Tubal Cancer - Anaesthetics

What is Anaesthetics?

Anaesthetics is a medical specialty concerned with the provision of anaesthesia, pain relief and perioperative medicine.

The anaesthetist's function is to make you insensitive to pain during surgery, to supervise your recovery from anaesthesia, and to ensure you are comfortable afterwards. Many drugs and techniques may be used including general anaesthesia, regional anaesthesia, local anaesthesia and conscious sedation together with monitoring techniques appropriate to your general medical condition and the magnitude of the surgery.

Your anaesthetist will stay with you at all times during and immediately after your operation and will carefully monitor the way your body responds to the stress it encounters.

You may have heard the terms anaesthesia and analgesia used. To clear up any confusion, the word anaesthesia means the absence of sensation, while analgesia is the absence of pain. If only unconscious the body still reacts to pain only you don't remember it. However the myriad of consequences of pain are still there including increased incidence of infections and complications.

Anaesthetics and Cancer of the Fallopian Tube.

What Carers need to know about Anaesthetics

Many people are frightened of an anaesthetic as it involves loss of control and entry into a dark and scary place (i.e. unconsciousness). During the preoperative visit the Anaesthetist will evaluate the patient for any medical conditions and how they might influence the anaesthetic. They will also try to allay the patient's fears by explaining what is about to happen.

The patient will frequently be given a premed tablet to make them a little drowsy before they go to theatre. When the nurse arrives to give this it is best to leave the patient to gently settle into a relaxed state induced by the drugs. On arrival in the operating theatre an intravenous drip will be started using a local anaesthetic and all subsequent drugs will be given through this. When the patient wakes up they will have been given enough painkillers to make sure they are comfortable for the trip back to the ward.

If the operation is major then the anaesthetist will remain in contact with the patient and supervise any advanced pain relief requirements, including patient controlled analgesia and epidural analgesia. The anaesthetist will also assist the surgical team with advice regarding monitoring in the high dependency unit, intravenous fluid and oxygen requirements.

Anaesthesia has come a long way since the days of chloroform and ether but this is how many of our patients remember us. The modern anaesthetic causes very little stress to a patient's health, pain is now readily controlled and post operative nausea and vomiting are a relatively infrequent occurrence.

What patients need to know about Anaesthetics.

Prior to surgery your anaesthetist will take a medical history and perform a physical examination. Based on these findings, together with the results of any investigations deemed necessary such as blood tests, ECG and/or chest X-Ray, your anaesthetist will formulate a plan of which type of anaesthetic to perform and will discuss this with you in detail.

To help with this planning process your anaesthetist will need to know about:

	your overall health, recent illness and previous operations.
	abnormal reactions to foods or drugs or allergies to any substance.
	history of asthma, bronchitis, heart problems or any other medical conditions.
	the current drugs you are taking including cigarettes, alcohol and birth control tablets.
	any loose teeth, caps plates or dentures.

If you are unsure of the tablets you are taking, ask your general practitioner to write a note to your anaesthetist. Bring your tablets with you to the pre-operative visit!

If you feel unhappy or concerned about any aspects of your anaesthetist's plan you should talk this over as a plan can usually be safely modified to cater for individual concerns.

How can you prepare for your operation?

There are several simple things that can be done to improve your general condition prior to your operation:

Moderate exercise such as walking will improve your general physical fitness.
Cease smoking as soon as possible, ideally six weeks prior to surgery.
Reduce alcohol consumption.
Continue regular medication such as drugs used to control high blood pressure which have been prescribed for you.
Do not take unprescribed Aspirin for 14 days prior to your operation. This is because it affects the body's blood clotting mechanisms and can increase the likelihood of excessive bleeding during and after surgery. Paracetamol may be used.
Notify your surgeon or anaesthetist of any serious medical problems, such as heart disease or asthma well in advance of your admission as you may require an early preoperative consultation.
If you are anxious about your anaesthesia, make an appointment to consult your anaesthetist, as this will provide you with information that may reduce your anxiety.

If your operation is planned as day surgery then you will be discharged from hospital approximately 4 hours after the end of your surgery. Whilst you will be safe to travel home you must be accompanied by a responsible adult who should stay with you till the next day. You must not drive, operate machinery or sign any legal documents for 24hrs after your anaesthesia has ended.

Further information

There are many sources of information about anaesthesia available on the internet. Some places to start include:

	The Australian Society of Anaesthesia http://www.asa.org.au/
	The Australian and New Zealand College of Anaesthetists http://www.anzca.edu.au/

Many Anaesthetic Departments have their own web site and these may be a good source of useful information specific to your local area.

	Caboolture Hospital Anaesthetic Department http://gasbone.herston.uq.edu.au/~cabanaes/
	Logan Hospital Anaesthetic Department http://www.palmer.net.au/logan/