Anaesthetic Account:

1. As independent medical specialists the services we render attract a fee that will be billed completely separately from the hospital and the surgeon. This fee is based on the duration of the case and may change with unforeseen events.
2. Our fees represent the service that has been delivered and are independent of the fees set by medical funders. Your medical aid may not cover all the fees charged by this practice; in which case you will have a co-payment for this anaesthetic. This practice has payment arrangements with Discovery (Classic), Polmed (Aquarium and Marine) and RFMCF. If you are a member of one of these medical aids and plans, you should not have a co-payment.
3. It remains the responsibility of the patient or elected accountee to ensure timely settlement of this account. Failure to settle accounts timeously may lead to additional debt recovery & legal costs, including interest at 15,5% per annum.

Feel free to contact us to enquire about co-payments or for a cost estimation.

Before and after your anaesthetic

During your pre-anaesthetic consultation with your anaesthetist, please disclose any medical conditions, chronic medications (including homeopathic medication and recreational drugs) and allergies. Please continue ALL chronic medications (except blood thinners) with a small sip of water on the day of surgery, unless expressly told not to.

It is extremely important that a patient’s stomach is empty before an anaesthetic to ensure their safety: inhalation of stomach content during anaesthesia may be life-threatening. Here is a guide of what is allowed at what time before your procedure:

• 6 hours -any solids (this includes food, dairy, carbonated drinks, juice with pulp).
• 4 hours - breastmilk (no other milk)
• 2 hours - clear fluids (water, apple/grape juice, black tea/coffee WITHOUT milk, non-carbonated energy drinks)

If you are returning home on the day of your procedure, you need someone to escort and drive you home, look after you and be able to return you to hospital if needed. You are not allowed to drive, operate heavy machinery, sign contracts, or make important decisions within the first 24 hours after your anaesthetic.

Please seek medical help if you experience chest pain, shortness of breath, altered touch sensation, muscle weakness, incontinence, headache, neck stiffness, fevers, rigors, voice changes or severe nausea and vomiting

Someone from the anaesthetic practice may phone you after your procedure as part of a routine check-up.

Types of anaesthesia

The choice of your anaesthetic depends on the type of surgery, your general health and preference, as well as the preference of the surgeon. Your anaesthetist will discuss the different options available to you after considering abovementioned factors.

Sedation: The patient is lightly asleep and can easily be roused. The patient may become aware of their surroundings. This is often used for Gastroscopies / Colonoscopies and for certain ortho-paedic procedures e.g. Carpal Tunnel and Trigger finger release.

Regional anaesthesia: A certain part of the body is anaesthetised for pain relief and surgery is done with patient either under general anaesthesia, sedation, or completely awake. This includes epidural, spinal and limb blocks. Commonly used for Caesarean Sections.

General Anaesthesia: The patient is deeply asleep under anaesthesia and can only be awakened once the anaesthetist stops administering the anaesthetic.

Monitoring: before you receive your anaesthetic, certain monitors will be placed on you. These may include ECG stickers on your chest, a blood pressure cuff around your arm, a finger saturation probe, stickers on your forehead to measure anaesthetic levels and in some specific cases extra drips in your wrist or neck.

The most important monitor is the anaesthesiologist who vigilantly monitors all your bodily functions (including breathing, heart rate and blood pressure), ensuring these remain within normal limits while the surgeon performs the procedure.

At the end of the procedure the anaesthesiologist wakes you up and transfers you to the recovery room or ICU, where you are further monitored until fully awake and stable.

Risks of anaesthesia

Despite constant vigilance and best anaesthetic practice, no anaesthetic is risk free. The following list is not complete, but contains some of the more common, but also more serious (although much rarer) complications. Speak to your anaesthesiologist if you require more information.

Risks in general:

Complications at injection sites, including bruising, bleeding, infection, nerve injury, scarring or even limb loss.

Injections in the neck, shoulder and chest may cause puncture of the lung (pneumothorax), necessitating placement of a tube between the ribs inside the chest to remove the air around the lung.

Allergic reactions (including malignant hyperthermia) may occur, which, if severe, can lead to cardiac arrest and death.

Nerve injury caused by positioning on the theatre tables may occur, which may lead to partial/complete numbness, paralysis, or blindness.

Bleeding during your procedure may necessitate a blood transfusion. Transfusions are not without risk (including allergic reactions or infections).

Blood clots may cause serious (even life-threatening) complications.

Risks of General Anaesthesia:

Nausea and vomiting.
Damage to eyes (including artificial eyelashes and makeup), lips, teeth, mouth, nose, throat and airway while placing the breathing tube under anaesthesia may occur. Surgical cleaning solutions may cause temporary or permanent blindness if in contact with eyes. Awareness under anaesthesia has been described.

Risks of Regional Anaesthesia:

All the regional anaesthetic agents can cause direct injury to, bleeding in/around, inflammation or infection of the spinal cord or nerves, leading to loss of sensation and paralysis of the specific body part, incontinence, impotence, or quadriplegia.

Eye blocks may rarely lead to partial/complete blindness.

Limb blocks can affect nerves other than those intended to be blocked, causing hoarseness, drooping of eyelids or difficulty breathing. This usually wears off with the block.

Spinal/epidural block may lead to difficulty urinating which requires placement of a urinary catheter. The block may spread to your arms and breathing muscles, leading to shortness of breath and requiring assisted breathing. Your blood pressure may drop making you feel dizzy or nauseous, but this is easily treated. Severe headache may occur after spinal/epidural and can be treated. In severe cases the treatment involves placing another epidural and injecting blood into the epidural space.

For more info on anaesthesia, visit: https://www.rcoa.ac.uk/patients/patient-information-resources
or follow this link: https://www.dropbox.com/sh/iq43p2g813uz7vy/AADMC0ZDwO6tHrJys8PEy4Woa?dl=0