Anaesthesia for Surgery
An anaesthetist is a medical specialist just like a surgeon, requiring the same length of training, and you will have a fully trained specialist anaesthetist for your surgery. The anaesthetist will contact you prior to your surgery to ask you about any previous and current health issues. Please feel free to ask about any aspect of your anaesthesia care. It is important you try to answer all questions fully to enable the anaesthetist to use the best anaesthetic techniques for your surgery.
Specifically, it is very important to tell the anaesthetist about
- any previous anaesthesia problems
- any allergies
- any history of pulmonary embolus (blood clot in the lung) or deep vein thrombosis (blood clot in the leg).
The anaesthetist will arrange for extra tests if they are required to give your anaesthetic safely. If needed, they may ask to see you prior to the day of surgery.
You will usually meet your anaesthetist before your operation on the day of surgery, who will answer any further questions you may have and obtain your informed consent for the anaesthesia. Laparoscopic sleeve gastrectomy procedure requires general anaesthesia: this is a combination of drugs used to put you into a state of controlled and reversible unconsciousness. The anaesthetist monitors you continuously during this time, and you will be given painkillers and anti-emetics (which help prevent nausea and vomiting) while you are asleep. In the recovery room, further medications will be given as needed.
Pain is normally minimal after this procedure, but can be felt in the small cuts made in the abdomen. Occasionally, the gas used to inflate the abdomen can cause pain in the shoulder tip, but this rarely lasts long and is easily controlled. If ongoing pain relief is needed, then a PCA pump (patient-controlled analgesia, ‘Pain Pump’) can be used. You push a button and the pump delivers a dose of painkiller. You cannot give yourself too much; the machine will limit the amount of painkiller it delivers to safe level. Nausea and vomiting can be troublesome for some people but there are many drugs we can use to prevent this. Your anaesthetist will chart a list of drugs for the ward nurses to give, and we would encourage you to use them as required. The nurses can contact your anaesthetist at any time for advice about pain-relief and any other non-surgical problem.
Your anaesthetist will be involved with your care for 2-3 days after the operation in co-operation with your surgeon. He or she takes care of pain-relief, nausea / vomiting and intravenous fluids, as well as managing most medical problems such as diabetes while you are in hospital.
Surgery can dramatically improve quality of life and improve medical conditions associated with obesity.
Perioperative Safety in the Longitudinal Assessment of Bariatric Surgery
New England Journal of Medicine 2009;361:445-54.
Quality of Life Outcomes of Bariatric Surgery: A Systematic Review.
Obesity Surgery2016 Feb; 26(2): 395-409