Sub-topics

When are you going to start ?
What will I see ?
What will I hear ?
What will I say ?
Will I be in pain ?
Will I feel sick ?
Wil I be cold ?

When are you going to start ?

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This is the question most often asked by patients when they are regaining consciousness in the recovery room, although the operation is now over. The reason probably lies in the fact that general anaesthesia is really a state of ‘suspended animation’. During this state, many body functions are temporarily changed. One of these functions is that of the ‘clock’ that all of us carry within us. This clock gives us the ability to know that time has passed. For example, when we awaken in the morning from a normal night’s sleep, we usually know that we have slept for some time. With general anaesthesia, this ability to tell that time has passed seems to be temporarily blocked. We are not sure how or why this happens, but the effect seems to last only as long as the state of unconsciousness.

What will I see ?

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At first your vision is likely to be somewhat blurred. It is not uncommon to see more than one nurse or anaesthetist, despite the fact that only one is present at your bedside! Gradually you will be able to focus better. Although it is reassuring to be able to see clearly, many hospitals do not recommend that you take your glasses with you to the Operating Room. (This is because of the possibility that they might be mislaid or dropped while you were unconscious.) In that case, you would not be able to wear your glasses until you returned to the ward. Some hospitals do allow you to keep your spectacles with you.

If the hospital allows your relatives to be with you in the Recovery Room, it may be best to leave your spectacles with them. (Some hospitals do not allow any visitors in the Recovery Room.) If your child normally wears glasses, then it is a good idea to have them available, so that the Recovery Room nurse can give them to your child as he or she awakens.

What will I hear ?

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In general, your hearing will not be significantly affected, although you may well forget instructions that are given to you during the early recovery period. Some people complain that sounds are louder than normal, but this is usually only temporary and is due to complex interactions between the various anaesthetic drugs and your hearing mechanism. A few patients may develop sudden loss of hearing in one or both ears after an anaesthetic and operation. One reason for this problem is the effect of pressure from the nitrous oxide on the eardrum and Eustachian tube (inside the ear). These patients may complain of pain and / or clicking and popping in the ear, like that which occurs in an aeroplane when climbing or descending. Very rarely, the mechanism of the hearing loss cannot be explained and hearing may or may not recover. However, this complication is extremely rare.

If you normally wear a hearing aid, you may choose to leave it in during the operation. This can be helpful if you have significant hearing loss and are having your operation under regional anaesthesia, when you might need to hear what your anaesthetist is saying to you. Other patients might choose not to wear their aids, especially if they fit loosely and do not provide good hearing. Some patients would prefer not to hear anything that goes on in the Operating Room or the Recovery Room and therefore leave the aids at their bedside.

What will I say ?

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You may say all sorts of things, mostly related to your sense of disorientation or your surprise at being awake so soon. You may refer to pain or other discomfort, which can then be treated appropriately. Occasionally, patients say suggestive things to their medical or nursing staff, because the effect of the drugs is to temporarily remove some inhibitions. This is very uncommon, and if it does occur, it is always treated with discretion. This type of reaction lasts only a brief time and patients have no memory of the event. If relatives are present, they should not be concerned.

Will I be in pain ?

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Your anaesthetist endeavours to ensure that you are as pain-free as possible at the end of your operation or procedure. This is not always easy to achieve. Some of the anaesthetic drugs provide some pain relief, but need to be stopped at the end of the anaesthetic so that you regain consciousness. A number of techniques are used to control postoperative pain, most being started during the anaesthetic. These techniques can be modified as necessary in the early postoperative phase in the Recovery Room, so that you have the maximum possible comfort. With some conditions, however, complete obliteration of pain may not be possible without risk of complications, especially where control of breathing may be affected.

Will I feel sick ?

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You may feel nauseated and it is not uncommon for patients to vomit or ‘dry retch’ once or twice in the Recovery Room. Often this will bring up some mucous or bile-stained fluid, and is usually the only time that vomiting occurs, although some nausea may continue. Your anaesthetist may have given you some anti-emetic drugs during the anaesthetic if vomiting is thought likely to be a problem. Even if an anti-emetic has not already been given, it is not too late to administer some in the Recovery Room, and the nurse will arrange for it to be given.

Will I be cold ?

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You may feel cold, and shivering is not uncommon in the Recovery Room. This is due partly to the fact that anaesthesia decreases the body’s ability to maintain a normal temperature, resulting in loss of body heat. Shivering is also due to some of the anaesthetic drugs that ‘switch on’ the shivering mechanism in the recovery phase.

In recent years, much more attention has been paid to ensuring preservation of body heat during surgery so that postoperative shivering is now less common. Devices such as warm water mattresses, warm air blankets, insulation wraps, and warmers for intravenous fluids and anaesthetic gases have contributed to this improvement.