Anaesthesia

Some might remark that bad surgery can maim, but it is bad anaesthesia that kills!

Mr Bloomfield mostly works with a single anaesthetist (Dr G. Vora) and this association spans several years. Dr Vora is skilled in the administration of combined spinal and epidural (CSE) anaesthesia, which is supplemented by intravenous sedation. The patient wakes up to be alert and pain free within minutes. The grogginess, nausea, sore throat and disorientation so often associated with general anaesthesia is almost completely abolished.

Using this technique, the patient is asleep, but not anaesthetised. (Actually a few brave souls have asked to stay awake despite the noise and hammering!) Patients are not aware of their surroundings. Patients breathe normally on their own, and there is no need for a tube down the throat.

Post-operatively, the epidural provides sustained pain relief, which is maintained by the slow infusion of local anaesthetic through a fine cannula (or tube) placed in the back. It sounds worse than it really is in practice!

Epidural or regional anaesthesia lowers the tissue perfusion pressure in the lower limbs- this tends to reduce intra-operative bleeding and therefore the need for post-operative transfusion. By a similar mechanism, the rate of deep venous thrombosis (DVT) is also reduced. Reducing DVT rates lowers the risk of clots breaking off to form emboli. Pulmonary emboli are potentially fatal.

The regional or CSE anaesthetic technique 'hides' the operation from the rest of the body until the epidural is removed the following day. There is less release by the body of stress hormones that can place a strain on the heart and other vital organs.

We have noticed a dramatic fall in the number, scope and seriousness of post-operative complications with use of the techniques described. Only one patient in twenty will require a blood transfusion. Most patients are suitable but there will be exceptions. Please speak to Mr Bloomfield or ask for Dr Vora if you would like to know more.