Before you go to sleep
If you haven’t already met your anaesthetist you will meet them either in the admissions area or in the anaesthetic room on the day of your surgery. At this stage if you have any concerns or worries about your operation or anaesthetic please let them know.
Once in the anaesthetic bay you will have an intravenous drip placed and often you will be given a sedative medication just before going into the operating theatre. You will not remember much after being given the sedative. Once inside the operating theatre routine monitors will be placed (these monitor your blood pressure, heart rate and breathing patterns). you will be given an oxygen mask and then receive another injection through the drip. This injection will be the anaesthetic medicine that induces unconsciousness. The next thing you will remember is waking up either in the recovery room or in the operating theatre.
During the operation your anaesthetist will remain with you the entire time monitoring your operation, your anaesthetic and all your vital physiological functions. They stay with you continuously until you reach the recovery room, where your care will continued by a recovery nurse. While you are in recovery if you have any discomfort or feel nauseated or sick it is important that you let the recovery staff know. They can administer pain killers or anti nausea drugs if they are required. The aim is to have you comfortable when you leave recovery for the post op ward.
Your Stay in Hospital
Generally speaking most people will stay 6-8 hours or overnight in hospital with your intravenous drip in to give you fluid and medications. Most patients generally have a pretty good stay in hospital and indeed generally have a good first 24 hours in terms of pain and discomfort, however if you have any discomfort please let the nursing staff know. The next morning most patients will be discharged home. If your operation is early in the day it will be possible for you to go home on the same day. When you go home we generally suggest asking the nursing staff to give you a disposable vomit bag for the car ride home. Whilst it doesn’t sound elegant, the motion of the car not infrequently can make you feel a bit nauseated.
Once home at some stage during the first day you will start to get some discomfort in your throat. This will generally get worse for 4 -5 days and then settle over the next week. During this time you will most likely need regular pain medication and it is not unusual to require them for up to a week or more after the operation. During this first week it is very important to remain well hydrated and to eat regularly, as drinking and eating help to keep the back of your throat clean and help it to heal.
It is common that you will need pain medication for up to a week after your operation. Most commonly you will be sent home on a combination of regular paracetamol and a stronger pain medication such as oxycodone, which you can take as well as the paracetamol when needed. By taking the paracetamol regularly it will decrease the amount of the stronger pain killers that you may need. Occasionally you may be also given an anti inflammatory agent celecoxib (Celebrex), or a sustained release strong pain medication tapentadol (Palexia SR) . If your pain is not controlled adequately with this combination you can also try a local anaesthetic gargle such as Difflam or Cepacaine from the chemist which will help to numb the back of your throat. If you still have significant pain after this then please contact your anaesthetist. Oxycodone and codeine are restricted medications that must be used only for postoperative pain as prescribed specifically for you. Under no circumstances should you give them to friends or family or leave them within the reach of children. Under current PBS restrictions the maximum tablets we can prescribe is ten. You can get a repeat prescription from your GP if required.
It is important to eat and drink regularly after your surgery. There are no absolute restrictions on your diet, however very acidic foods such as oranges, pineapples, tomatoes and other citrus fruits tend to irritate the throat and the milky dairy type products tend to soothe the throat. Some common favourites include smoothies, custard, jelly, ice cream, Paddlepops, mashed potato, Weetbix, macaroni and cheese and other pasta. If you don’t feel like eating much that is not unusual, a breakfast drink like Up and Go will give you reasonable calories and fluid replacement as a supplement. A normal diet and plenty of water will help you heal as quickly as possible.