South Dublin Surgical Hub

General Anaesthesia Information Sheet

This is a generic information sheet for general anaesthesia. There are different way of providing anaesthesia for operations depending on which part of your body you are having surgery on.

These include: general anaesthesia (‘being knocked out’); a spinal/epidural (injection in back); or a nerve block. These techniques can also be combined. If you have a spinal or nerve block, we can also provide sedation alongside this.

Your anaesthesiologist will discuss the options available on the morning of surgery and if you have a personal preference, it will be respected.

1. What do I do the night before my admission?

All patients must fast before surgery – this is for your safety and failure to follow these instructions may result in your surgery being cancelled. It does not matter which anaesthetic technique is planned- all require you to be fasted.

• Do not eat anything for 6 hours before your appointment time. (e.g. if your appointment time is 09:00AM then you should not eat anything from 03:00AM).
• This does not include medication – you will have discussed which medications you can take at your pre-assessment visit / phone call – follow the instructions given to you at that time.
• Before you are fasting you can eat and drink as normal however we suggest you only have a light meal before you start to fast

For 6 hours before your appointment time:

Acceptable

• Water
• Cordial
• Fruit juice (without bits / pulp)
• Black tea or coffee (no milk)
• Tablets + medications (only if you have been told to take them)

Not acceptable

• Any food
• Fizzy drinks
• Milk
• NG / gastrostomy feed
• Thickened fluids

Exceptions to this are patients who are nil by mouth for medical or surgical reasons

• Try to abstain from smoking or drinking alcohol for 24hrs prior to admission
• You should take a shower or bath before you come in
• Do not apply creams, powder or perfume after the bath/shower
• Remove any make up, nail varnish, jewellery or metal hair clips - this includes body piercings and gel/false nails

2. What should I bring with me on the morning of my admission?

• Bring a list of your medications
• If you wear glasses, contact lenses or hearing aids bring these with you along with a case to put them in.
• You can bring a book/magazine to read while you are waiting to go to theatre.
• Please bring a phone number for the person collecting you.
• Do not bring valuables or large sums of money as the hospital will not accept responsibility for them
• If you suffer with obstructive sleep apnoea and have a CPAP machine, please bring this with you on the day of surgery

3. Where do I go on the morning of my admission?

• The South Dublin Surgical Hub (SDSH) is on the 1st floor of Mount Carmel Hospital, accessible by lift.
• When you come in the front door the stairs are straight ahead of you and the lift is on the left. The 1st floor is accessible from the stairs and the lift.
• When you get out of the lift follow the signs for the SDSH reception which is straight through the double doors

4. What do I do when I get to the SDSH?

• All patients must register at the front reception desk in the SDSH
• When you enter reception take a seat and you will be called up to the desk

5. What happens at registration in the Day Ward on the morning of your admission?

You will be asked to confirm your details

• Name/Address + Contact details
• GP
• Name and contact details of next of kin

6. What happens following registration?

• A nurse will escort you from reception. Family members are not permitted beyond this point.
• You will be admitted into the unit by one of our nurses who will also do some routine checks e.g., blood pressure, temperature
• You will then be seen by the surgeon and the anaesthetist if required.
• At the time of your surgery, you will be escorted to the anaesthetic room and introduced to the anaesthetic team
• Following your surgery, you will wake up in the Recovery Room before being transferred back to your ward
• A nurse will then plan your discharge with you.

7. Planning for discharge.

• From admission we will be planning your safe discharge from hospital
• You must arrange to be collected from the unit by a responsible adult either in a car or taxi - this person must be available to collect you within the units opening times 7.30 am to 7:30 pm
• Public transport is not suitable following a general anaesthetic

It is recommended that for 24hrs after your general anaesthetic you do not:

• Smoke
• Consume alcoholic drinks
• Drive or operate machinery
• Enter into legally binding contracts
• Handle hot plates/ovens/electric carving knives etc

Some patients may need to return to SDSH the following day or week for a change of dressing.

You will be given an information leaflet explaining your wound care and out patients follow up (if required)

Any follow up appointment, if required, may be made at reception prior to discharge

NB: If you feel unwell or develop any symptoms of a chest infection/other illness or you are prescribed antibiotics within 6 weeks of your planned date of surgery, please contact the Clinical Nurse Specialist in the Pre-Assessment clinic on the following number 01-4746808 to discuss same.

Useful Contact Numbers:

South Dublin Surgical Hub:

1. Reception: 01-4746838/6808
2. Pre assessment 01-4746801/02

St James Hospital:

1. 01-410 3000

1. What do I do the night before my admission?

• You should take a shower or bath before you come in

 
2. What should I bring with me on the morning of my admission?

• Bring a list of your medications
• You do not need to bring pyjamas/dressing gown or slippers-if required these will be provided to you
• If you wear glasses, contact lenses or hearing aids bring these with you along with a case to put them in.
• You may wish to bring a book/magazine etc to keep you occupied during your wait for theatre
• Do not bring valuables or large sums of money as the hospital will not accept responsibility for them.
• If you are having an Ingrown Toe Nail (IGTN) removed you will need to be accompanied home by a responsible adult. Public transport is not suitable for patients following this procedure.

 
3. Where do I go on the morning of my admission?

• The South Dublin Surgical Hub (SDSH) is on the 1st floor of Mount Carmel hospital
• When you come in the front door the stairs are straight ahead of you and the lift is on the left. The 1st floor is accessible from the stairs and the lifts
• When you get out of the lift follow the signs for the SDSH reception which is straight through the double doors

4. What do I do when I get to the day SDSH?

• All patients must register at the front reception desk in the SDSH
• When you enter reception take a seat and you will be called up to the desk

5. What happens at registration in the Day Ward on the morning of your admission?

You will be asked to confirm your details. Including:

• Name/Address + Contact details
• GP
• Name and phone number of next of kin

6. What happens the morning of my admission?

• You will be admitted into the unit where nursing staff will carry out your admission and some routine checks e.g., blood pressure, temperature.
• You will then be escorted into the minor theatre which is located in the unit. The doctor will explain your procedure and you will be asked to give your written consent for your procedure at this time (some patients may already have completed this form at a previous Out Patients visit).
• The procedure will then be carried out.
• Following this you will be prepared for discharge by one of the nurses.

7. Planning for discharge.

• From admission we will be planning your safe discharge from hospital
• As you have had a local anaesthetic you can go home unaccompanied please note exception for IGTN removal
• You will be given an information leaflet explaining your wound care and out patients follow up (if required)
• Some patients may need to return to SDSH or St James Hospital the following day or week for a change of dressing.

Useful Contact Numbers:

• South Dublin Surgical Hub Reception: 01-474 6838
• St James Hospital: 01-410 3000

Information for patients about nerve blocks

This is a generic pre operative information page. You may be offered a nerve block as part of the anaesthetic plan for your surgery. This information will allow you to understand the benefits of having a nerve block as well as the possible risks. You will also have the opportunity to speak to your anaesthetist (doctor who will look after you during your operation and make sure you don’t feel any pain or discomfort) about nerve blocks as well.

Nerve blocks are injections of local anaesthetic (numbing medicine) given near nerves to numb certain parts of the body, for example, a hand, arm, leg or foot. After the injection, your arm or leg will slowly become numb and you won’t be able to move it, although you may still feel some movement during the operation. Your anaesthetist will check the effect of the nerve block before the surgery starts to make sure you won’t feel any pain or anything unpleasant.

What are the benefits of having a nerve block?

Depending on the type of operation nerve blocks can sometimes be used instead of a general anaesthetic (going to sleep). This can be particularly useful for patients who have medical conditions which put them at a higher risk from a general anaesthetic but there are other advantages too:

• Better pain relief after surgery.
• Less need for pain killers containing opioids (morphine-like drugs). These can make you feel sick, sleepy and may cause constipation. More rarely there is a risk of addiction if you take them for a long time.
• Avoiding a general anaesthetic, including its risks and side effects. The common side effects of a general anaesthetic include sickness, sore throat and drowsiness.
• Being able to move around and eat and drink earlier and often leaving hospital sooner.

If you are having a nerve block instead of a general anaesthetic sometimes you are given sedation to make you relaxed and sleepy. Sedation may be light or deep so you may remember everything, something or nothing about the operation. You can discuss this further with your anaesthetist.

Occasionally you will have a nerve block and a general anaesthetic – this is for pain relief after the operation. In this case the nerve block is usually performed before you have the general anaesthetic as it is often safer for you to have the nerve block whilst you are awake.

What are the risks of having a nerve block?

Nerve blocks are very safe, but there are some complications which you should be aware of.

• The nerve block not working as expected. Occasionally nerve blocks do not work 100% as well as we would like. This is quite common but can usually be fixed by giving you another injection. Rarely you will be given a general anaesthetic instead. Your anaesthetist will check to make sure the nerve block is working appropriately before the surgery starts to make sure you don’t feel any pain or anything unpleasant.
• Bleeding / bruising. This is often a small bruise at the site of the injection and will get better on its own. Occasionally some pressure might need to be applied to the area.
• Local anaesthetic overdose. This happens if you are given too much local anaesthetic or the anaesthetic is given into a blood vessel by mistake. Anaesthetists train for many years to learn how to give local anaesthetics safely so this risk is very low but can cause you to feel unwell, have a tingling sensation around the mouth and tinnitus (ringing in the ears) and in extreme circumstances a seizure or other life-threatening event.
• Nerve damage. This is rare. The risk is thought to be between 1 in 1,000 and 1 in 10,000. This means if 1,000 or 10,000 people had a nerve block, we might expect 1 person to have some nerve damage. Usually this is an area of skin which stays numb for a prolonged period of time but in very rare circumstances it can result in prolonged weakness as well. There are other causes of nerve damage that can happen during an operation so if this happens, we will arrange to see you again to assess what the problem is. Almost all cases of nerve damage are temporary and return to normal within 6 weeks however in extremely rare cases the nerve damage can be permanent.

 How long will the nerve block last?

Nerve blocks usually last for up to 18 – 24 hours but this can vary depending on the type of nerve block and local anaesthetic you have been given. Your anaesthetist will be able to explain how long to expect the nerve block to last. Some areas may feel numb for up to 48 hours (2 days) after the operation.

When you get home your arm or leg will still be numb and weak and will be at risk of being injured without you realising. You will be given advice about how to take care of your arm or leg when you are leaving the hospital.

The effect of nerve blocks can stop quite suddenly so you will be given information about when and how to take pain killers when you get home.

If you have any queries, please contact the South Dublin Surgical Hub

Monday to Friday 8:00AM to 6:00PM
(01) 474 6803