Anaesthesia and preparing for surgery

Anaesthetists are the specialist doctors who enable our talented surgeons to perform complex surgeries.

Anaesthetists are the specialist doctors who enable our talented surgeons to perform complex surgeries.

In Australia, doctors specialise in anaesthesia and pain medicine by undertaking a further eight to ten years of post-graduate training after medical school. As perioperative physicians, anaesthetists serve a central role around the time of surgery. Anaesthetists optimise patients’ medical conditions before, during and after surgery as well as using general anaesthetic and regional anaesthetic techniques to reduce inflammation and the surgical stress response. This helps reduce the risk of postoperative complications, facilitates rapid recovery from surgery and reduces postoperative pain.

Before surgery

Anaesthetists help ensure patients have the best chance for a good outcome from surgery. Patients may be referred to the Pre-Anaesthetic Clinic (PAC) for medical assessment and blood tests to allow for risk assessment and optimisation prior to major surgery. A multidisciplinary team comprising anaesthetists, nurses, pharmacists, dietitians, exercise physiologists etc. will help ensure patients are ‘fit for surgery’. Some high-risk patients may be referred for cardiopulmonary exercise testing (CPX / CPET) and active prehabilitation (exercise, nutrition, quit smoking programs etc.) prior to surgery.

During surgery

Anaesthetists provide critical functions by keeping patients safe and stable during surgery, focusing on:

  • Providing continual medical assessment of patients with expertise to diagnose and treat medical problems or emergencies that may occur;
  • Monitoring and controlling patients’ heart rate and rhythm, breathing, blood pressure, body temperature and fluid balance;
  • Managing patients’ pain and level of consciousness to optimise conditions for safe and successful surgery.

After surgery

Anaesthetists and surgeons have developed Enhanced Recovery After Surgery (ERAS) programmes to optimise recovery time from surgery. As Fellows of the Australian and New Zealand College of Anaesthetists, our anaesthetists are dedicated to working predominantly at Peter MacCallum Cancer Centre—undertaking research in perioperative anaesthesia and working closely with our surgeons and other multi-disciplinary teams—and to provide-world class expertise in anaesthesia for cancer related surgery. We aim to provide the best anaesthesia care possible and thereby optimise patients’ outcomes on their cancer journey.

Prepare for your anaesthetic and surgery

Weeks before your surgery:

  • Complete and return the Heath Assessment Questionnaire (HAQ)

This form provides important information for us to help prepare you for your anaesthetic and to keep your anaesthetic safe.

  • Bring copies of past heart-related tests

(e.g. echocardiograms, stress tests, pacemaker insertions, angiograms etc.) and details of your heart, lung or other specialists who may have seen in the past.

  • Stop smoking

You should take immediate steps to quit and remain smoke-free until at least one week following your procedure—or preferably indefinitely. Quitting smoking is one of the best things you can do to recover from surgery, and reduces the risks of wound infection, pneumonia and a heart attack.

  • Get regular exercise

Even a daily, rigorous walk to the park will help.

  • DO DOT interrupt prescribed medications unless your anaesthetist or surgeon recommends it

Bring all your regular medications to hospital. Unless otherwise instructed, take all your regular medications on the day of surgery with a sip of water.

  • Stop all natural or herbal supplements two weeks prior to surgery

Some supplements can thin the blood resulting in increased bleeding during your procedure.

Days before your surgery:

  • If you are not staying overnight in hospital, make arrangements for a responsible adult known to you to take you home

It is also recommended that you have someone stay with you during the first 24 hours. You will NOT be allowed to leave alone or drive yourself home. Do not make important decisions for the first 24 hours after your anaesthetic. If you have local anaesthesia with no sedation, it may be possible to go home without someone to accompany you.

  • Leave your jewellery and valuables at home

  • Wear loose fitting clothing

Wear clothes that are easy to put on and will fit over surgical dressings.

  • Stay warm on the day of surgery

  • Observe fasting guidelines

(No food or drink other than water for SIX hours prior to your surgery; you may have water up to TWO hours before your surgery). An empty stomach helps prevents regurgitation of stomach contents under anaesthesia,

  • Take all your normal prescribed medications on the day of surgery (with a sip of water) unless your anaesthetist or surgeon recommends otherwise

Bring all your regular medications to hospital.

What happens during your anaesthetic

Surgery needing a general anaesthetic requires administering medication through a cannula placed in your arm. This process places patients in a controlled state of unconsciousness for surgery. During your operation, other medications and fluid are administered to maintain unconsciousness and assist with minimising postoperative nausea, pain and the inflammatory response to surgery.

Advanced technology is used to monitor your body's functions, and your anaesthetist is present at all times.

At the end of the operation, you will be transferred to the recovery room where you will wake within minutes. You are then moved to the ward, intensive care unit or discharged home depending on the procedure you have had. Some surgical procedures result in discomfort that may require you to be discharged with analgesia medication..

Risks and complications of anaesthesia

Find out more about the risks and complications.

Referral information

Your specialist will refer you to the anaesthetics service or the Pre-Anaesthetics Clinic should you need this service.