Haere mai! We would like to help you to be prepared for your upcoming anaesthetic. Once you receive your surgical letter, it will confirm the facility (Auckland City Hospital or Greenlane Clinical Centre or an outsourced private surgical facility) that has been allocated for your operation.

The information about your operation, and advice on how to prepare for it, is in the document below. The specific advice is dependent on the location of your operation, so please be sure to read the relevant information for your situation. 

Take special note of when you need to stop eating and drinking, and if you have any special instructions regarding bloods tests or any routine medication.

Your experience is important to us, please speak with your Doctor or Nurse if you have any questions or concerns.

If your operation will take place in a facility other than Auckland City Hospital or Greenlane Surgical Unit, please follow the instructions of the surgical booking team.

• Information for your operation (PDF, 1.2 MB)
  

  For surgery at Te Toka Tumai Auckland facilities (Auckland City Hospital or Greenlane Clinical Centre), please read this booklet.

Labour can be a very personal and emotional experience, and therefore is not always the best time to receive information or make a decision about pain relief such as an epidural.

We feel it is better to give information in advance so you can make an informed decision and create a birth plan that suits you.

We are offering a free hour long talk by an Anaesthetist at 7.30pm on selected Mondays. Please see the link below for the dates.

Common questions that are discussed at the talk include:

• What options are there for pain relief in labour?
• What does an epidural involve?
• Can everyone have an epidural?
• Who performs the epidural?
• Is having an epidural painful?
• How long does it take to work?
• Does it always work?
• How long does it work for?
• When should I have my epidural?
• Will the epidural affect my baby ?
• What are the side effects or complications of having an epidural?
• What if I need surgery?
• What are spinals?

How to Book

As numbers are limited, bookings must be made for the talks. Phone Olivia Tapuosi on (09) 307 4949 extension 23781 during office hours to book.

Please sign in at the 5th floor reception area at Auckland City Hospital, Park Rd, 5-10 minutes before 7.30pm on your designated evening. You will be met by an anaesthetist who will take you to the room where the talk is to be held.

• Labour Pain Relief Information Evenings 2023 (PDF, 654 KB)
  

  Information evenings about pain management options for labour at Auckland City Hospital - dates and location

• Labour Pain Relief Information Evenings 2024 (PDF, 640.9 KB)
  

  Information evenings about pain management options for labour at Auckland City Hospital - dates and location

If you have been invited to attend an appointment at the Women’s Health Pain Clinic at Greenlane Clinical Centre, below is a printable information leaflet about the clinic. There is also more information about the Women's Health pain service on this website: Pain Clinic | Te Whatu Ora (adhb.govt.nz)

• Women's Health Pain Clinic (PDF, 485 KB)
  

  This information sheet provides some additional information about what to expect when you attend your appointment, the services we can offer, and the information you may be asked to provide.

Anaesthesia is essential for all surgery. 

Our job is to facilitate pain-free surgery and to ensure the safety of the patient before, during and after the surgery.

We will always tailor and deliver the safest anaesthetic for you. 

Often, a number of choices of anaesthetic techniques will be equally safe and effective for the surgery you are about to have.  We will discuss the options with you and value your input into the final decision on the actual anaesthetic you receive.

The more informed you are and the more you input into the details of the anaesthetic, the more comfortable you will be.  We will always be there to support your decision and guide you towards the safest and most comfortable anaesthetic experience.

Below you will find a list of different anaesthesia techniques and some short explanations of how they work, when they might be appropriate and potential risks. These are broad descriptions only. The decision regarding appropriate anaesthesia modality(ies) for your specific surgery is always made on a case-by-case basis.

A combination of medications are given to make you unconscious.  Although often referred to as "sleep", this unconsciousness is very different from your nightly rejuvenating sleeping.

Medications are given to you through your veins using the intravenous cannula that will have been placed, and maybe through your lungs, using a breathing tube that we place after you have become unconscious.  This breathing tube also ensures you do not snore while you are unconscious. 

Anaesthetising a patient can take anywhere from 10 minutes upwards.  We make sure the patient is safe and fully anaesthetised before we allow surgery. The surgery then takes as long as necessary.  There are a lot of changes in the body while it is undergoing surgery; managing these changes and ensuring your safety is the anaesthetist's sole responsibility while the surgeon concentrates on doing the best surgery possible.

When the surgery is finished, the anaesthetic process is reversed while the patient is still in the operating room. After the patient has stabilised they are then transferred to the Recovery Room (PACU) and further monitored to ensure that they remain stable.  Patients will usually spend an hour in the PACU area prior to being returned to the ward. 

Modern anaesthesia is extremely safe.  We now have medication that is very well tolerated and short-acting. This  allows patients to have a minimal "hangover" effect from the anaesthetic drugs themselves, and enables the body to concentrate on recovering from the surgical process.

Some common unwanted effects can occur after surgery and these may be due to our anaesthetic medications, the surgical process, your position while having the surgery, the reason for you needing the surgery or a combination of all of these things.

After cleaning and application of a local anaesthetic, we slowly introduce an epidural needle through the skin and ligament of the spine, ultimately into the "epidural" compartment of the spinal column. Usually we then place a tiny catheter into this space through which various agents can be administered to provide pain relief or lower-body anaesthesia. Epidural anaesthesia is performed many dozens of times a day around the Auckland region and is known to be extremely safe and effective.

After cleaning with an antiseptic solution and application of local anaesthetic a very fine needle is introduced into the fluid surrounding the nerves below the spinal cord.  Local anaesthetics and/or opioids are placed into this fluid, which then numbs the lower half of your body to allow the surgery to be pain free. 

After cleaning with an aseptic solution, either a nerve stimulator or an ultrasound machine is used to locate the nerves supplying the area for surgery.  Local anaesthetic is then placed near the nerve and the area will go numb.  The surgery can occur without pain.  There may still be some sensations of movement and pressure.

• Regional Anaesthesia Information Brochure 2023 (PDF, 472 KB)

Local anaesthetic is introduced directly around the area to have surgery and the site goes numb.  Only relatively small areas can be numbed up like this; therefore the limb or area of the body outside of the local anaesthetic retains all its functions.  There may still be movement and pressure sensations; but enough local anaesthetic can be given such that no pain is felt.  This type of anaesthesia is usually supplied by the surgeon doing the surgery.

After placing an intravenous line, we are able to supply medications that allow you to become more relaxed.  In the peri-operative context this is usually used in conjunction with some other form of local anaesthesia.

Common unwanted side effects

• Nausea and/or vomiting - this is a common side effect which may be due to the surgical process or anaesthesia. If you have previously had nausea or vomiting, please inform your anaesthetist as there are various ways of addressing this problem. 
• Headache - There are many different causes for this ranging from not having had your normal morning coffee; to being thirsty and not having enough liquid to drink.  After a spinal or epidural anaesthetic there is a risk of developing a "post-dural puncture headache" which will need anaesthetic input to diagnose and treat.
• Sore or dry throat or lips - this is because of the dryness of the anaesthetic gases, including the oxygen you need to be given.  Breathing tubes placed past your throat while under general anaesthetic can also contribute. It is often worse if you have even a mild cold, and will usually respond well to having small sips of cold water.
• Pain and/or bruising can occur at injection sites as we need to use a needle to insert our cannulas. 
• Tingling and numbness in a part of your body that was given local anaesthetic.  After spinal/epidural or nerve blocks it is reasonably common to have "pins and needles" or areas of numbness as the nerves recover from the local anaesthetic.  The vast majority of these feelings will have gone totally by six months after the surgery.

Less common unwanted side effects

• Muscle aches and pains - these can be caused by having the surgery, having to lie still for the length of the surgery or even by our anaesthetic medications.
• Weakness - this is often a reflection of your body recovering from the surgical process.
• Mild allergic reaction - itching or a rash.  The itching may well be a side effect of the medication we give you to make you comfortable from a pain point of view.

Uncommon unwanted side effects

• Awareness under general anaesthetic - being paralysed but awake during surgery. Anaesthetists always try very hard not to have this happen, and with modern monitoring equipment it now happens exceedingly rarely.  If you have any concerns please mention them to your anaesthetist.
• Damage to teeth, dental prosthetics and lips - again we try very hard to not have this happen but when we put in the breathing tube every patient is different and damage may occur.
• Damage to the voice box and chords causing temporary loss of voice.
• Allergic reactions - if you are aware of medications that you have reacted to in the past, please make us aware of this.  Even if you have told other people who are caring for you, this is the type of information that cannot be repeated too often.  If an allergic reaction occurs during your anaesthetic, your anaesthetist is taught how to handle this and after you recover they will refer you to an allergy testing clinic to ensure we identify the medication that you must never have again.
• Blood clots in the leg - much like the ones developing during long airline journeys. 
• Damage to nerves, pressure areas and even paralysis - we do protect you to prevent these but they can still happen after a regional or a general anaesthetic. 

Very rare and infrequent events that may cause death or paralysis

• Severe allergy and shock
• Very high temperature as a result of a genetic reaction to our anaesthetic
• Stroke or heart attack
• Vomit in the lungs
• Blood clots in the lungs
• Blood clots in the back
• Brain injury
• Nerve injury that is permanent.

We strive to avoid all untoward events, and we are also trained in managing untoward events, so that if anything does happen it is the anaesthetist that will manage them and guide you through the recovery process.  Please feel free to contact the Anaesthetic Department if you are at all concerned after you have had an anaesthetic.

The risks of anaesthesia are increased by or in:

• Elderly patients
• Bad cold or flu, asthma or other chest disease - the risk of this extends for about 6 weeks after the event
• Smoking
• Obesity
• Diabetes
• Heart disease
• Kidney disease
• High blood pressure
• Other medical conditions.