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General Anaesthesia

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What Is General Anaesthesia?

General anaesthesia is a medically induced state of controlled unconsciousness. Under general anaesthesia, you are completely asleep and unaware of your surroundings, unable to feel pain. This allows the surgical team to perform complex procedures safely, effectively, and without causing distress.

When Is General Anaesthesia Used?

General anaesthesia may be recommended for:

  • Major surgeries – e.g. abdominal, orthopaedic, cardiac, or neurosurgical operations
  • Procedures that would be painful or traumatic if performed while awake
  • Operations requiring complete muscle relaxation – such as joint replacements or laparoscopic surgeries
  • Surgeries involving body areas that cannot be numbed using local or regional techniques

How Is General Anaesthesia Delivered?

Anaesthesia is administered and continuously managed by a specialist anaesthesiologist. It usually involves a combination of:

  • Intravenous (IV) Medication
    Drugs are administered via a drip in the arm to induce unconsciousness quickly.
  • Inhaled Anaesthetic Gases
    Once asleep, anaesthesia is often maintained with gases delivered via a face mask or breathing tube.
  • Airway Management
    While you are asleep, your anaesthesiologist will assist and protect your breathing. This often involves placing a breathing tube or specialised airway device.
  • Continuous Monitoring
    Your vital signs (heart rate, blood pressure, oxygen levels, depth of anaesthesia) are closely monitored and adjusted as needed throughout the procedure.

What to Expect After Anaesthesia

Once the surgery is complete, the anaesthetics are stopped, and you will gradually wake up. You’ll be monitored in a recovery area where your pain, breathing, and vital signs will be closely observed until you are stable and alert. If you have undergone a major procedure or have major risk factors, you may be transferred directly from the theatre to the ICU after your operation for continued monitoring and specialist care.

Potential Risks and Complications

While general anaesthesia is very safe in modern practice, complications can occasionally occur. Your risk depends on your medical history, the type of surgery, and other factors. Most side effects are mild and temporary.

Common Complications:

  • Nausea and vomiting
  • Sore throat
  • Shivering or feeling cold
  • Headache
  • Dizziness
  • Itching
  • Pain at injection sites
  • Swelling or bruising at the IV site
  • Confusion or memory problems (more common in older adults)

Rare Complications:

  • Injuries to teeth, crowns, lips, or tongue
  • Hoarseness or voice changes
  • Difficulty urinating
  • Visual disturbances
  • Worsening of underlying conditions (e.g. asthma, diabetes, heart disease)

Very Rare Complications:

  • Nerve injuries causing temporary or permanent weakness/paralysis
  • Eye injuries
  • Lung infections
  • Awareness during surgery
  • Stroke or unexpected bleeding
  • Allergic drug reactions
  • Inherited reactions such as malignant hyperthermia, suxamethonium apnea, or porphyria

Extremely Rare and Serious Risks:

  • Heart attack
  • Embolism (blood clot)
  • Severe oxygen deprivation

Your anaesthesiologist will discuss relevant risks with you based on your health and the planned procedure.

Fasting Guidelines

To ensure your safety under general anaesthesia, you will need to fast before surgery.

  • No Solid Food: Stop eating at least 6 hours before your scheduled procedure.
  • Clear Fluids Allowed: You may drink water, clear apple juice, or weak black tea up to 2 hours before surgery. Avoid milk, formula, or juice with pulp.
  • Babies and Infants: Fasting instructions vary by age and type of feeding. Please follow the specific instructions provided by your anaesthesiologist.

Medical History and Medications

Before your procedure, your anaesthesiologist will meet with you to:

  • Review your medical history and current health status
  • Go over your current medications
  • Perform a focused examination and discuss the anaesthetic plan with you

Please bring a complete list of medications, including:

  • Blood thinners (e.g., Aspirin, Warfarin, Clopidogrel)
  • Herbal or homoeopathic supplements (ideally stop 2 weeks before surgery)
  • Any recreational substances, smoking habits, or alcohol intake

Pregnancy and Breastfeeding

Let your anaesthesiologist know if you are pregnant, trying to conceive, or breastfeeding, as this may influence anaesthetic choices.