ANXIOUS ABOUT ANAESTHESIA?

ASKING QUESTIONS CAN HELP YOU LOSE FEAR The thought of undergoing an operation under anaesthesia can be frightening. It’s an extreme form of losing control, putting yourself entirely in the hands of another person. Experts recommend asking as many questi

If you find the thought of anaesthesia frightening, don’t worry, you are not alone. “I totally understand that,” says Frank Wappler, a professor of anaesthesiology. After all, you put yourself entirely in the hands of the anaesthetist. Many patients worry they won’t wake up after an operation, or that they won’t be unconscious during the procedure, he says.

What people really fear is the loss of control, according to Irmgard Pfaffinger who heads a German psychotherapy association. “I am completely at the mercy of another person. I can’t even breathe myself and have to rely on the anaesthetist to ensure I have the right amount of air.”

The prospect can be especially frightening for people about to have their first surgical operation. “For them it is something entirely new, and we all have a certain fear of something new,” Pfaffinger says.

It also depends on the kind of person you are. Some are more anxious, while others are able to trust the anaesthetist will do everything right.

BUILDING TRUST

This is a way to let go of your fears and worries. The time to do that is in a preliminary talk with the anaesthetist that takes place before all operations. Ideally, it’s a chance to meet the anaesthetist who will take care of you in the operating theatre. It is very important that patients are allowed to ask anything that they are worried about during that preliminary discussion.

The anaesthetist too may have many questions, concerning the patient’s body size, body weight, allergies and illnesses. All that information helps them to ensure you have the right dose of anaesthetics. “If someone is a chronic pain patient, for example, we often need a higher dose of painkillers,” says Wappler.

The meeting is also a chance for the anaesthetist to describe all the steps in the process, covering what exactly happens, when it happens and what side effects there might be. “This is the first step towards trust,” Wappler says.

Being better informed will help you relax ahead of the operation and on the day.

“If a patient knows beforehand exactly what is going to happen, and then it happens that way, that is reassuring,” Pfaffinger says.

If you’re very anxious, that is something to bring up in the preliminary discussion. Usually, the patient won’t be given sedatives anymore. “But if someone says, ‘I’m a very anxious person, can you give me something to calm me down?’ then we can start to help with medication the evening before the operation,” says Wappler.

You will also find that many anaesthetists have a friendly and empathetic manner and that can help if the patient starts to feel anxious, right before they lose consciousness. The anaesthetist may engage patients in small talk, to help distract them from the process, says Wappler.

He wants patients to know one thing: “You are the centre of attention here like hardly anything else in life.” During an operation, a whole team of specialists is focused entirely on just one patient.

The anaesthetist only handles the anaesthetic. They first give the patient a painkiller, then a sleeping pill. Depending on the operation, they might also add a muscle relaxant.

The first drug has a rapid effect. “With the painkiller containing morphine, you already notice that people relax, that they become physically calmer. Their heart rate and blood pressure normalize,”says Wappler.

With the sleeping pill that follows, the patients then quickly doze off. There is no chance they will feel something during the operation, Wappler says. “We stroke the patient’s eyelashes and see if they blink — a reflex. When they don’t, they are fast asleep.”

The doctors also handle the patient’s breathing, with devices to monitor their blood pressure, heart rate or oxygen saturation and raise the alarm if needed.

The anaesthetist is constantly alert. “If someone starts to sweat because they don’t have enough fluids or because they are stressed, I can immediately take corrective action,” says Wappler.

Most people don’t want an operation at first, but he advises patients to welcome anaesthesia as a blessing of modern medicine.

And, he says, plenty of patients wake up feeling relaxed and say, “I have never slept as deeply as I did then!”

BEING BETTER INFORMED WILL HELP YOU RELAX AHEAD OF THE OPERATION AND ON THE DAY. IF A PATIENT KNOWS BEFOREHAND EXACTLY WHAT IS GOING TO HAPPEN, IT IS REASSURING