Starting with what you already know
Every conversation starts with you. Some people have had many anaesthetics; others have never had one. I will ask what you understand about your procedure and your anaesthetic, and about any previous experiences, good or bad. If you have had problems before, such as severe nausea, difficulty waking, a reaction to a medication, or being told your airway was difficult, please tell me. That history helps me plan.
Information from websites, social media and AI
Many people read about anaesthesia before surgery, whether on hospital websites, social media, or by asking an AI tool such as ChatGPT. That is sensible, and it often leads to good questions. Please bring what you have read, or what you are worried about, to our discussion.
Online information also has limits. It is general rather than written for you, it may be out of date or from another country, and AI tools can sound confident while being wrong. Part of our conversation is working through what applies to you, and gently correcting anything that might be misleading or worrying you unnecessarily.
Your proposed anaesthetic
I will explain the anaesthetic I recommend, why, and what it involves. Not every technique suits every patient or procedure. The terms below are ones you may hear.
- General anaesthetic (GA)
- A controlled, deep sleep so that you are unaware and feel no pain.
- Sedation
- Medication to help you relax and feel drowsy. You may remember some of the procedure.
- Spinal and epidural
- An injection near the nerves in your lower back to numb the lower body, used alone or with sedation or a GA.
- Regional (nerve block)
- Local anaesthetic placed near specific nerves to numb an arm, leg or other area, often giving good pain relief afterwards.
- TIVA
- Total intravenous anaesthesia: a general anaesthetic given entirely through a drip rather than with anaesthetic gases.
- Breathing devices
- A breathing tube (ETT) or laryngeal mask (LMA) to support your breathing during a GA. A video laryngoscope (VL) or awake fibreoptic intubation (AFOI) may be used when extra care is needed.
- Additional monitoring
- For some major procedures, an arterial line (continuous blood pressure) or a central venous catheter (CVC), and sometimes planned care in intensive care (ICU) afterwards.
Risks, benefits and reasonable alternatives
Every anaesthetic has benefits and risks. I will talk with you about the risks that are material to you: those a reasonable person in your position would want to know about, and those I know matter to you personally. Your health, your procedure and your own priorities all shape that discussion, and for major surgery I may use formal risk-assessment tools to individualise it.
Depending on your situation, we may discuss some of the following. Most people need to discuss only some of them.
Common and usually short-lived
Pain, nausea and vomiting, sore throat, discomfort at the drip site.
Less common
Damage to teeth, allergic reactions including anaphylaxis, awareness during anaesthesia.
Heart, lungs and brain
Heart and blood pressure problems, breathing problems and aspiration, stroke, confusion or delirium after surgery, blood clots, and the possible need for a blood transfusion.
Spinal, epidural and nerve blocks
Headache after a spinal or epidural, nerve injury, local anaesthetic toxicity, and very rarely paralysis.
Positioning and other
Eye injury, pressure areas, risks of lying face-down or in other positions, rare loss of vision, and infection.
Very rare
Death caused directly by anaesthesia is very rare, and is discussed honestly where it is relevant to you.
How often these occur is explained on Anaesthetic Safety & Risks. We will also talk about the reasonable alternatives to what I recommend, including their own benefits and risks.
Questions and deciding together
You can ask anything, and you can take time to think. If something is unclear, I would rather explain it again than have you go to theatre unsure. Where there is more than one reasonable option, we weigh them together against what matters most to you. Agreement to proceed comes only after your questions have been answered.
How our discussion is recorded
I record our consent discussion in your hospital notes using a structured record. It notes the anaesthetic planned, the risks we discussed, that your prior knowledge and any online or AI information were considered, that misconceptions were clarified, that your individual risks and alternatives were discussed, and that your questions were answered. Any specific concerns or additional risks we talk about are written down too.
Written information before your procedure
Before surgery you will usually receive written information, including an informed financial consent explaining anaesthetic fees, and an anaesthetic questionnaire about your health. Completing the questionnaire carefully helps me prepare. If you have concerns before your procedure, please contact the practice.