Anaesthesia

Your anaesthetic will keep you comfortable, safe, and pain-free throughout your procedure, making the experience as smooth as possible for both you and your surgeon. The technique used will depend on the nature of your surgery, your general health, and your personal preferences.

• General anaesthesia renders you completely unconscious.
• Sedation is used for shorter, less painful procedures to manage discomfort.
• Regional anaesthesia numbs a specific part of the body, such as the arm, lower body, or an area of skin.

Your anaesthesiologist will recommend the technique best suited to your needs and circumstances, always prioritising your safety.

Most techniques require the placement of an intravenous (IV) cannula—usually in the arm or hand—through which fluids and medication are administered. Before general anaesthesia or sedation, you will also receive oxygen via a face mask. Some regional techniques require specific body positioning to access the relevant nerves.

The Anaesthesiologist

An anaesthesiologist is a medical doctor with at least thirteen years of training, five of which are spent specialising in anaesthesiology. Their expertise covers:

Common Complications (1 in 10 to 1 in 100 cases)

Your anaesthesiologist will:

• conduct a pre-operative assessment to confirm you are fit for surgery;
• prescribe pre-operative medication to reduce anxiety, stress, or pain where needed;
• administer anaesthesia to facilitate your procedure and ensure your comfort and safety;
• monitor your vital signs—including heart rate, blood pressure, temperature, and respiration—throughout surgery;
• monitor and adjust the depth of anaesthesia to keep it safe and effective;
• manage any complications that arise during surgery, such as changes in blood pressure, breathing difficulties, or heart problems;
• oversee your transfer to intensive or high care if your surgery requires it; and
• prescribe post-operative treatment—such as pain relief or anti-emetics—to support your recovery.

What to Discuss With Your Anaesthesiologist

Your anaesthesiologist will walk you through the available anaesthetic techniques and post-operative care options. Be prepared to share the following:

Your anaesthesiologist can also help you know what to expect—physically and emotionally—before and after surgery.

Fasting

Do not eat for at least six hours before your anaesthetic. This applies to general anaesthesia, sedation, and regional anaesthesia. In some circumstances, small amounts of water may be permitted up to two hours beforehand. Discuss this with your anaesthesiologist well in advance.

If you have eaten within six hours of your surgery, inform your anaesthesiologist immediately. Your procedure may need to be postponed for your safety.

For specific guidance on fasting—particularly for children or infants—contact your anaesthesiologist directly.

Risks and Complications

Anaesthesia always carries some risk. While every precaution is taken to avoid complications, adverse events can occur. Your anaesthesiologist is trained to manage these, though doing so may involve additional medical costs. The following information is intended to help you give informed consent. Please discuss any concerns with your anaesthesiologist before your procedure.

This list is not exhaustive and is not intended to cause alarm. It is important that you complete the accompanying questionnaire fully and accurately.

Common complications (1 in 10 to 1 in 100 cases)

These are rarely serious and usually resolve without treatment:

• nausea and vomiting;
• sore throat;
• shivering;
• headache;
• dizziness;
• visual disturbances;
• itching;
• pain at the injection site;
• swelling or discomfort at the IV site; and
• confusion or memory loss, particularly in elderly patients.

Rare complications (1 in 1,000 cases)

These are usually not serious but may require treatment:

• injury to teeth, crowns, lips, tongue, or mouth;
• muscle pain;
• difficulty urinating, particularly in male patients;
• depressed respiration; and
• worsening of pre-existing conditions such as diabetes or heart disease.

Very rare complications (1 in 10,000 to 1 in 200,000 cases)

These are serious and include:

• eye injury;
• allergic reactions to anaesthetic drugs;
• nerve injury;
• lung infection, particularly in smokers;
• awareness during surgery; and
• malignant hyperthermia (a rare inherited condition causing dangerous muscle heat production).

Death (approximately 1 in 300,000 cases)

In extremely rare cases, death may occur—usually when the heart or brain is deprived of oxygen due to breathing problems, heart failure, or a severe allergic reaction.

Intravenous line complications

Potential complications associated with IV cannula placement include:

• pain during insertion;
• swelling at the insertion site;
• bleeding from the puncture site; and
• difficult insertion requiring multiple attempts.

An IV line can also become infected, particularly if it remains in place for several days.

Airway management

While you are unconscious, a tracheal tube or other airway device may be used to keep your airway clear and safe. These can occasionally cause minor injury to the lips, teeth, tongue, throat, vocal cords, or trachea. Please inform your anaesthesiologist of any previous airway difficulties, and adhere strictly to the fasting guidelines to reduce the risk of stomach contents entering the airway during induction.

Fees

Anaesthesiologist fees fall within the Health Professions Council of South Africa guidelines. The fee covers:

• the pre-operative consultation;
• anaesthetic care from the start of your anaesthetic until you are awake in recovery and able to be left in nursing care; and
• specific procedures to enhance safety and support post-operative pain relief and recovery.

Factors that may affect the fee include:

• the duration of your procedure;
• after-hours, emergency, or late-addition surgery;
• advanced pain management techniques; and
• ongoing care in an intensive care unit.

Depending on your medical aid or insurance plan, your healthcare funder may cover between 30% and 100% of the anaesthesiologist’s fees—similar to how excess levels work in short-term insurance. You remain ultimately responsible for this account, so consult both your medical aid and your anaesthesiologist before your procedure.

Consent and the Pre-Operative Period

You may request or decline a sedative from your anaesthesiologist. Bring all your regular medication to the hospital and confirm with your anaesthesiologist which to take pre-operatively. Please note that signing an informed consent form after receiving a sedative is not legally valid. Ensure you sign all consent documentation before taking any pre-operative medication.