this does not mean that anything went wrong during the anaesthesia. Pain: This is due to the surgical procedure. The Anaesthesiologist administers pain medication during the procedure. He will also prescribe appropriate post-operative medication. Nausea and vomiting: There are various reasons for this e.g. the type of operation, your pre-operative condition, the use of pain killers as well as the use of anaesthetics. Some Anaesthesiologists will administer "anti-nausea" medication during the procedure, but medication can also be prescribed post-operatively. Drowsiness after the procedure: Some patients are very sensitive to anaesthetic drugs. Everybody reacts differently - some people need more anaesthesia than others. The length of procedures also influences the post-operative recovery. Less serious side-effects may include: Dry mouth or temporary breathing problems, itchiness, bruising or pain at the spot of injection. Rash due to plasters or medication. Sore neck, sore or dry eyes. Pain in arms or legs due to the positioning during the operation. You may also feel cold and shaky. These side-effects usually do not last long and do not need any treatment.

What are the complications of anaesthesia?


The less serious complications have already been discussed. Modern anaesthesia has an excellent safety record. However, serious complications and even death can occur. Most procedure-related complications resulting in serious long term damage or death are related to the reason for the operation and the whole perioperative sequence of events. For example, e.g. you may have a massive heart attack, be admitted to the hospital in dire straits and die or suffer from heart failure after a coronary artery bypass operation. Mortality attributable to general anaesthesia is rare and occurs in less than 1 in 100,000 operations. The fact that you have a highly trained specialist in charge of your anaesthetic is already a step in the right direction. Please tell your anaesthetist about any serious medical condition and particularly about previous anaesthetic complications in yourself or your family. More serious complications are not necessarily due to the anaesthesia, but a combination of various factors. These include: serious allergic reactions, heart attacks, massive blood loss, thrombosis, pulmonary embolism, stroke, serious asthma attacks and other cardio-pulmonary problems. These complications are very rare and your anaesthesiologist is well qualified to deal with any such complication.

What happens if I am allergic to anaesthetics?


Some people may think that they "are allergic to anaesthetics" because of previous unpleasant experiences such as nausea and vomiting. These are side-effects and not allergies. True allergies include swelling of the mouth, throat or eyes, breathing problems, hives and wheals, and sometimes a drop in blood pressure. It is possible for a patient to show allergic reactions to some drugs, although it seldom happens. If it does happen, it is seldom permanent, because anaesthesiologists are specialists who will notice these reactions immediately and act fast to prevent any permanent damage. Allergy to latex is an increasing phenomenon, but seldom serious. If you suspect such an allergy you should inform your surgeon and anaesthesiologist in order to avoid rubber products being used. If any allergies occur, you will be tested after the operation so that those products can be avoided in future. You may have to wear a "medic-alert" bracelet. Allergic reactions to one type of anaesthetic do not mean that you will not be able to receive anaesthetics in future.

My child and anaesthetics: How can I help?


The anaesthesiologist and surgeon will do their utmost to keep your child happy during his stay at hospital. You as the parent can also help. It is important to prepare the child as soon as it has been decided that an operation is necessary. Children deal with surgery and anaesthetics better if they are well prepared. The keyword is honesty. Explain to him that he will be in a strange environment, but that there will be friendly people to look after him. Children should know that they are going to get an operation and that they might feel a bit uncomfortable afterwards. Prepare them for the fact that you will not be with them constantly, but that you will be close by. Talk to them light heartedly about the hospital, the long passages, the hospital beds and the possibility of other children in the ward. A calm parent leads to a calm child. How long must my child fast before the operation? As a general rule children should not eat any solid food or milk 6 hours prior to the operation. Clear liquids may be given up to 3 hours before the procedure.

When can I resume my normal activities?


Normally this depends on the type of surgery you had and you will be guided by your surgeon. Anaesthetics are usually out of the system within a few hours, but it is not advisable to drive a motor car or to sign any legal documents for at least 24 hours after anaesthetics. If you have any questions other than these, consult your surgeon or anaesthesiologist.
This information was reproduced from the South African Society of Anaesthesiologists (SASA) website Patient Corner page with permission from the webmaster (http://www.sasaweb.com)