National Anaesthesia Day Success Stories
October 14 2016
National Anaesthesia Day Success Stories
Monday October 17 is National Anaesthesia Day. Northland District Health Board is sharing stories of Northland patients who have benefited from regional anaesthesia during surgery plus insights from Anaesthetist Dr Fred Muller after 30 years of practice.
Anaesthesia Now Safer and More Selective – Dr Fred Muller’s 30 years of insight
Anaesthetist Dr Fred Muller, who will retire this November, has seen changes in the role of anaesthetists over three decades at Whangarei Hospital.
Fred came to Whangarei Hospital in February 1986 from South Africa. Fred says in the 1980s Pentothal was most often used, and ‘putting people to sleep’ was the main conception of how general anaesthetic should be used. Today when a general is required, Diprivan allows patients to awake clear-headed with less likelihood of nausea, and when it comes to regional anaesthetic the use of ultrasound-assisted procedures allows anaesthesia to be put into a patient’s body with extreme precision.
Other changes over the years have included the arrival of the laryngeal mask airway meaning direct vision isn’t necessarily needed to secure the patient’s airway, the advent of nurse-led Pre-operative Assessment Clinics and ‘Pain Rounds’ in which nurses plan post-operative pain management “to optimise patients’ comfort, recovery and mobilisation.”
“In the past the recovery room was little more than somewhere for patients to ‘sleep it off,’” Fred says, but now the Post-Anaesthetic Care Unit diligently manages patients’ awakening, airways, local anaesthetic infusions, blood pressure and pain scores.
Fred agrees National Anaesthesia Day is successfully correcting misconceptions about the role of anaesthetists and fewer patients express surprise when hearing their anaesthetist has undergone as rigorous and lengthy a training as any surgeon.
Anaesthesia Allows Surgery While Wide Awake
In August, patient Robert Danks benefited from an anaesthetic in his arm so controlled that it allowed surgeons to cut into his tendons, fix a cord of skin which was bending Robert’s fingers, take a thick skin graft from his arm and apply it to his hand – all while the patient was wide awake.
Robert was given an axillary nerve block for the operation to relieve Dupuytren's contracture, which is a hand deformity affecting a layer of tissue lying under the skin of a person’s palm.
An axillary nerve block means anaesthesia is injected around a precise nerve in the axilla, near the armpit, to numb any one of several discrete areas of the hand and arm.
“The anaesthesia was pretty painless. Within 10-15 minutes the arm was numb,” Robert says. “I was wide awake during the surgery. They put a cover between my head and my arm so I couldn’t see what they were doing. I didn’t feel a thing.”
Quick Recovery from Caesarean Section
Danielle Lastotchkine-Pelsky of Maungakaramea had a Caesarean section under spinal anaesthetic in August. A spinal anaesthetic is an application of regional anaesthesia designed to numb everything below the chest area so women can enjoy seeing the delivery of their child with minimal pain.
Danielle’s spinal helped keep her calm and safe while giving birth to her baby girl Everly Vienna Drake on August 24.
“I have a massive fear of needles and so I was quite scared about going into the process,” Danielle said. “Being awake during surgery was going to be a new experience for me.”
“The anaesthetist, Sharon Dempsey, made me feel calm throughout and at every little step she kept me informed of what was happening and made me feel at ease and held my hand.
“When Everly was coming out of my stomach I was able to look over the curtain to see her. My partner Lochlan was allowed to take photos of her coming out and cut the cord.”
Spinal and epidural anaesthetic are different, although both are types of regional anaesthetic. A spinal is usually used for a planned Caesarean section. An epidural is used for labour pain relief and can be converted to anaesthesia if needed by adding stronger local anaesthetic.
Epidural Allows Swift Recovery After Serious Surgery
Lionel ‘Barry’ Moor of Kaikohe had an epidural as well as general anaesthetic in August and said it resulted in zero pain when he awoke after almost eight hours of surgery.
An epidural is applied via
a thin plastic tube which placed in the epidural space just
behind the spine. Local anaesthetic numbs the nerves as they
leave the spinal cord.
Barry needed surgery for a hernia which occurred after earlier gall bladder surgery.
“This is the first time I’ve had an epidural and I swear by it now,” Barry said two days after the surgery. “I woke up feeling more refreshed than expected. The biggest [benefit of an epidural anaesthesia] was no pain afterward. None whatsoever.”
An epidural was a good option for pain relief for Barry because of the size and location of his hernia. The epidural stayed in Barry for 3-4 days, with local anaesthetic solution running into it, using a pump to carefully control the rate. Barry was monitored throughout by a trained nurse and followed up daily by the pain service to reduce the risk of side effects and complications.
“I need an ankle operation soon and I will certainly be choosing a general anaesthetic with epidural.”