Curious to know more?

Sedation and general anaesthesia are at opposite ends of the continuum of unconsciousness. Deep sedation is somewhere in between. The choice of what technique is used will depend on your body and any medical problems you may have, what procedure you’re having and your personal preference as a patient. Dr Maghami will discuss these with you either in the days before your procedure or on the day of your procedure. His ultimate aim is to keep you safe and comfortable during your surgery.

Sedation

Sedation can be light, aiming to have you comfortable for your procedure. You will still generally remember what happened during the procedure with this sort of technique, but you will be relaxed, pain free and comfortable during your procedure. Deep sedation is a slightly deeper plane of anaesthesia and unconsciousness, where you may remember what happened during the procedure (most people won’t though). You will still be relaxed, pain free and comfortable during your procedure.

General anaesthesia

General anaesthesia is designed to have a patient completed unconscious during their anaesthetic.

Risks of anaesthesia

Anaesthesia, especially in Australia, is exceedingly safe. The Australian "Safety of anaesthesia" report of 2018-2020 reported that anaesthesia-related mortality was 2.96 per million population per annum. Unwell or very unwell patients form the majority of these deaths, so if you are in a generally good medical condition your risk is even lower.

The Royal College of Anaesthetists has also produced this summary with rough figures.

Dr Maghami will have a discussion with you about the risks of anaesthesia - if there are any risks that particularly worry you or if you have any other concerns please let him know when you speak.

Regional anaesthesia

Regional anaesthesia is a bit different to sedation, deep sedation or general anaesthesia. Regional anaesthesia involves the injection of local anaesthetic (a drug) around nerves in your body. This medication numbs your nerves and blocks pain signals from travelling for around 12-18 hours. You will still feel touching and pressure while the nerve block is working, but it shouldn’t be painful. It is possible to do entire procedures just with a nerve block alone and with you wide awake (e.g. no sedation), however most people request for the regional anaesthetic to be combined with some sedation. It may also be performed as part of a general anaesthetic for post-operative pain control - Dr Maghami will discuss this with you if this is the case.

Benefits of regional anaesthesia:

  • Excellent pain relief which lasts a while and doesn’t require strong opioids (opioids have side effects)

  • Quicker time to discharge from hospital

  • Faster mobilisation

  • Has been shown to reduce the incidence of chronic pain associated with certain procedures

  • May avoid having a general anaesthetic and all the risks associated with this

Risks of a regional anaesthetic:

  • There are two main risks of a regional anaesthetic. One is failure of a nerve block - this may happen for many reasons. Dr Maghami uses ultrasound to try and minimise this risk. The other risk is the risk of permanent nerve damage - this is roughly 1:5,000. This may lead to permanent loss of strength or function in a limb. If you’re curious for more information, read this leaflet. Or discuss your concerns with Dr Maghami.

Spinal or Epidural

A spinal and epidural are slightly different again to the previous anaesthetic methods discussed.

With a spinal anaesthetic, Dr Maghami typically use a small needle to inject local anaesthetic (a drug) into the fluid which surrounds your spinal cord. This anaesthetises the nerves in this area to cause a short lived numbness and loss of sensation and strength in your lower limbs and abdomen. This is useful for operations in the abdomen (ie caesarian sections) or lower limb (ie hip or knee replacements). You can be fully awake for your operation with this anaesthetic, however it can also be combined with deep sedation. The spinal anaesthetic procedure itself is usually not too sore, we numb your skin prior and you usually just feel pressure during the spinal anaesthetic procedure. Occasionally you may feel some pain in your legs during the procedure - if this happens just let Dr Maghami know and he will redirect his technique.

An epidural works in a similar fashion to a spinal anaesthetic but the insertion technique is slightly different. Dr Maghami uses a needle to find the correct space, and once in the space he will thread a very small plastic catheter into that space. This will be kept in place while you need pain relief. You can lie down and move around the bed with this catheter in place. Nowadays this is most commonly used for pain relief during labour.

Both spinal and epidural anaesthetics are very safe. The main risks to know about is the risk of a headache that can last a few days. This risk is 1:200 with epidurals and approximately 1:500 with spinal anaesthetics. Rarely this headache may become chronic and long term. The risk of an infection in your spine or serious nerve damage is very rare (for epidurals this is a 1:150,000 and 1:250,000 risk respectively).

The Australian Society of Anaesthetists also has a patient information page if you’d like to read more about any of the above