Your anaesthetist works in conjunction with your surgeon to ensure your surgical procedure and recovery period is as comfortable and pain free as possible. There are a number of different anaesthetics and their use depends on factors such as the type of surgery or procedure you are having and your past medical and surgical history. Your anaesthetist will discuss the type of anaesthetic with you prior to your surgery. The most common are:

General anaesthesia
General anaesthesia refers to a carefully controlled state of unconsciousness. The goal is that you feel nothing and have no awareness during your operation. I will give you medicines through a small plastic tube in your hand or arm. Throughout the procedure, I continuously monitor your breathing, heart rate, and other vital signs, adjusting the anaesthetic and continuing to give you medications as needed to keep you as safe and comfortable as possible.

Deep sedation (such as gastroscopy or colonoscopy)
The goal is that you feel calm, and completely comfortable during your procedure. Most people will have very little or no recollection of the procedure afterwards. I will give you medicines through a small plastic tube in your hand or arm. I will monitor you continuously, and you will recover in a monitored area by trained staff. This sedation wears off quickly and most people feel well enough to head home on the same day.

Light sedation (such as cataract surgery)
I will give you medication to help you feel relaxed and drowsy while remaining conscious. You will be aware of your surroundings but should feel calm and comfortable. If having eye surgery I will also use local anaesthetic eye drops or perform an eye block (numb the nerves to the eye) so you shouldn’t feel pain. This sedation wears off quickly, and most people go home shortly after their procedure.

Spinal or regional anaesthesia
I will numb a specific part of your body so you have little or no sensation during the procedure. Alongside this, you can either remain awake, have light sedation/deep sedation to help you relax, or be given a general anaesthetic — for example, joint replacements are often done with a spinal combined with a general anaesthetic, so you are numb and unconscious at the same time. You will often be numb for a period of time after the procedure finishes, which is helpful in making you more comfortable.

Caesarean section
This is usually performed under a spinal anaesthetic, which numbs you from the chest down while you remain awake. This allows you to be present for your baby’s birth and to have your support person with you. Rarely, a spinal is not suitable, in which case a general anaesthetic may be used instead.

Anaesthesia for children
To ensure your child’s experience is as calm as possible, please be mindful of your words and body language. When talking to your child about what will happen, try to avoid negative words like “pain” and phrases like “it won’t hurt a bit.” Instead talk about how they will be as “safe and comfortable as possible.” On the day, your child will generally respond better when they can see that you are outwardly calm (even if you’re feeling nervous too). If they are particularly anxious, please let staff know, and a sedative medication can be provided before starting the anaesthetic. One person may accompany the child into the operating room to assist with going to sleep. As soon as your child is asleep, we will show you to a waiting area.

There are two ways to begin anaesthesia in children:

1. Anaesthetic gases are inhaled through a mask, then once asleep, an intravenous line (IV) is placed.
2. An IV is placed while the child is awake and medications given through the IV to begin the anaesthetic. Before placing the IV, the anaesthetist will talk to children about “putting a tiny plastic straw” in their hand or arm. Often a white numbing cream, EMLA, is placed on potential IV sites prior to placement.

As children grow, it is more often appropriate to place an IV before they go to sleep. The pre-operative staff will apply topical numbing cream in preparation for a possible IV insertion.