We are fortunate in Australia as it is one the safest countries in which to have an operation. This is due to advances in drugs, equipment and more importantly, the extremely well trained medical personnel who operate this technology. In Australia, your anaesthetist and surgeon are both highly trained specialist doctors who have completed their medical degree and then undergone at least 5 postgraduate years of intensive training.
The Australian and New Zealand College of Anaesthestists (ANZCA) is one of Australasia's largest specialist medical colleges and is the professional organisation for around 6400 specialist anaesthetists (Fellows). ANZCA sets the requisite standards for training and accrediting physicians in perioperative medicine who are also experts on pain relief, resuscitation and medical crisis management. Perioperative medicine is a continuum which encompasses pre-operative evaluation and preparation, intra-operative care and post-operative care. Although every patient's journey is different, the destination is always the same as a result of rigorous training by ANZCA. The anaesthetist will always endeavour to steer the patient towards safety.
Anaesthesia is the art and science of keeping a patient alive during the challenges of surgery when the patient is unable to look after himself or herself. Having an anaesthetic is a quite a big deal and it is a lot more complex than just "having a sleep". Things can go wrong even in the fittest patients. Since you are temporarily handing over your life to your anaesthetist, you need to feel confident in this doctor who is responsible for looking after your life during a very vulnerable period. This confidence will go a long way towards alleviating the patient's preoperative anxiety. It is a significant responsibility which requires diligence and vigilance. Your anaesthetist will stay with you for the whole duration of your procedure and concentrate solely on you - constantly monitoring your bodily functions, adjusting the level of your unconsciousness to suit the surgery, making rapid decisions to resolve any crises and ensuring that your recovery is as smooth as possible.
WHAT TYPE OF ANAESTHESIA?
The type of anaesthesia you will receive is dependent on your health and also the requirements of your surgery. The different types are not mutually exclusive and can be used concurrently. Since every patient is unique, there is no blanket "one size fits all" anaesthetic. The best anaesthetic is the safest one that is been tailored to suit you.
General anaesthesia involves inducing a controlled state of unconsciousness for the duration of your surgery. This is achieved by carefully administering a mixture of intravenous and inhaled anaesthetic medications. Although you will be unaware of events around you, your anaesthetist will stay with you the whole time to constantly monitor your condition and titrate the intensity of your anaesthetic.
Sedation is like a "lighter" form of general anaesthesia but you will still be very sleepy and have no recollection of the procedure. You will continue to breathe spontaneously without airway instrumentation which helps to reduce the risk of complications such as sore throat and dental injury. Sedation is also called twilight anaesthesia and is commonly used during endoscopy and to supplement regional anaesthesia. Sedation can vary in its intensity. "Conscious sedation" is lighter sedation where the relaxed patient is still responsive to verbal commands, whereas "procedural sedation" is deeper sedation to allow patient to tolerate procedures that may otherwise be uncomfortable.
Regional anaesthesia involves injecting drugs to numb nerves to the specific part of the body where you are having surgery. This will allow painless surgery with the option of being totally awake or sedated. The intensity of numbness can be also be adjusted to provide prolonged post-op pain relief by administering drugs via a catheter. One example is the use of epidurals for pain relief during labour and post knee replacement surgery.
