During your operation

In the Anaesthetic Room

When it is the right time for your surgery you may walk with a Nurse to the anaesthetic room. If you are unable to walk you will be taken in a chair or on a bed.

The anaesthetic room is next to the operating theatre. Several people will be there, including your Anaesthetist and an Anaesthetic Practitioner. Equipment will measure your:

• Heart rate – 3 sticky patches on your chest (electrocardiogram or ECG)
• Blood pressure – a cuff on your arm
• Oxygen level in your blood – a clip on your finger (pulse oximeter)
• A needle is used to put a thin soft plastic tube (a cannula) into a vein in the back of your hand or

Drugs and fluids can be given through this cannula

If needles worry you, please tell your A needle cannot usually be avoided, but there are things he or she can do to help. Finally, the type of anaesthetic chosen will be given.

You and your anaesthetic

The choice of anaesthetic depends on:

• Your operation
• Your physical condition
• Your preferences and the reasons for them
• Your anaesthetists recommendations for you and the reasons for them

Your Anaesthetic

The Anaesthetist will meet you before you operation and will discuss which types of anaesthetic can be used. If you are having a local or regional anaesthetic you can decide whether you want to:

• Be fully alert
• Be relaxed and sleepy (sedation)
• Have a general anaesthetic as well

A spinal anaesthetic

• Local anaesthetic is injected near to the nerves in your lower back
• You are numb from the waist downwards
• You feel no pain and you may even prefer to stay awake
• You can also have drugs which make you feel sleepy, calm and relaxed
• It will take 4-6 hours for normal movement to return in your legs
• The Anaesthetist will stay with you the whole time

The majority of patients have their hip replacement surgery under this technique because it reduces the risk of blood clots and you are less likely to need a blood transfusion. You are also much less likely to fell nauseous or vomit with spinal anaesthesia. Urinary incontinence can be associated with spinal anesthesia, sometimes lasting longer than the sensory effect of the spinal medicine.

General Anaesthetic

A general anaesthetic gives a state of controlled unconsciousness during which you feel nothing. You receive:

• Anaesthetic drugs (an injection or breathing gas)
• Strong pain relief drugs
• Oxygen to breathe
• Sometimes a drug to relax your muscles
• Anaesthetist stays with you at all times to give you drugs to keep you anaesthetised
• Once the operation is finished the anaesthetic drugs will be stopped and reversed so that you regain consciousness

Recovery

After your operation you will be taken to the Recovery room where you will be watched closely by your nurse to make sure your breathing and heart functions are stable and you are comfortable.

Side Effects

The anaesthetist will have discussed with you the risks and benefits associated with the different anaesthetic options.

Nausea and Vomiting

A regular anti sickness drug is given to you whilst you are taking strong analgesic medication during your stay in hospital.

Pain Relief

The amount of discomfort you have will be monitored regularly using a scale of 0 (no pain) – 10 (severe pain)

• You will have the 12 microgramme Fentanyl patch in place for 72 hours
• You also have Paracetamol 1G four times a day and for the first 24hours this is given intravenously through a cannula
• If you can take anti-inflammatory medicines you will have Ibuprofen three times a day
• Extra analgesia can be given for breakthrough pain
• Your discomfort should be tolerable
• Do not expect to be totally pain free

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