An anaesthetist is a doctor who has specialised in anaesthesia after finishing a university medical degree and then has completed at least two years as a hospital doctor within Australia. During their training, anaesthetists become experts in pain management, resuscitation, and care of the critically ill patients.
Overall it takes at least 12 years of training and many examinations to become a specialist anaesthetist.
‘Anaesthesia’ is derived from the Greek word meaning ‘without sensation’.
Anaesthesia may be applied to the whole body, which is known as general anaesthesia, or to part of the body, which is known as regional or local anaesthesia. All anaesthesia involves giving specific drugs that interfere with the transmission of nerve impulses to the brain so as to reduce sensation including consciousness, memory and pain. ‘Anaesthetic’ is the term used to describe some or all of the drugs used to produce anaesthesia.
You are put into a state of carefully controlled unconsciousness for the duration of the operation, and will have no awareness of other sensations including pain. You will often be asked to breathe oxygen through a mask just before your anaesthesia starts. Anaesthesia will usually be initiated by the injection of medications through a cannula placed in your vein and maintained with intravenous drugs or a mixture of gases which you will breathe. Your anaesthetist will be monitoring your condition closely and constantly adjusting your level of anaesthesia throughout your operation.
Regional anaesthesia is when local anaesthetic drugs are injected near to a bundles of nerves to numb only the area of your body which requires surgery. You may remain awake for the surgery, or you may be given a sedative.
Regional anaesthesia is usually used if significant surgery and post-operative pain is expected in an area of your body. Nerve blocks may provide excellent pain relief after surgery. This may reduce the need for stronger forms of intravenous and oral pain relief and thereby reduce the chance of side-effects from these medications.
Spinal or epidural blocks numb sensation from your legs or abdomen by the injection of local anaesthetic medications into or near the spinal canal.
Other regional blocks are performed for surgery on eyes, limbs or extremities.
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 “twilight anaesthesia” is where your anaesthetist administers medications to make you relaxed and drowsy. Recall of events is possible with sedation.
Anaesthesia is a medical specialty that is based on excellent clinical practice, excellent organisation and excellent communication with other healthcare workers in order to provide quality of care and utmost safety of every patient undergoing a surgical procedure.
Patient safety is central to everything that Anaesthetists do, and this allows us to bring patients safely through the most challenging of operations. The foundation of safe anaesthesia is the high level of training involved to become a specialist Anaesthetist.
Modern surgical techniques would not be possible without the anaesthetic drugs, techniques and the equipment that Anaesthetists use today.
Your Anaesthetist will stay with you for the duration of the operation and monitor you closely.
Ultimately your wellbeing before, during and immediately following surgery is the responsibility of your Anaesthetist.
Your Anaesthetist is responsible for:
- Assessing your health and advising you on which type of anaesthetic is suitable for your surgery. Questions are encouraged. A plan for your anaesthetic will be determined after discussion with you.
- Giving you an anaesthetic and keeping you safe and well during surgery. Your Anaesthetist stays with you all the way through your operation. Modern equipment and monitoring will be used to assess your condition continuously throughout your operation and your Anaesthetist will keep you safe and well by administering medications and fluids as required.
- Planning your emergence from anaesthesia and pain relief so that you are as comfortable, nausea free and healthy as possible in the recovery room immediately after surgery.
You can find out more about the process of anaesthesia by reading the booklet Anaesthesia Explained.
The role of your Anaesthetist
People often think of anaesthesia as being put to sleep or ‘knocked out’. This is not strictly true. Instead, an anaesthetist puts you into a state of carefully controlled unconsciousness, so that your surgery will be painless and not remembered. Anaesthetists and airline pilots are often compared when discussing human factors and safety. Both professions continuously train to solve a problem if it occurs, even though the chance of that problem occurring is rare.
Anaesthesia is not a period of chance. Your anaesthetist will carefully and constantly monitor all your bodily functions during your operation, and afterwards, to make sure your recovery is as smooth and pain-free as possible.
There are some things you can do which make your anaesthetic safer.
Get a little fitter – regular walking is a good start
Don’t smoke – ideally, give it away six weeks or more before surgery
Drink less alcohol
Past Medical History and Health Issues
Your GP’s health summary and any specialist reports will have information that is very helpful in individualising your anaesthetic plan. Please bring these with you if possible.
If you have any kind of health problem please tell your anaesthetist as early as possible before your operation. You may be required to see your anaesthetist or your specialist prior to your operation.
Your anaesthetist will be interested in your history of:
Lung disease such as severe asthma or emphysema.
Any other conditions that you see a specialist for.
In most instances you should continue to take any medications which have been prescribed for you, with a sip of water, regardless of whether you are fasting, but remember to let your anaesthetist and surgeon know. This is particularly important for those patients taking heart medications and blood pressure medications
If you are a diabetic, discuss a plan for managing your diabetes with your anaesthetist prior to surgery.
Blood thinning medications
Sometimes surgeons will ask you to stop aspirin and other blood thinning agents (clopidogrel, dabigatran, rivaroxaban or warfarin). However, it is sometimes important (eg in those with stents and artificial heart valves) to continue these medications or substitute with another medication. Please continue to take these medicines until you have discussed this with your anaesthetist, who may in some instances have to discuss your case with your GP and cardiologist.
If you are taking any herbal medications including fish oils please stop these 7-10 days prior to your surgery. This is to ensure there is not interaction with anaesthetic drugs or unexplained bleeding issues during surgery.
It is a fact that smoking worsens your outcome from surgery and increases your risk of lung, heart and wound related complications during and after surgery, and that quitting smoking may reduce the risk of complications.
1 day : Quitting smoking for one day will lower carboxyhaemoglobin and nicotine levels in your blood and could be expected to improve oxygen delivery to your tissues.
3 weeks: Quitting smoking for as little as three weeks has been shown to improve wound healing.
6-8 weeks : Quitting smoking for 6-8 weeks is good for your lungs, resulting in less mucous and sputum and improved lung function, with less chance of your airways closing during your anaesthetic.
6 Months : Your immune system functions almost as well as that of a non-smokers, significantly reducing your postoperative risks.
Please quit smoking before you come for your anaesthetic.
If you need help doing see please visit: www.quitnow.gov.au
The fee for your anaesthetist is separate from the fees charged by your surgeon and the hospital at which you are having your surgery/procedure.
Anaesthetists are Specialist Doctors. Their fees are set based on the Relative Value Guide (RVG) which is recommended by Medicare, the Australian Medical Association (AMA), and the Australian Society of Anaesthetists (ASA) .
The fee is generally derived from three components:
- The type of surgery
- The duration of the operation/procedure
- Your general health and and medical conditions you have
Dr Jane Hosking’s aim is to provide an estimate of fees to all patients as early as possible, and at least prior to hospital admission. Please note that although every effort is made to provide accurate estimates, based on the above variables, the final post operation account may differ to the estimate provided.
In emergency cases, informed financial consent prior to anaesthesia may not be possible, in which case Dr Hosking’s staff will contact you as soon as possible after the service to explain fees.