Common Concerns and FAQs

        



I am due to have two anaesthetics within a very short time. Is there an increased risk in having two anaesthetics close together?

There is normally no increased risk in having two anaesthetics close together. This applies whether it is two general anaesthetics, two local or regional anaesthetics (such as epidurals or spinals), or a combination of general, regional and local anaesthetics. It is, however, important to tell your anaesthetist about any recent anaesthetics of any sort and to discuss with him or her the options for a second or subsequent anaesthetic.

A relative recently developed a problem with breathing after an operation and was told that she had suxamethonium apnoea. What is this condition, is it inherited, and should we be tested for it?

Suxamethonium (Scoline™) is a muscle relaxant drug which is now uncommonly used by anaesthetists. However, there are some emergency situations where it is still the most appropriate choice.

A few people suffer from a condition known as ‘suxamethonium apnoea’. This is a rare, inherited condition, and if someone in your family is known to be affected, it may be wise for other members of the family to be screened for it by means of a blood test. Your GP should be able to arrange the blood test after discussion with the anaesthetic department at your local hospital.

When suxamethonium is used, the muscles are profoundly relaxed and the patient is unable to breathe for themselves. The effect usually lasts 3-4 minutes. In patients who have suxamethonium apnoea, the effect is prolonged for anything up to 4 hours. All trained anaesthetists are aware of the condition, and in the unlikely event that a patient develops it after being given suxamethonium, breathing is assisted by means of a mechanical ventilator until the drug wears off. The patient is usually sedated during this time because the experience may be frightening and unpleasant. However, there should be no long-lasting effects and recovery is complete.

What is the currently quoted risk of death under general anaesthesia?

Data on this question are hard to find, especially from within the UK. It is difficult to separate purely anaesthetic risk from that due to surgical skill, postoperative care and other factors, such as comorbidities in patients. Generally speaking the figure is estimated to be between 1 in 100,000 and 1 in 200,000.  The RCoA has produced a comprehensive information leaflet on anaesthesia and risk of death, which can be found here.

Where can I find information about epidurals?

The RCoA has produced several comprehensive patient information leaflets on epidurals and associated risks. These can be found here.  If you would like information about epidurals in labour, we would advise that you read the information produced by the Obstetrics Anaesthetists Association.

How common is awareness and ‘waking up’ during general anaesthesia?

A study in March 2013, by the RCoA and Association of Anaesthetists of Great Britain and Ireland (AAGBI) involving 80% of all senior anaesthetists working in the NHS, has revealed that incidences of awareness are much less common in the UK than previously thought, with one episode known to anaesthetists in every 19,000 general anaesthetics. More information on the study can be found here.

Can the RCoA offer advice to patients about treatment?

TThe RCoA is an academic institution. We regret that we cannot give advice to individuals regarding their personal treatment.  If you are submitting your enquiry to the RCoA in writing please note that we are unable to respond immediately. The RCoA often uses specialist advisers to answer enquiries and this may delay a response for several days.  For any immediate medical concerns you are advised to contact your GP or the emergency services without delay. Should you need more specific advice regarding your treatment you are advised to contact the hospital where you are being treated.

The RCoA publishes a comprehensive series of Patient Information leaflets offering information on the different types of anaesthetics and the risks associated with them. We would advise you to take a look at these leaflets as they may contain the information you are looking for. You can see the full series here.

Can the RCoA recommend an anaesthetist or advise on the competence of an anaesthetist?

No, the RCoA cannot recommend or vouch for individual anaesthetists.  Information on individual medical practitioners and their registration is held by the General Medical Council and can be accessed by members of the public here.

Can the RCoA provide expert witnesses?

No. The RCoA does not hold lists of experts to provide a medico-legal opinion, as this is outside our remit. The RCoA is an academic institution, with the sole purpose of educating and training anaesthetists.

Can the RCoA offer advice if I want to complain about the treatment I have received or the anaesthetist who treated me?

Please note that the RCoA is not a regulator and does not have the authority to act on complaints raised by patients. For a list of regulators and advice on how to complain about your treatment please visit the Complaints about your Doctor or Treatment page.

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