Arriving at hospital
Please arrive at the time the hospital gives you. This is often some time before your procedure, because there is preparation to do and operating lists can change during the day. Waiting can be the hardest part, so bring something to read.
At admission, a nurse will confirm your details, check your blood pressure, pulse, temperature and oxygen level, and ask about your health and medicines. You will change into a hospital gown and may be given compression stockings to help prevent blood clots. An identification band, and an allergy band if needed, will be placed on your wrist.
Safety checks
You will be asked the same questions several times by different members of the team. This can seem repetitive, but it is deliberate. Each check is an independent safeguard. Staff will confirm:
- your name and date of birth;
- the procedure you are having and, where relevant, which side of the body;
- that your consent is in place;
- when you last ate and drank;
- your allergies;
- your medicines, including when you last took any blood thinners, diabetes or GLP-1 medicines.
Please answer each time, and speak up if anything does not sound right.
Meeting your anaesthetist
I will see you before your procedure, if we have not already met beforehand, or to review any changes if we have. We will go through your health and previous anaesthetics, check your airway and teeth, and confirm the anaesthetic plan, its risks and the alternatives. This is a good time to ask questions or raise any worries, however small. If you are anxious, please tell me. There is a great deal I can do to help.
The way we reach decisions together is explained on Understanding Your Anaesthetic & Informed Consent.
Into the theatre
When it is time, you will walk or be taken on a trolley to the anaesthetic bay or directly into the operating theatre. Theatres are often cool and brightly lit, with a number of people preparing equipment. Everyone there is part of your team, and you will be offered warm blankets.
The team will complete another brief check of your identity and procedure. You will then be connected to the monitors: sticky pads on your chest to watch your heart, a clip on your finger to measure oxygen, and a blood pressure cuff on your arm.
A small plastic tube, called a cannula or drip, is placed in a vein in your hand or arm. This is how medicines and fluids are given. The needle is removed, leaving only the soft tube. If you are worried about needles, let me know, as numbing cream or other measures can help.
Starting your anaesthetic
If you are having a general anaesthetic, you will usually breathe oxygen through a soft mask for a few minutes first. The anaesthetic is then given through your drip. Some people feel a cool sensation or a brief sting in the arm, and many describe a pleasant, heavy feeling. Most people fall asleep within a minute, and few remember anything after that point.
If you are having a spinal anaesthetic or a nerve block, this is usually done in the anaesthetic bay or theatre, often after a little sedation to help you relax. Local anaesthetic numbs the skin first. You may feel pressure, or a brief tingling as the nerves are approached. If you are having sedation, you will gradually feel drowsy and relaxed.
During the procedure
While the procedure takes place, I monitor your breathing, heart, blood pressure, oxygen levels and depth of anaesthesia continuously, and adjust your anaesthetic and fluids as needed. I also give medicines to manage pain and reduce nausea after you wake. You are positioned carefully and padded to protect your skin, nerves and eyes, and kept warm.
If you are awake or sedated, you may hear voices or equipment. Please tell me if you are uncomfortable at any time. You can talk to me throughout.
Waking up in recovery
At the end of the procedure, the anaesthetic is stopped and you begin to wake. Any breathing device is removed, usually before you are fully awake. You are then taken to the recovery room, sometimes called the post-anaesthesia care unit (PACU), where a specialist nurse looks after you closely.
You may wake with an oxygen mask on your face and monitors still attached. It is common to feel drowsy, cold, or a little confused at first, and to have a dry or sore throat. Your nurse will check your comfort regularly and give you pain relief and anti-nausea medicine as needed. Please tell them how you feel.
What happens next is explained on Recovery & Aftercare.
Family and carers
A family member, friend or carer is usually welcome to stay with you during admission, and may be able to stay until you go to theatre. Arrangements vary between hospitals, so check with yours. Recovery rooms are usually restricted to patients and staff, but your family can be contacted when you are back on the ward or ready to go home.
If you need an interpreter, have a disability, or care for someone else who needs support, please let the hospital know beforehand. A carer may sometimes stay with you longer, for example for a person living with dementia or with significant anxiety. Please ask about this when you book.
If you are going home the same day, the person collecting you should be ready to take you home and stay with you overnight.