Anaesthetics
Wirral University Teaching Hospital Anaesthetic department has been recognised again for providing the highest standards of patient care.
The department has received the prestigious Anaesthesia Clinical Services Accreditation (ACSA) from the Royal College of Anaesthetists for a second time in 2023.
In order to receive accreditation, departments must demonstrate a high standard in areas such as patient experience, patient safety and clinical leadership.
Anaesthethesia means ‘loss of sensation’. An anaesthetic is what is given to cause anaesthesia.
Anaesthetic drugs are used for pain relief during investigations or surgical operations so that you do not feel any pain.
It’s normal to feel anxious about your anaesthetic, but our highly qualified team will be able to reassure you at the pre-assessment appointment you will have and on the day of your operation.
Anaesthetists
Our anaesthetists are highly skilled specialist doctors who are trained in anaesthesia. Before your procedure, they will discuss with you what anaesthetic methods are appropriate, along with any risks or side effects.
If you have any queries about your anaesthetic it is important that you raise them with your anaesthetist.
Nothing will happen to you until you understand and agree with what has been planned for you. Your anaesthetist will make sure that you are safe throughout the surgery or investigation, and that you will wake up comfortably after your procedure. They will also help with any pain relief that you might need.
Sedation
Sedation is a suitable way of keeping you relaxed during your procedure. It is used when you are undergoing an investigation or having surgery in combination with a local or regional anaesthetic. The aim of the sedation is to allow you to relax and not feel anxious or nervous during your operation.
The benefits
Without sedation the operation or procedure would possibly cause you anxiety. Recovery is quick after sedation. For day surgery it normally means that you can go home earlier.
A general anaesthetic can often be avoided by having sedation. You can even listen to your own music device during your procedure.
General reasons for having sedation:
- When you feel very anxious or worried about a procedure or investigation
- Where the procedure is short or involves only a small area of the body, this can be in combination with a local anaesthetic
- Where the procedure is not very painful
- When you are too unwell to safely receive a general or alternative anaesthetic, some procedures can still be performed under sedation in combination with a local anaesthetic.
Risks of sedation:
- Headache, feeling sick or vomiting and having difficulty in remembering what happened during the treatment
- Allergic reactions can occur whenever any medication is given
- Deep sedation can sometimes affect your breathing and can lower your blood pressure.
During a procedure under sedation you will be monitored by an anaesthetist or health professional who will be able to treat these side effects.
General Anaesthesia
If you are having a general anaesthetic, it will be given to you by an anaesthetist, either as a liquid that is injected into your veins through a cannula (a thin, plastic tube that feeds into a vein, usually on the back of your hand) or gas that you breathe in through a mask.
Your anaesthetist will stay with you throughout the procedure. They will make sure that you continue to receive the anaesthetic and that you stay asleep, in a controlled state of unconsciousness.
After the procedure, the anaesthetist will reverse the anaesthetic and you will gradually wake up.
General anaesthetic is essential for some surgical procedures where it may be safer or more comfortable for you to be unconscious.
Side effects
General anaesthetic has some common side effects. Your anaesthetist should discuss these with you before your surgery. Most side effects occur immediately after your operation and do not last long. Possible side effects include:
- Feeling sick or vomiting after surgery – about 33% of people feel sick after an operation. This usually occurs immediately after, although some people may continue to feel sick for up to a day
- Shivering and feeling cold – about 25% of people experience this. Shivering may last for 20 to 30 minutes after your operation
- Confusion and memory loss – this is more common in elderly people and is usually temporary
- Chest infection – this can sometimes occur in people who have abdominal surgery and who smoke
- Bladder problems – men may have difficulty passing urine and women may leak urine. This is more common after a spinal or epidural anaesthetic
- Minor, temporary nerve damage – this affects around 1% of people and causes numbness, tingling or pain. It may get better in a few days or it may take several weeks to improve
- Dizziness – this can occur temporarily after your operation
- Bruising and soreness – this can develop in the area where you were injected or had a drip inserted. It usually heals without treatment
- Damage to teeth and mouth- During your operation, you may need to have a tube inserted down your throat to help you breathe. Afterwards, this causes a sore throat in about 40% of people. Around 5% of people may have small cuts to their lips or tongue from the tube. Around 1 in 4,500 people may have damage to their teeth.
Complications and risks
Some more serious complications are associated with general anaesthetics, but they are very rare (occurring in less than one case for every 10,000 anaesthetics given). Possible complications include:
- Permanent nerve damage, causing paralysis or numbness
- A serious allergic reaction to the anaesthetic or other drugs (anaphylaxis)
- Death – this is very rare (there is approximately one death for every 100,000 general anaesthetics given)
Whether you are at any risk of these complications will depend on:
- Your medical history – whether you have any other illness
- Personal factors – whether you smoke or are overweight, for example
- Type of surgery needed – whether it is planned or carried out in an emergency, or whether it is a major or minor procedure
Type of anaesthetic needed. General anaesthetics can have more side effects and complications than local anaesthetics.
Your anaesthetist will discuss the risks with you before your operation. You may be advised to stop smoking or lose weight, if doing so could reduce your risk of developing complications. In most cases, the benefits of being pain-free during an operation outweigh the risks.
Local Anaesthetic
A local anaesthetic is a type of painkilling medication that is used to numb areas of the body during some surgical procedures. You stay awake when you have a local anaesthetic but in some cases the local anaesthetic can be combined with sedation.
How does local anaesthetic work?
Local anaesthetic causes loss of feeling to a specific area of your body without making you lose consciousness. It works by blocking the nerves from the affected part of your body so that pain signals cannot reach your brain. You will not be able to feel any pain during the procedure but you may still feel some pressure or movement.
It only takes a few minutes to lose feeling in the area where local anaesthetic is given. The doctor will make sure that the area is fully numb before starting the procedure. It can take a few hours for local anaesthetic to wear off and for full feeling to return. You should be careful not to damage the area during this time.
When is local anaesthetic used?
Local anaesthetic is often used by dentists, surgeons and GPs when carrying out minor operations on small areas of the body. For example, local anaesthetic is often used during:
- The removal of a tooth or a filling
- Minor skin surgery, such as the removal of moles
- Some types of eye surgery, such as the removal of cataracts
- For surgery the local anaesthetic is often injected into the skin around the operation area to make it numb and pain free to be able to perform the operation.
We always test the effectiveness before we go any further.
Regional Anaesthesia
Local anaesthetic or regional anaesthesia does not put you to sleep but works by blocking the signals that pass along your nerves to your brain. We can block the nerves at different levels to numb a certain area, for example we can block just a finger or a whole region like an arm, a leg or we can numb both legs with a spinal or epidural anaesthesia so it only numbs a part of your body.