Australia has some of the most highly trained and regarded Anaesthetists in the world. Specialist Anaesthetists are doctors that have completed their medical degree and then continued on to do specialist Anaesthetic training. Your specialist anaesthetist has undergone a minimum of 13 years of graduate and post graduate studies, is a medical doctor and a fellow if the Australian and New Zealand college of Anaesthetists.

Click here for further information on what an Anaesthetist is.

Click here for a detailed explanation on the different types of anaesthesia.

Yes, modern anaesthesia, especially in Australia, is very safe. In recent years there have been many advances in the anaesthetic drugs and monitoring equipment. These advances, teamed with a high standard of practice in Australia, means that you can be assured about the safety of anaesthesia. That being said, medical procedures and medical conditions have varying degrees of inherent risk. It is important that you give your Anaesthetist a full medical history before your operation.

Click here to read more information about the risks of anaesthesia.

Click here to read a detailed explanation on what an epidural is, as well as the risk associated with epidural anaesthesia

Yes. Herbal medicines, vitamin supplements and other "over the counter" drugs are commonly used however not everybody is aware of how these drugs can affect your body when you are having an anaesthetic and surgery. Herbs such as gingko, ginseng and garlic are all known for impairing your bloods ability to clot which could result in excessive bleeding during and after surgery. Herbal preparations including valerian and the very commonly used St John's Wart can cause a prolongation of anaesthesia. Other herbal preparations and supplements can also have varying effects on your body which may need to be taken into consideration when planning your anaesthetic.

It is important for you to discuss these medications and any other medications that you are taking, with your Anaesthetist, prior to surgery.

Generally speaking, herbal preparations should be stopped at least two weeks before surgery.

If you are having a general anaesthetic, your anaesthetist may need to pass a breathing tube into your trachea via your mouth, in order to help you breathe normally. Crowns, bridges, fillings and cosmetic implants are usually not as strong as normal teeth so there is a very small risk of damage to these when having an anaesthetic.

Teeth that are loose, broken or in poor condition are also at risk of damage. If this is the case, it may even be advisable to seek the opinion of a dentist prior to surgery. Whilst the risk to your teeth is very low, you should be aware of this risk.

If you have any concerns regarding your dental condition, please discuss it with your anaesthetist prior to surgery.

Yes. It is very important that your anaesthetist and surgeon are aware if you have any of these devices implanted

If you have a history of difficult intubations for surgery, please bring along any reports, documents or letters that may have been given to you by your previous anaesthetist/s. This will greatly help to plan your individualised anaesthetic. Please take comfort in the knowledge that there have been many anaesthetic advances in recent years and there are a number of different techniques and methods that can be used to safely secure your airway.

In order for your anaesthetist to plan the most appropriate anaesthetic for your individual needs, it is important that you provide your anaesthetist with a full and comprehensive medical history. Once Dr Goonan has been confirmed as the Anaesthetist looking after you for you upcoming surgery, please complete the Pre-Operative Patient Questionnaire.

The questionnaire will cover area such as;

• your current health status
• long term medical issues such as heart disease, diabetes, emphysema
• any recent changes in your health  - such as recent illness, hospital admissions or surgical procedures
• current medications
• allergies
• previous experience/s with anaesthesia.

All surgical procedures and anaesthetics have the potential for complications to occur. This may result in the need to change to a different type of anaesthetic or the anaesthetic may need to be converted to a general anaesthetic. As a result, all patients will need to be fasted prior to their surgery.

There are many factors that can effect fasting times, so your Anaesthetist will advise you when to commence fasting. It is very important for you to have an empty stomach prior to any surgery or procedure that requires any type of anaesthesia.  During the period of fasting, you must avoid eating, drinking or chewing anything - including all foods, drinks, lollies and chewing gum.

When a patient is given a general anaesthetic, some of the normal muscles and reflexes of the body are either reduced or lost completely. One of these is the one that keeps food in the stomach and prevents it from coming back up and going in to the lungs. Normally, when we are awake, if this happened, we would cough in order to protect the lungs from being filled by the food and fluids that are meant to be in the stomach. When we are anaesthetised, the ability to protect the lungs is greatly reduced and the consequences of this could be life threatening.

Your anaesthetist will advise you of a time to commence fasting for your surgery. During the period of fasting, you must avoid eating, drinking or chewing anything - including all foods, drinks, lollies and chewing gum.

Yes. All jewellery should be removed prior to surgery for a number of reasons. These include:

• to prevent it from getting caught on surgical drapes and causing unintentional damage or harm to the patient
• tongue piercings can be an issue when having a general anaesthetic. This is because the breathing tube that needs to be inserted by your Anaesthetist can get caught on the piercing
• metal studs and bars may result in an electrical burn if they come into contact with electrical surgical equipment
• some patients (depending on the type of surgery) may have some swelling post-operatively
• to prevent it from falling off or being lost during surgery.

Yes. Some types of nail polish can interfere with the monitors that we use to observe your oxygen levels  Makeup can mask subtle colour changes which may occur in your face. Your Anaesthetist needs to observe any changes that may occur, therefore makeup, particularly lipstick, should be removed.

Smoking reduces the levels of oxygen in your blood, slows wound healing and can cause breathing problems during and after surgery.  It is therefore very important for you to avoid smoking for as long as possible before your surgery. As an absolute minimum you should not smoke for at least 2 weeks before your surgery.

Click here for further information on smoking and surgery as well as information on how to quit smoking.

If you are unwell with the following symptoms prior to your surgery, please contact your surgeon’s office to discuss the possibility of postponing your procedure

• fever (high temperatures),
• cold or flu
• vomiting
• diarrhoea

Alcohol - It is best to try and avoid alcohol for at least 24hours prior to your anaesthetic.

Recreational drugs (also known as "street drugs" or "illicit drugs") can have unpredictable interactions with anaesthetic agents which can cause potentially dangerous and even life-threatening effects. If you take any recreational drugs, for your safety, it is very important that you tell your anaesthetist. Please note that all information is treated confidentially.

Your Anaesthetist will stay with you the entire time you are in surgery. During your operation, they will be monitoring your vital signs and adjusting the anaesthetic to meet your individual needs. Your Anaesthetist will also monitor your fluid and blood volume as well as the functioning of your heart, lungs and kidneys with special monitors. In addition to the anaesthetic, your Anaesthetist may also administer IV fluids, antibiotics, blood and other necessary medications. When your surgery is completed, your Anaesthetist will accompany you to the recovery room or intensive care unit (whichever is applicable) and stay with you until you are stable and the anaesthetic is wearing off.

Yes. Generally speaking, all patients having an anaesthetic will have an IV cannula inserted. The IV may be used to provide:

• anaesthetic agents during surgery
• analgesia to treat post-operative pain
• hydrating fluids and blood (if necessary)
• antibiotics intraoperatively
• an access point in the event that emergency drugs and medication need to be given

The IV cannula is usually removed when you are able to drink fluids and there is no further need for intravenous medications.

There are many factors taken into consideration when determining the need for a blood transfusion. The most important is the type of operation you will be undergoing and your medical condition prior to surgery. Often the need for a blood transfusion is known before the surgery, however, sometimes unexpected events occur during surgery and the need for an emergency transfusion may arise. If you have personal beliefs regarding, or concerns about blood transfusion, you should discuss this with your Anaesthetist.

Nausea and vomiting are commonly associated with anaesthesia and surgery. Some of the factors which contribute to your risk of postoperative nausea and vomiting include:

• the type of surgery you are having
• type of anaesthesia
• age
• gender
• past experience of postoperative nausea and vomiting

There have been significant advances in the treatment of post operative nausea and vomiting in recent years and there are a variety of medications available that can alleviate the symptoms. If you have a history of nausea or vomiting after previous surgery please discuss this with your Anaesthetist prior to surgery.

According to the Royal College of Anaesthetists (UK) "small quantities of anaesthetic drugs may be present in breast milk in breastfeeding mothers. In general, this does not cause a problem, but mothers should discuss the problem with their anaesthetists, who can then choose appropriate drugs and advise on the potential side-effects on the infant. It is usually possible to time surgery so as to minimise the effect, or to express breast milk for use in the immediate post-operative period."

A sore throat after surgery is very common and almost 50% of patients will experience it in varying degrees. The insertion of the endotracheal tube ("breathing tube") is one cause, however, sometimes a sore throat will occur even without intubation. This is generally not a major problem and will usually resolve within a few days. Throat lozenges, gargles and soft foods may help to relieve the symptoms. If the pain or discomfort persists or increases, please contact your Anaesthetist.

If you are expecting to go home on the day of your surgery, it is important to organise for a family member or friend to drive you home from the hospital. For at least 24 hours after an anaesthetic, it is recommended that you do not

• drink alcohol
• drive your car
• operate dangerous equipment or tools
• make important decisions
• sign legal documents.