Patient Information

Anaesthesia temporarily affects your body's ability to protect your airway (your windpipe), which means there's a small risk that food or liquids in your stomach could be inhaled into your lungs during surgery. To reduce this risk, it's very important to follow the correct fasting (nothing-by-mouth) guidelines before your procedure.

🔔 Why Fasting Is Important

• Ensures your stomach is empty before anaesthesia.

• Prevents aspiration pneumonia, a potentially serious complication.

• Helps your anaesthetist keep you safe during your surgery.
  
  

✅ Standard Fasting Guidelines (for healthy patients)

These are minimum safe fasting times. Your doctor may adjust them based on your condition or procedure.

Type of Intake

Minimum Fasting Time Before Anaesthesia

Solid Foods: 6 hours

Formula Milk (for infants) 6 hours

Breast Milk (infants) 4 hours

Clear Fluids* 2 hours

* Clear fluids include:

• Water

• Clear apple juice

• Rooibos tea (no milk)

• Black tea or coffee (no milk or cream)

• Isotonic drinks (e.g. Rehidrat, Powerade – if advised by your doctor)
  
  

⛔ Do not drink milk, yoghurt, smoothies, or any fluid with pulp or fat within 6 hours of anaesthesia — these are treated as solids.

🕑 Example Fasting Timeline (Morning Surgery) - Your anaesthetist will confirm specific times for fasting.

Type

Last Time Allowed

Light meal (toast, cereal) 12:00 midnight

Clear liquids (water/rooibos) Up to 05:30 AM

Surgery time 07:30 AM or later

For afternoon surgeries, your fasting times will be adjusted accordingly — your anaesthetist or pre-op nurse will advise you.

⚠️ Special Considerations

• Children: Fasting times are adapted to age. Clear fluids are encouraged up to 2 hours before the operation to prevent dehydration.

• Diabetics: Special instructions will be given about medication and fasting. Please discuss this with your doctor beforehand.

• Emergency surgeries: Different fasting rules may apply depending on the situation.

• Pregnant women (C-sections): You’ll receive specific instructions regarding fasting and antacid use.
  
  

📋 Reminders Before Your Procedure

• DO NOT eat chewing gum or suck on sweets before your operation.

• DO NOT smoke or vape on the day of your surgery (ideally stop 24 hours before).

• DO NOT take any medication unless advised to by your doctor or preoperative nurse.

• Bring a list of all your current medications on the day of your procedure.
  
  

📞 Questions or Concerns?

If you're unsure about what or when to eat or drink before your surgery, please contact your:

• Anaesthetist

• Surgeon’s office
  
  
  

For more information, visit the South African Society of Anaesthesiologists (SASA) website:
🌐 https://www.sasaweb.com

🔹 What Is General Anaesthesia?

General anaesthesia is a controlled, medically-induced state of unconsciousness used during surgery. While you are asleep, you will feel no pain, won’t be aware of the surgery, and won’t remember the procedure afterward.

A qualified anaesthetist (a specialist doctor) will administer the anaesthetic and monitor your vital signs continuously to ensure your safety and comfort.

🔹 What to Expect: Before, During & After

1. Before the Procedure

• You will be asked about your medical history, medications, allergies, and previous anaesthetic experiences.

• Your blood pressure, oxygen levels, and general health will be assessed.

• You must follow fasting guidelines carefully (see fasting guidelines above).

• You may be given medication to help you relax (pre-med).
  
  

2. During Anaesthesia

• A drip (IV line) will be inserted into your arm or hand.

• Anaesthetic drugs will be given through this IV, and you’ll fall asleep quickly.

• A breathing tube may be inserted to support your breathing.

• Your heart rate, blood pressure, oxygen levels, and breathing will be closely monitored.
  
  

3. After Anaesthesia

• You will wake up in the recovery room under close observation.

• You may feel groggy, cold, or slightly nauseous — this is normal and usually temporary.

• Pain, if present, will be managed with appropriate medication.
  
  

🔹 Common Side Effects (Temporary)

• Drowsiness or confusion

• Nausea or vomiting

• Sore throat (from the breathing tube)

• Muscle aches or chills

• Dry mouth
  
  

These effects usually pass within a few hours. Let your nurse or anaesthetist know if they persist or worsen.

🔹 Risks and Safety  (These Risks will be discussed pre-operatively during the process of Informed Consent)

General anaesthesia is very safe for most patients when performed by a trained anaesthetist. However, like all medical procedures, it does carry some risks, including:

Minor Risks

Nausea and vomiting

Shivering or cold feeling

Sore throat or hoarseness

Confusion in older patients

Severe Rare Risks

Severe allergic reaction (anaphylaxis)

Aspiration (food or stomach contents in lungs)

Heart or breathing complications

Awareness under anaesthesia (extremely rare).

Your anaesthetist will take all necessary precautions to minimise these risks.

🔹 Special Considerations

• Medical Aid Patients: Anaesthetic billing is separate from your hospital or surgeon fees. You may receive a separate invoice from your anaesthetist.

• POPIA Compliance: All personal and medical information is handled confidentially in accordance with the Protection of Personal Information Act.
  
  

🔹 Preparing for Anaesthesia

✅ Do:

• Inform your doctor of all medications, including herbal or traditional remedies.

• Follow fasting instructions exactly (see Fasting Guidelines)

• Arrange for someone to take you home if you're having day surgery.

• Ask questions — your anaesthetist is there to support and inform you.
  
  

❌ Don’t:

• Eat or drink after the allowed times.

• Smoke or vape on the day of surgery.

• Drive, operate machinery, or sign legal documents for 24 hours afterward.

🔹 What Is Regional Anaesthesia?

Regional anaesthesia is a type of anaesthesia where medication is injected near nerves to block sensation and pain in a specific part of the body — such as an arm, leg, or the lower half of the body. You may remain awake, sedated, or occasionally have light general anaesthesia, depending on your procedure and preference.

A trained anaesthetist will perform the block and monitor you throughout your surgery to ensure your comfort and safety.

🔹 Types of Regional Anaesthesia

Spinal anaesthesia

Numbs the lower body (hips, legs, bladder etc.). commonly used for Caesarean sections, orthopaedic surgery...

Epidural anaesthesia

Similar to spinal, slower onset, commonly used for pair relief in labour or abdominal surgery.

Nerve blocks

Various nerve blocks can be used to anaesthetise the arm, shoulder, leg, foot or trunk.

🔹 What to Expect

Before the Procedure

• Your anaesthetist will explain the procedure and get your consent.

• An IV cannula will be inserted on your hand or arm.

• You may receive light sedation to help you relax.

• The injection site will be cleaned, and local anaesthetic will be applied to numb the area.
  
  

During the Procedure

• You will feel pressure but should not feel severe pain.

• You may stay awake or lightly sedated — you will not see the surgical field.

• The anaesthetist will monitor your vital signs throughout.
  
  

After the Procedure

• The area may stay numb for a few hours.

• Movement or sensation will return gradually.

• You may experience tingling, heaviness, or warmth during recovery.
  
  

🔹 Benefits of Regional Anaesthesia

✅ Excellent pain control during and after surgery
✅ Avoids full unconsciousness
✅ Less nausea and drowsiness
✅ May allow quicker recovery and mobilisation
✅ Reduces need for strong opioids

🔹 Common Side Effects (Usually Temporary)

• Numbness or weakness in the affected area

• Tingling or "pins and needles"

• Low blood pressure (especially with spinal/epidural)

• Mild headache or backache

• Urinary retention (trouble urinating — usually resolves quickly)
  
  

These side effects are monitored and managed by your healthcare team.

🔹 Rare but Serious Risks

Although rare, regional anaesthesia can have complications:

Possible Risks

Nerve injury or prolonged numbness: Rare (less than 1 in 10,000)

Infection at injection site: Very rare

Bleeding (especially with blood thinners): Rare

Allergic reaction to anaesthetic: Extremely rare

Severe spinal headache (PDPH): Rare, treatable

Your anaesthetist will assess your risk and take every precaution to ensure your safety.

🔹 Special Considerations

• Medical Aid: Your anaesthetist’s account is billed separately. You may receive a separate invoice for the regional anaesthesia service.

• POPIA Compliance: Your personal information is handled in accordance with the Protection of Personal Information Act.
  
  

🔹 After Discharge (Home Care)

• Avoid putting weight or strain on the numbed limb until sensation and strength return fully.

• If you experience unusual symptoms (persistent numbness, pain, or swelling), contact your doctor immediately.

• You may be given a contact number to reach your anaesthetist if needed.
  
  

🔹 What Is Sedation?

Sedation is the use of medication to help you relax, reduce anxiety, and in some cases, not remember a medical or surgical procedure. It does not make you completely unconscious like general anaesthesia, but you may be drowsy or lightly asleep.

Sedation is often used for minor or less invasive procedures, and it's administered and monitored by a trained anaesthetist or sedation-qualified medical professional.

🔹 Levels of Sedation

There are different levels of sedation depending on the procedure and your needs:

Types

• Minimal sedation: You remain awake and calm, able to respond normally to questions and instructions — often used to ease anxiety.
  
  

• Moderate sedation: You feel drowsy and may not remember parts of the procedure, but you can still respond to touch or voice.
  
  

• Deep sedation: You are on the edge of sleep, not easily awakened, but still breathing on your own — used for more invasive or uncomfortable procedures.

🔹 Common Procedures Done Under Sedation

• Colonoscopy or gastroscopy

• Dental procedures

• Plastic or dermatological surgery

• Minor orthopaedic procedures

• Eye surgery

• Some gynaecological procedures
  
  

Your doctor will decide if sedation is appropriate based on your health, anxiety level, and the nature of your procedure.

🔹 What to Expect

Before the Procedure

• You’ll be assessed by your anaesthetist.

• You must follow fasting instructions (usually no food for 6 hours, clear fluids up to 2 hours before).

• Let your doctor know about any chronic conditions, medications, allergies, or if you’re pregnant.

• You will be asked to sign a consent form.
  
  

During the Procedure

• Sedation is given through a small drip (IV) in your arm.

• You may feel relaxed, sleepy, or unaware of what is happening.

• Your breathing, pulse, blood pressure, and oxygen levels will be monitored continuously.
  
  

After the Procedure

• You’ll wake up in a recovery area.

• You may feel sleepy or forgetful for a while.

• Most patients go home the same day, once fully awake and stable.
  
  

🔹 Common Side Effects (Mild and Short-Term)

• Drowsiness or grogginess

• Headache or dizziness

• Nausea (less common than with general anaesthesia)

• Dry mouth

• Minor memory loss of the procedure (normal)
  
  

🔹 Is Sedation Safe?

Yes, sedation is generally very safe, especially when administered by trained professionals. Your anaesthetist is there to monitor you and handle any issues that may arise.

However, like any medical treatment, sedation has rare risks, including:

Potential Risks

Low oxygen or breathing difficulty: Rare and monitored

Aspiration Rare

Allergic reaction to medication: Very rare

Irregular heart rate or blood pressure: Rare, treatable

Prolonged drowsiness or confusion: More common in elderly

Your anaesthetist will discuss any specific risks relevant to your condition.

🔹 Important Instructions for Patients

✅ Do:

• Follow fasting instructions exactly.

• Arrange for a responsible adult to drive you home and stay with you for 12–24 hours.

• Tell your doctor about all medications, including natural remedies.

• Wear comfortable, loose-fitting clothing.
  
  

❌ Don’t:

• Eat or drink after the fasting cut-off time.

• Drive, operate machinery, or make legal decisions for 24 hours afterward.

• Drink alcohol for at least 24 hours.
  
  

🔹 Special Considerations

• Medical Aid Billing: You may receive a separate bill for sedation services. Please check with your provider or ask the practice to confirm your cover.

• POPIA: Your personal and medical information is protected under South Africa’s privacy laws.
  
  

🔹 Questions?

If you have concerns or would like to speak with the anaesthetist beforehand, please let us know. We’re here to make your experience as safe and stress-free as possible.