Anaesthesia for spinal surgery

You will receive general anaesthesia. This is a drug-induced state of loss of consciousness. It is a deep sleep state whereby we aim for you to not be aware of the operation.

Depending on the complexity of the surgery and/or your own medical history we may need to put in extra monitoring to normal. For example an arterial line to keep a close eye on your blood pressure, heart and fluid status.

In very complex operations we may put in a central venous line and may need to give you a blood transfusion. In this case I will see you before the operation in my rooms.

We will get you off to sleep on your back but to operate on your spine we often need to position you on your belly or front (prone position). This in addition carries some extra risks related to pressure on your eyes, face, nerves and chest.

What are the risks of the anaesthetic?

Modern anaesthesia is generally very safe. Every anaesthetic has a risk of side effects and complications. Whilst these are usually temporary, some of them may cause long- term problems.

The risk to you will depend on:

• whether you have any other illness

• personal factors, such as whether you smoke or are overweight • how simple or complex your surgery is

• whether your surgery takes a short or a long time and

• whether your surgery is done in an emergency.

Common side effects and complications of anaesthesia

• Nausea or vomiting

• Headache

• Pain and/or bruising at injection sites

• Sore or dry throat and lips

• Blurred/double vision and dizziness

• Problems in passing urine. Less common side effects and complications of anaesthesia

• Muscle aches and pains

• Weakness

• Mild allergic reaction - itching or rash

• Temporary nerve damage.

Uncommon side effects and complications from anaesthesia

• Being awake under general anaesthetic

• Damage to teeth and dental work

• Damage to the voice box and cords, which may cause a temporary hoarse voice

• Allergic reactions and/or asthma

• Blood clot in the leg

• Epileptic seizure

• Chest infection (more likely with smokers)

• Permanent nerve damage due to the needle when giving an injection or due to pressure on a nerve during the surgery

• Worsening of an existing medical condition.

* eye damage/blindness

* pressure on your ulnar or common peroneal nerve

Rare risks which may cause death

• Severe allergy or shock

• Very high temperature

• Stroke or heart attack

• Vomit in the lungs (pneumonia)

• Paralysis

• Blood clot in the lungs

• Brain damage. Increased risks

Risks are increased if;

− you are elderly

− smoke and

− are overweight and if you have the following:

− A bad cold or flu, asthma or other chest disease

− Diabetes

− Heart disease

− Kidney disease

− High blood pressure

− Other serious medical conditions

Your responsibilities before surgery

You are at less risk of problems from an anaesthetic if you do the following:

* Increase your fitness before your surgery to improve your blood circulation and lung health.

* If you are overweight, loosing some weight will reduce many of the risks of having anaesthetic.

* Give up smoking at least 6 weeks before your surgery to give your lungs and heart a chance to improve. Smoking cuts down the oxygen in your blood and increases breathing problems during and after an operation.

* Drink less alcohol as alcohol may alter the effect of the anaesthetic drugs. Do not drink any alcohol 24 hours before surgery.

* Stop taking recreational drugs before surgery as these may affect the anaesthetic. If you have a drug addiction please tell me.

Your recovery from surgery

After the surgery, the nursing staff in the Recovery Area will watch you closely until you are fully awake. You will then be returned to the ward or Day Procedure Area where you will rest until you are recovered enough to go home.

Tell the nurse if you have any symptoms such as pain, headache, nausea, or vomiting. The nurse will be able to give you some medication to help.

Things for you to avoid after general anaesthesia

A general anaesthetic will affect your judgment for about 24 hours. For your own safety;

• Do NOT drive any type of car, bike or other vehicle.

• Do NOT operate machinery including cooking implements.

• Do NOT make important decisions or sign a legal document.

• Do NOT drink alcohol, take other mindaltering substances, or smoke. They may react with the anaesthetic drugs.

• Have an adult with you on the first night after your surgery.