Most of your usual medications can be taken on the day of your procedure with a small sip of water. However, some medications need to be stopped before certain procedures. 

You should have received advice about this prior to your procedure. If you are taking any of the following types of medication, you should find out IF and WHEN you need to cease the medication:

• Blood thinners: usually surgeons will provide advice about this, as these medications can increase bleeding from anywhere that biopsies or incisions are made. Some of these medications need to be stopped anywhere from 3-10 days before your procedure so please contact your surgeon in advance. Your surgeon may also provide advice on whether a shorter acting blood thinner needs to be given while you are off your usual blood thinner.
• Diabetic medications.
• Insulin and insulin pumps: please contact your anaesthetist, GP, diabetes educator, endocrinologist or surgeon for advice.
• SGLT2 inhibitors are newer diabetic medications that can cause serious problems if not stopped before surgery. Seek advice if you are on any of these medications that contain SGLT2 inhibitors: dapagliflozin (Forxiga), empagliflozin (Jardiance), ertugliflozin (Steglatro), Xigduo, Jardiamet, Segluromet, Glyxambi, Qtern, Steglujan. For surgery and procedures requiring one or more days in hospital, and/or requiring ‘bowel preparation’ including colonoscopy, you will need to cease your “SGLT2 inhibitor” at least 3 days pre-procedure (2 days prior to surgery and the day of surgery/procedure). For day-stay procedures (including gastroscopy), your “SGLT2 inhibitor” can be stopped just for the day of the procedure. Fasting before and after the procedure should be minimised. You should seek advice as your other diabetic medications may need to be increased while you are off these medications.
• Please wean opioid medications (pain killers) to the lowest dose possible prior to your procedure.
• Herbal medications should be stopped 2 weeks prior to procedures

• Each year, about 4 million Australians have a procedure requiring anaesthesia
• During a lifetime, most people in Australia will have at least one anaesthetic and many will need more
• Most surgery would not be possible without some form of anaesthesia
• Your anaesthetist will be a specialist doctor who has undergone many years of training
• Australia is one of the safest places in the world to undergo anaesthesia

Australia is one of the safest places in the world to undergo anaesthesia. However, there are risks associated with anaesthesia. Similarly, there are risks associated with not going ahead with a procedure. 

Your anaesthetist will aim to make your risk profile as low as possible, and don’t forget there are things you can do to decrease your risk.

The chance of having a particular complication depends on your pre-existing medical conditions and the type of procedure you are having. Fortunately, complications that occur more commonly are minor and short-lived. Major complications are rare.

Please ask your anaesthetist about risks that are of particular concern to you. Remember, you can do this at any time and we will be happy to answer your questions.

General anaesthesia and sedation may impair your motor skills and cognition. Even if you feel ‘normal’, to protect yourself and others, for 24 hours after your procedure please do not:

• drive (you will not be covered by insurance if you have an accident)
• operate machinery (eg power tools, cooking)
• sign any legal documents or make important decisions
• drink alcohol or take any recreational drugs

Confusion can happen during an illness (e.g. infection) as well as after an operation. It can occur immediately after surgery or over the next few days. Some degree of confusion after an operation is very common and most people make a good recovery. If it has occurred previously, it is more likely to happen again. Older age and a known, existing cognitive problem both increase the likelihood. 

Certain anesthesia techniques may reduce confusion. There are lots of things you can do too, before and after your operation, to help to lower the risk of developing postoperative delirium.

Talk with your anaesthetist about your concerns. They will be able to provide advice and tailor your care appropriately.

An anaesthetist is a specialist doctor. In Australia, they have studied a minimum of 13 years after school to become qualified as a Specialist Anaesthetist. Upon completion of their medical degree  (about 6-8 years of university study) and basic hospital training (about 3 years), doctors may choose to specialise in an area of medicine, surgery or general practice.

Doctors who wish to become specialist anaesthetists must undertake a completive selection process, then work and study in an accredited hospital training program for at least a further five years. During this time they gain knowledge, skills and experience in the areas of anaesthesia, intensive care, emergency, pain medicine and perioperative medicine.

A fee will be charged for your anaesthesia services. The fee for your anaesthesia is separate from the fees

• charged by any other doctors caring for you. 
• charged by the institution (hospital, day surgery facility, endoscopy centre etc) where the service takes place.

If you have concerns about this estimated fee you should discuss them with your anaesthetist prior to your anaesthesia.

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General Anaesthesia

Most common form of anaesthesia is general anaesthesia, which means you will be fully asleep. It is a state of controlled unconsciousness during which you feel nothing and may be described as anaesthetised. This is important for some operations and may be used as an alternative to regional anaesthesia for others. 

Regional Anaesthesia

Regional anaesthesia can be used for operations on larger or deeper parts of the body. Local anaesthetic medicine is injected near to the bundles of nerves which carry signals from that area of the body to the brain. Often regional anaesthesia is carried out in addition to general anaesthesia to provide pain relief for AFTER the surgery.

The most common regional anaesthetics (also known as regional blocks) are spinal and epidural anaesthetics, and femoral, sciatic, and brachial plexus blocks. 

Local Anaesthesia

A local anaesthetic numbs a small part of your body. It is used when the nerves can easily be reached by drops, sprays, ointments or injections. You stay conscious but free from pain.

Sedation

Sedation is the use of small amounts of anaesthetic or similar drugs to produce a sleepy-like state. It makes you physically and mentally relaxed during an investigation or procedure  (such as an endoscopy). 

Read more.

Adults

Food: No food for 6 hours prior to anaesthesia.

Liquids: You can have small amounts of CLEAR FLUID until 2 hours before anaesthesia. No liquids for 2 hours prior to anaesthesia.

Children older than 6 Months

Food: No food/breast milk/formula for 6 hours prior to anaesthesia.

Liquids: You can have small amounts of CLEAR FLUID (no more than 3ml/kg/hr) until 1 hour before anaesthesia. No liquids for 1 hour prior to anaesthesia.

Quitting smoking prior to surgery will decrease your chance of having complications. 

The longer the period of not smoking before surgery, the better it is for your health. Smoking has been shown to increase the risk of complications during and after surgery such as pneumonia, stroke, heart attack and surgical wound infection.

It's normal to be slightly apprehensive when coming into hospital as this can be a foreign environment for many. Dr Brinkmann and her team understand this, and they will provide reassurance, explaination and respectful care every step of the way.  Remember you are being cared for by an experienced and professional team that will take very good acre of you!

Often simply feeling fully informed and understanding what to expect, helps patients allay anxiety and feel safe.

Other strategies are also used such as local anaesthetic cream to improve comfort for cannualation. Occasioinally a pre-med sedative can be used.

Please discuss any concerns with your anaesthetist, surgeon or nurses. We are good listeners and are here to help!