ANAESTHETICS FOR YOUR PROCEDURE

Gynaecology and obstetrics

Vaginal operations

IVF

This will usually be done under sedation. You can be as awake or asleep as you like. If you are feeling discomfort you can immediately have more drugs to easy your pain. Recovery is quite quick but you still need to exercise care during the day such as not driving, operating machinery, or sign legal documents.

Epidurals for Labour

There are many choices for painrelief including simple measures such as a hot shower, escalating to nitrous oxide and pethidine injections.

The following information is for Epidurals:

You must usually be in established labour.

There are risks associated with the procedure.

Minor risks include:

1. Failure
2. Incomplete block
3. Decreased blood pressure
4. Headache

Major risks include:

1. Nerve damage
2. Permanent paralysis

There is no association with the insertion of an epidural and the presence of back-ache.

An epidural takes time to perform. Indicate early if you would like an epidural, especially during office hours, as all anaesthetists may be busy with routine work. After an anaesthetist has arrived you will need an intravenous cannula and fluids, the equipment will need to be set up and the procedure performed. The drugs take time to work. So, even a routine epidural can take 30 – 40 minutes to get you adequate pain relief.

Incomplete block:

Sometimes a small wedge or “window” is missed by the drugs. This can usually be fixed by repositioning you and injecting more drugs, or pulling the catheter out a little bit. On occasion the epidural may need to be fully replaced.

Blood pressure:

This can fall because of the effect of the epidural drugs. It will be monitored carefully each time drugs are given.

Caesarian sections (LSCS)

There are a number of options for anaesthesia for LSCS.

It can be performed under general anaesthesia and this is done for emergencies where the mother or the baby are at risk. It differs from elective general anaesthetsia because you may have a full stomach. You will be given an antacid to drink before you have a facemask applied to your face to deliver oxygen to fill up your lungs. When you are going to sleep the anaesthetic assistant will press on your throat to prevent anything that may be in your stomach form coming up into your lungs. This can be a little uncomfortable but it is brief and for your safety.

An elective LSCS will be done under spinal or epidural. A spinal is a single dose of drug into the fluid around your spinal cord and an episdural leaves a small tube, called a catheter, in place to allow for top ups. It is usual to have a spinal as the block is more dense and so you feel less.

There are risks associated with the procedure.

Minor risks include;

1. Failure
2. Incomplete block
3. Decreased blood pressure
4. Headache

Major risks include:

1. Nerve damage
2. Permanent paralysis

There is no association with the insertion of an epidural or spinal and the presence of back ache.

The operation will not commence unless the anaesthetic is working. Even so you can sometimes feel things but there should be no pain, much like when you are at the dentist. You will feel pushing when the assistant helps to push your baby out by pushing just under your rib cage.

Communicate with me at anytime is very important and there are a number of options that we can undertake, especially once the baby is born. If all else fails we can always convert to a general anaesthetic.

This can fall because of the effect of the epidural or spinal drugs. It will be monitored carefully each time drugs are given. However, your change in blood pressure may make you feel sick before the reading actually changes. Please tell me if you are feeling ill and we can treat it straight away.

Post operatively you will have strong painkillers and regular antiinflammatories.