Patients whose surgery, social or medical fitness does not allow day surgery will be admitted to the general gynaecology wards.
The same principles of anaesthesia apply. We aim to ensure that patients are fully awake promptly after surgery and comfortable with controlled nausea and vomiting. However, admission to the ward allows us to use additional techniques to control pain:
Patient controlled analgesia
Patient controlled analgesia, or PCA, is a method of pain control that allows you to give yourself some pain relief as and when you need it.
Regional local anaesthetics
Transversus Abdominis Plane (TAP) block is a local anaesthetic block and is given by the anaesthetist when you are asleep and will help numb the nerves supplying sensation to the front of the abdomen. This works with other pain medication to control pain after abdominal surgery such as hysterectomy or laparotomy.
Epidural analgesia benefits patients with medical conditions such as respiratory or cardiac disease following major surgery. For safety reasons, the epidurals are inserted when the patient is awake, in the anaesthetic room and then tested before a general anaesthetic or sedation is given.
The operating department
The operating department includes a reception waiting area, anaesthetic rooms, operating theatres and a recovery room. It looks and feels quite different from other hospital departments. Operating theatres are brightly lit and are purposely quite cool in temperature. As it is important for you to keep warm, a blanket will help if you feel cold.
Theatre staff normally wear coloured 'pyjamas' and paper hats. Because of this, they all look much the same, but you will probably recognise your anaesthetist having met him or her already.
If you have walked to theatre, you will now need to get onto a theatre trolley for your anaesthetic. This is narrower and higher than a hospital bed and may feel quite cold and hard. A member of staff will help you climb onto it. Theatre staff will check your identification bracelet, your name and date of birth and will ask you about other details in your medical records as a final check.
The anaesthetic room
You will then be taken into the anaesthetic room or, sometimes, into the operating theatre. Several people will be there, including your anaesthetist and the anaesthetic assistant. There may also be an anaesthetist in training, a nurse and a student doctor or nurse. All the checks you have just been through will be repeated once again. If you are having a general anaesthetic, you will probably now need to remove your glasses, hearing aids and dentures to keep them safe. If you would prefer to leave your dentures in place, ask your anaesthetist if this would be alright. During your operation, your anaesthetist will attach you to machines to monitor:
- Your heart: sticky patches will be placed on your chest (electrocardiogram or ECG)
- Your blood pressure: a blood-pressure cuff will be placed on your arm
- The oxygen level in your blood: a clip will be placed on your finger (pulse oximeter).
More monitoring may be needed for major operations.