Have you ever wondered what an anaesthetist does? As in, really does?
One thing’s for sure: if you’re due to have operation in the near future, you’re certain to meet one.
Anaesthetists are a little like car engines. They may not necessarily be the first thing you think of, but you won’t be going anywhere without one.
So what role will they play in your operation? Meet Dr Stuart Batistich, one of our trusted anaesthetists here at Chris Bailey Orthopaedics. We asked him to explain more about how the discipline works.
Stuart, welcome to the blog.
Thank you. It’s a pleasure to be here.
Do we detect a trace of non-Hampshire in your accent?
I’m Australian! I originally trained in Melbourne. Then I went travelling around the world and met my wife – an English rose! I’m still stuck here 20 years later.
Why did you become an anaesthetist?
As a junior doctor, it was the anaesthetists who always seemed to have an air of calm about them – even in emergency scenarios. They’d come in, take over the airway – it felt reassuring when they turned up. I think that’s what drew me.
In a nutshell, what is anaesthesia?
Think of it as a triad. One part is sending to sleep: ‘hypnosis’. Another is pain relief: ‘analgesia’. The third part is relaxing the muscles: ‘paralysis’. But not every operation needs all three of those things.
What’s the most common misconception about your role?
That all we do is knock people out and wake them up again! We see patients beforehand: to discuss the best options for their procedure, to calm nerves. Also a lot of my work is ‘awake surgery’, so I’ll be chatting to patients during their operation. I’ll put music on for them, even let them choose a movie to watch with some procedures. Then afterwards I’m helping them with the right course of pain relief. So we take patients through the whole journey.
In operations, is it a case of one-drug-fits-all?
No: 99% of people will receive a standard anaesthetic, but every case is tailored. Let’s say you’re in a lot of pain before your operation. You’re probably already taking a strong painkiller like Cocodamol. That means you’ll be resistant to the standard painkillers. In that case we would make sure you’re given extra pain relief to make you comfortable.
Do different anaesthetists use different anaesthetic techniques?
Yes. Some predominantly use gases. Some use intravenous (IV) drips. Personally, I use IVs both for putting people to sleep and for administering pain relief. That requires specialist machines for dosage, and we’re fortunate enough to have them in our hospitals.
Some people find that painkillers make them feel sick – what happens then?
In those cases we might do something called a nerve block; that’s an injection to an individual nerve to switch off its pain signals. It gives really good pain relief for the first 24 hours, but without the sick feelings.
Do patients ever want to avoid ‘going under’?
Quite regularly with operations on the upper limb and joint replacements on the knee and hip, where general anaesthesia is not needed. There we might do a localised nerve block or spinal anaesthetic with a sedative to relax them during the procedure. Sometimes patients say, “I’m desperate not to feel any pain at all.” For them, a nerve block with a general anaesthetic might be best. So it’s about discussing the options, working out what’s best for each patient.
How long does it take for a general anaesthetic to wear off?
It’s very variable. A drug might make one patient feel brilliant in recovery, while another doesn’t feel great for a couple of days. The drugs we use these days tend to act rapidly and wear off very quickly. It usually takes between two and 20 minutes to wake up from an operation, and a few hours to wear off completely, depending on the anaesthetic and surgical procedure.
You sometimes hear scare stories about waking up in theatre. Is that a genuine risk?
It’s incredibly rare. In most operations it would be very obvious if a patient were waking up: their blood pressure and heart rate would shoot up and they would start moving well before being ‘awake’. Also, we have very high quality monitors these days; tests like electroencephalograms (EEG), which tell us when the brain is asleep, and when it’s waking.
What do you love most about the job?
It’s the satisfaction you get from seeing patients happy after their operation. People often say to me, “I was so nervous, but it turned out to be brilliant. It was nothing like what I was expecting.” Maybe they were waiting months for this operation, feeling massively anxious. Now they’re on the other side, it has gone well and they can get on with life. That’s a great feeling.
Any regrets about swapping Aussie for Hampshire?
I sometimes miss the weather and the outdoor living! But there are so many great things about the UK. I have a family here now. I also love the summers. I run a medical cricket team in my spare time. We’ll often play on pristine village pitches, then go off to a lovely local pub to mull things over for the long summer evening. That’s absolutely fantastic.
Stuart is just one of the many experts who keep Chris Bailey Orthopaedics running smoothly. You can find out more about Chris and his team on our website, or call in to book an appointment with us today.