Does the Specialist Anaesthetist stay there during the surgery?

Yes, the Anaesthetist always stays in the operating room while patient is Anaesthetised. Anaesthetists do this to ensure patients under anaesthetic are not exposed to any harm, and ensure the body maintains normal function while under the effect of the Anaesthetic. This includes attaching and checking monitoring, heart function, lung function, blood pressure, oxygen levels, kidney function, as well as managing any emergencies such as severe bleeding, cardiac arrest, or severe allergy (anaphylaxis).

What happens during Surgery?

The anaesthetist normally inserts a plastic straw (cannula) into the back of a patients hand which allows administration of the anaesthetic medications. This includes antibiotics to prevent surgical infections, and medications to prevent patients experiencing pain or nausea after surgery.

This cannula is also used in the case of an emergency to administer life-saving medications, fluids, and if needed blood.

After a patient is asleep, the Anaesthetist normally inserts a breathing device into the mouth and lungs. This allows the Anaesthetist to provide oxygen to a patient while they are under the anaesthetic. This device is removed before a patient wakes up.

Monitoring

Standard Anmonitoring includes:

•Oxygen level monitoring

•ECG (heart monitoring)

•Blood Pressure

•Temperature

•Muscle strength monitoring

•Urinary output (kidney monitoring)

•Gas monitoring (anaesthetic gas, Oxygen and Carbon dioxide levels).

In special circumstances we will also add additional monitors including

•Brainwave monitoring (EEG)

•Brain oxygen level monitoring

•Arterial Blood Pressure monitoring

•Heart filling pressure monitoring

•Heart function monitoring with Ultrasound

Your Anaesthetist monitors these functions during the operation and documents their results to assist future anaesthetists determine how patients tolerated their anaesthetic. This helps improve safety for future anaesthetics.

Nerve Blocks (Regional Anaesthesia)

Nerve blocks are used for many purposes as part of surgery and anaesthesia. In some situations, surgery can be performed solely  under nerve block, which avoids the need for a general anaesthetic.

Nerve blocks are extremely safe, and it is considered best practice to use them as part of managing patients pain both during and after surgery. Anaesthetists are experts at nerve blocks, and use very specific needles and ultrasound devices to improve accuracy and safety of nerve blocks.

In some situations your Anaesthetist can insert a nerve catheter, which can remain alongside a nerve for up-to 3days following surgery. This ensures patients have the best possible pain relief, and avoids the need for large amounts of oral pain-killer medications. This is part of ensuring patients mobilise and recover fast from surgery, which improves safety and patient satisfaction.

Nerve blocks also assist in preventing the development of persistent pain after surgery, which is being recognised as a significant issue with many surgery types.

Dr Dennis Millard has completed an anaesthetic fellowship with a focus on regional anaesthesia, at both Sir Charles Gardiner Hospital and Hollywood Hospital. Dr Dennis Millard is credentialed to perform the following nerve blocks safely

Thorax

– Spinal block

– Epidural

– Paravertebral block

Lower limb

– Lumbar Plexus block

– Femoral nerve block

– Adductor canal block

– Sciatic nerve block

– Ankle block

Upper limb

– Axillary nerve block

– Wrist block’s

– Interscalene nerve block

– Supraclavicular nerve block

Abdomen

– Rectus sheath block

– TAP block

Eyes

– Subtenon Nerve block

– Subconjunctival nerve block