Patient information
Below is some information which will help you prepare for the day of your procedure. Should you require any additional information, please feel free to contact us.
On the day of Surgery
- If you have been booked for a morning list, please do not eat anything after midnight the night before, although you may drink water until 05:00 am on the morning of your operation.
- If you have been booked for an afternoon list, please do not eat anything after 07:00 am on the morning of the operation, although you can drink water until 10:00 am.
- Infants may have formula milk until 6 hours before their operation, breast milk until 4 hours before their operation and water or clear apple juice (no pulp) up to 1 hour before presenting to hospital in healthy children.
These instructions are important. If there is food or liquid in your stomach during your anaesthetic, it could come up into your throat and damage your lungs. Even if you are not having a general anaesthetic or sedation, you will still be asked to follow these instructions. This is because a general anaesthetic may rarely be needed unexpectedly, and you need to be prepared. If you are unsure when you need to stop eating or drinking, or feeding your child, please use our fasting calculator.
You can check on the instructions for patients on chronic medications whether it is safe to you’re your usual medication.
If it is, and unless told otherwise, take your medication at the usual times with a small sip of water. You may be asked by your anaesthesiologist or your surgeon to omit some of your usual medications before surgery. If you are unsure, please feel free to contact us for instructions on which medication to take.
At the hospital you will be admitted to the ward, where you will be given a hospital gown to put on. Jewelry should preferably be removed or, if this is not possible, covered with tape to prevent damage to it or to your skin. You can wear your hearing aid, glasses and dentures until you are in the theatre. If you are not having a general anaesthetic, you will usually be able to keep them on during the operation.
Anaesthetic medications and fluids can be given through the drip. Should you have a needle-phobia, please let us know as there are other options available but these may be associated with increased risk depending on your medical conditions.
Your anaesthesiologist will stay with you for the entire procedure and will watch your condition very closely, adjusting the anaesthetic as required. If you are awake or having sedation, the anaesthetic team will stay right beside you and make sure you are relaxed, comfortable and pain free while in theatre.
Although it is very rare, it is possible to lose a significant amount of blood during and after certain types of operations. A blood transfusion can be used to replace this blood but will not be recommended unless absolutely necessary. Please ask your anaesthesiologist if you would like to know more about blood transfusion and possible alternatives. If you are Jehovah’s Witness or for any other reason are not willing to have a blood transfusion, even in life threatening emergencies, please be sure to indicate this on the consent form prior to your procedure and bring this to the attention of your anaesthesiologist.
After your operation, you will be taken to the recovery room, which is near the operating theatre. There will be other patients in the same room, but you will have your own nurse to look after you. Your heart rate, blood pressure and oxygen levels will be monitored carefully. You may be given oxygen through a light plastic face mask and your drip will continue. If you have pain, nausea or any other problems, the nurse will treat these promptly. When the recovery room staff are satisfied that you have recovered safely from your anaesthetic, you will be taken back to the ward. Whilst the anaesthetic / sedation wears off quickly, your judgement may be impaired for up to 24 hours. Please avoid any dangerous activities (including driving), avoid consuming alcohol, do not engage on social media and ensure that you do not need to take responsibility for small children during this period. It is essential that you have a responsible adult or escort who will be available to you during this time to help, in case complications arise.
Anaesthetic options for your operation
Nature of General Anaesthesia
General anaesthesia is often used for many types of operations. Your anaesthesiologist will give you medication either through a drip or via a mask. This medication will cause you to lose consciousness (go to “sleep”) so you will not be aware of the surgical procedure being performed. A tube may be placed in your throat to help you breathe. This tube will be removed as you wake up and you will probably not remember it, but your throat may be painful after the procedure. Whilst you are asleep, the anaesthesiologist will remain with you at all times to monitor your heart rate, blood pressure, breathing and other vital signs to ensure they are normal and remain steady. As part of the general anaesthetic, your anaesthesiologist will ensure that you are given pain medication as required. Once your surgery is complete, your anaesthesiologist will reverse the anaesthetic medication and you will wake up.
What if I do not want a general anaesthetic?
If you do not want to have a general anaesthetic, your anaesthesiologist can discuss with you other choices for anaesthesia and pain relief after the operation, as well as their potential side effects.
Potential Complications of General Anaesthesia
Modern anaesthesia is extremely safe and your well being is our top priority. However, even in the very best hands, very rarely complications may occur. Whilst our intention is not to frighten you, as part of responsible practice, we are obliged to inform you about these possible risks. If you are particularly concerned about any of these complications, please feel free to contact us before your procedure.
Nature of Spinal and Epidural Anaesthesia
Spinal and epidural anaesthesia may be used for surgical procedures from the chest down. They are commonly used for Caesarian Section and for orthopaedic surgery. In theatre, you will be asked to sit or lie on your side. Your anaesthesiologist will clean your back thoroughly and then place clean sheets over you. A first injection of local anaesthetic will be given to numb the skin – this injection may burn for a short while. You will then be asked to bend your back forwards (like an “angry cat”) and the spinal or epidural injection will be performed. Here, local anaesthetic and other medications are injected close to the nerves coming out of your back. As it starts taking effect, you will start noticing a warm and heavy sensation in the part of your body being targeted. Both legs may start to feel heavy and it may be impossible to move them. You may still feel touch and movement, but you will have no pain once the spinal or epidural has taken effect. Depending on what medications are given, this may last several hours. The spinal or epidural may be used alone or may be used in combination with a general anaesthetic or conscious sedation. In the case of an epidural, a small plastic tube may be left in your back so that local anaesthetic and other medication may be infused for the days following your surgery to assist with your pain control.
What if I do not want a spinal or epidural anaesthetic?
If you do not want to have a spinal or epidural anaesthetic, your anaesthesiologist can discuss with you other choices for anaesthesia and pain relief after the operation, as well as their potential side effects.
Potential Complications of Spinal and Epidural Anaesthesia
Modern anaesthesia is extremely safe and your well being is our top priority. However, even in the best hands, very rarely complications may occur even when steps are taken to avoid them. Whilst our intention is not to frighten you, as part of responsible practice, we are obliged to inform you about these possible risks. If you are particularly concerned about any of these complications, please feel free to contact us before your procedure.
Nature of Regional Anaesthesia
As part of your anaesthetic management for your operation, your anaesthesiologist may suggest using a technique called a “nerve block”. Medication called local anaesthetic is injected around a nerve to the area of your operation, making that part of the body numb.
Benefits of a nerve block
Nerve blocks have many benefits including:
- Better pain relief after your surgery, especially in the first few days after surgery
- Less need for strong pain-relieving drugs such as opioids (e.g.: morphine)
- Fewer opioid-related side effects (e.g. nausea, vomiting, drowsiness, constipation, urinary retention and itching)
- Shorter recovery time after your surgery
- Possibly earlier hospital discharge
- Extremely safe procedure
How the nerve block is performed
Your anaesthesiologist has been trained to perform safe and effective nerve blocks. The nerve block may be performed while you are awake, sedated or under anaesthesia. If you are awake while the block is being performed, you may feel some discomfort as the needle is introduced. Let your anaesthesiologist know if you have excessive pain or strange feelings shooting through the part of your body being blocked. The block may be performed using:
- nerve stimulator (your muscles will twitch slightly) and/ or
- ultrasound guidance (nerve and needle are visualized, allowing a faster, more comfortable and safer nerve block)
After surgery
A “single shot” block can give pain relief for up to 24 hours. Sometimes a very narrow plastic tube called a “catheter” can be left in place to allow local anaesthetic to be administered continuously for a few days after surgery to assist with pain relief. Whilst your limb is numb, it is important to protect it from extreme hot or cold, pressure or awkward positions which may injure you without your knowledge. If you have weak or numb leg, only walk when there is somebody to assist you to make sure that you do not fall. If your limb is still numb after 72 hours (3 days) please contact your anaesthesiologist. You will be given clear instructions for discharge with a nerve block.
As the block starts wearing off, you may feel pins-and-needles in the affected area. Be sure to take some pain medication before the block wears off totally to prevent the pain coming back suddenly. Your anaesthetist will discuss with you what pain medication to take.
Do I need to do anything with the pain catheter?
If you are going to have a catheter, your anaesthetist will explain what to expect and how to manage your catheter in your preoperative consultation and you will be given clear instructions for discharge with a nerve catheter. It is important to be careful that the catheter is not pulled out since this may decrease its efficacy. If you notice redness, swelling or pain at the catheter insertion site, please make the ward staff or anaesthetist aware of this immediately since it may indicate the beginning of an infection.
What if I am still in pain?
Occasionally, a nerve block may not take away all of your pain. If your pain is not well controlled, you will be offered alternative pain medication that your doctors have prescribed.
What if I do not want a nerve block?
If you do not want to have a nerve block, you will be informed about your other choices for anaesthesia and pain relief after the operation, as well as their potential side effects.
Potential Complications of Regional Anaesthesia
Modern anaesthesia is extremely safe and your well being is our top priority. However, even in the very best hands, very rarely complications may occur. Whilst our intention is not to frighten you, as part of responsible practice, we are obliged to inform you about these possible risks. If you are particularly concerned about any of these complications, please feel free to contact us before your procedure.
Nature of Conscious Sedation
Conscious sedation aims to keep you relaxed and comfortable during your surgical procedure but you will not be totally unconscious and will still be breathing on your own. You may be aware of what is happening, or may sleep through the procedure depending upon the depth of the sedation. Your anaesthesiologist will give you some medication through a drip to make you feel relaxed and drowsy. If the procedure is likely to be painful, the sedation will be used with medication to prevent the pain. Your anaesthesiologist will remain with you throughout the procedure to ensure that your blood pressure, breathing, and other vital signs remain steady throughout. The sedation wears off quickly and so is useful for short, uncomplicated procedures. However, please remember that your judgement may be impaired for up to 24hours and you are advised not to engage in any dangerous activities (including driving) or taking care of small children during this period and have a responsible adult be with you during this time.
What if I do not want to have conscious sedation?
If you do not want to have conscious sedation, your anaesthesiologist can discuss with you other choices for anaesthesia, as well as their potential side effects.
Potential Complications of Conscious sedation
Modern sedation is extremely safe and your well being is our top priority. However, even in the best hands, very rarely complications may occur even if steps are taken to avaid them. Whilst our intention is not to frighten you, as part of responsible practice, we are obliged to inform you about these possible risks. If you are particularly concerned about any of these complications, please feel free to contact us before your procedure.
Pain relief
You may be given a prescription for pain medication to use in hospital and at home. Your anaesthesiologist will explain how to take the medication and it is very important to follow these instructions and not to take any other pain medications without your anaesthesiologist’s knowledge.
During your hospital stay you may be prescribed strong pain killers to be given by injection, either via a drip (intravenous injection) or into your muscles. These injections will be administered by the nursing staff at the hospital.
Nature of Regional Anaesthesia
Local anaesthesic agents may be placed around a specific nerve with an injection to numb the area or limb the nerve supplies. This may form part of your pain management plan after an operation
Benefits of a nerve block
Nerve blocks have many benefits including:
- Better pain relief after your surgery, especially in the first few days after surgery
- Less need for strong pain-relieving drugs such as opioids (e.g.: morphine)
- Fewer opioid-related side effects (e.g. nausea, vomiting, drowsiness, constipation, urinary retention and itching)
- Shorter recovery time after your surgery
- Possibly earlier hospital discharge
- Extremely safe procedure
How the nerve block is performed
Your anaesthesiologist has been trained to perform safe and effective nerve blocks. The nerve block may be performed while you are awake, sedated or under anaesthesia. If you are awake while the block is being performed, you may feel some discomfort as the needle is introduced. Let your anaesthesiologist know if you have excessive pain or strange feelings shooting through the part of your body being blocked.
The block may be performed using:
- nerve stimulator (your muscles will twitch slightly) and/ or
- ultrasound guidance (nerve and needle are visualized, allowing a faster, more comfortable and safer nerve block)
After surgery
A “single shot” block can give pain relief for up to 24 hours. Sometimes a very narrow plastic tube called a “catheter” can be left in place to allow local anaesthetic to be administered continuously for a few days after surgery to assist with pain relief. Whilst your limb is numb, it is important to protect it from extreme hot or cold, pressure or awkward positions which may injure you without your knowledge. If you have weak or numb leg, only walk when there is somebody to assist you to make sure that you do not fall. If your limb is still numb after 72 hours (3 days) please contact your anaesthesiologist. You will be given clear instructions for discharge with a nerve block.
As the block starts wearing off, you may feel pins-and-needles in the affected area. Be sure to take some pain medication before the block wears off totally to prevent the pain coming back suddenly. Your anaesthetist will discuss with you what pain medication to take.
Do I need to do anything with the pain catheter?
If you are going to have a catheter, your anaesthetist will explain what to expect and how to manage your catheter in your preoperative consultation and you will be given clear instructions for discharge with a nerve catheter. It is important to be careful that the catheter is not pulled out since this may decrease its efficacy. If you notice redness, swelling or pain at the catheter insertion site, please make the ward staff or anaesthetist aware of this immediately since it may indicate the beginning of an infection.
What if I am still in pain?
Occasionally, a nerve block may not take away all of your pain. If your pain is not well controlled, you will be offered alternative pain medication that your doctors have prescribed.
What if I am still in pain?
If you do not want to have a nerve block, you will be informed about your other choices for anaesthesia and pain relief after the operation, as well as their potential side effects.
Potential Complications of Regional Anaesthesia
Modern anaesthesia is extremely safe and your well being is our top priority. However, even in the very best hands, very rarely complications may occur. Whilst our intention is not to frighten you, as part of responsible practice, we are obliged to inform you about these possible risks. If you are particularly concerned about any of these complications, please feel free to contact us before your procedure.
Patient Controlled Analgesia (PCA) is a system where you will be able to administer your own pain medication either through a drip, nerve catheter or epidural catheter. The pain medication is contained a special pump which is programmed to give a specific dose should you press a button. In order to limit the risk of side effects of the medication, it is very important that you follow your anaesthesiologist’s instructions on how to use the pump. You should press the button only if you have pain and nobody else should push the button for you. Should your anaesthesiologist feel that this would be a good option for you, they will explain exactly how to use the PCA device both before and after your operation
Any additional cost implications will also be discuss.
Billing Policy
Anaesthetic fee structure
Fees charged by anaesthesiologists fall within the guidelines of the Health Professions Council of South Africa (HPCSA). Included in the anaesthesiologist’s fee are:
- the pre-anaesthetic consultation
- anaesthetic care from when you enter the operating theatre until you are able to be left in the care of a nurse in the recovery room
- specific procedures to enhance safety and provide postoperative pain relief
Factors which can influence the fee that is charged include:
- the duration of your procedure
- if your procedure is an emergency
- if specialised techniques are used to manage your postoperative pain
- if your anaesthesiologist continues your care in the Intensive Care Unit
- if your child is less than 1 year of age
- if you are older than 70
- if your body mass index is more than 35
Gwen, André and Nadine each have their own separate practice, our billing policies are aligned. Our standard billing rate is Discovery Classic, and we are contracted in with specific medical aids. If you would like to request a cost estimate for your anaesthetic bill, please fill in our cost estimate request form. The proportion of the anaesthetic account which will be covered by your health funder will depend upon what medical aid and what plan you are on. Whilst the guarantor remains responsible for settlement of the account, regardless of what portion is paid by your medical funder, we also understand that times are difficult for many of our patients. Should you be unable to pay a copayment because of financial hardship, please contact us to request the deferral of payment or make an arrangement to remit payment on a monthly basis at an agreed rate.
Informed Consent
As Anaesthesiologists we are required by the HPCSA (Health Professions Council of South Africa) to keep detailed records about our patients and their procedures. These records contain information of a personal nature. The use and processing of this information falls under the Protection of Personal Information (POPI) Act. View the PDF link not working on site
To ensure that we are fully compliant with both HPCSA regulations and POPI act, part of the consent (view consent form) which you will be asked to sign includes a POPI agreement which enables us to use your information to provide the best quality anaesthetic care.
The parts of the consent pertaining to POPI have been reproduced below for your information where you will be asked to give consent for:
- Your medical records being kept and transferred in digital format.
- Your personal information is stored in a secure location and is accessible to third parties only with signed confidentiality clauses as part of their employment agreements/ contracts.
- Your personal information collected in terms of this consent to be utilised for healthcare of the patient, billing and collection of debt as well as processing of queries, complaints or compliments and may be forwarded to the relevant health care professionals or organisations as required by law.
- Sharing of information on your account information with your medical funder, with other credit grantors and with the credit bureau.
- Your personal and clinical information to be shared with other persons or institutions (e.g.: medical scheme) if this is necessary to serve a legitimate purpose within the ordinary course and scope of the anaesthesiologist’s duties, provided such disclosure is in the patient’s interests.
- The release of any clinical information, including the patient’s HIV status, to any other member of the medical/ paramedical profession responsible for your safety and treatment.
- The processing of your health and personal information in order to provide you with proper treatment, care and/or for the administration of the institution or professional practice concerned. This consent would extend to responsible parties acting as service providers to the institution or the professional practice concerned.
- The sharing of patient, guardian and guarantor information with the South African Society of Anaesthesiologists CEO and its Private Practice Business and Regulation Business units in the event of a complaint (which information will be kept confidential within the SASA CEO, Private Practice and Regulation Business Units).
- Communication with your family/ nominated others with respect to your medical care and medical account.
- Anonymous data of a clinical (including anonymised ultrasound images) and practice management nature to be collected and used in published or unpublished research, clinical audits, quality control, teaching and training.
We may use your anonymous data of a clinical and practice management nature to be collected and used in published or unpublished research, clinical audits, quality control, teaching and training. This could include anonymised ultrasound images. Whilst your data will assist with research, it will be impossible to trace any data or images to you and confidentiality will be maintained.
Should we require the use of anonymised photographs, we shall contact you for express written permission before using photographs for any research, publications, presentations, teaching or training. Any images will be used only in accordance with international standards for patient confidentiality and you will have the option to opt out at any time.
We strive to use up-to-date, evidence based medical practice and employ state-of-the art equipment.
The following links may provide useful additional information.
These links are external and Syncerus has no control over their content.
We are fully qualified doctors with years of training exclusively in the practice of anaesthesia, intensive care and pain management, resuscitation and advanced life support.
Contact Us
044 630 0660
info@synceruscare.co.za
Postnet Suite 204
Private bag x 6590
George
6530