Anaesthesia stops you feeling pain and other sensations. It can be given in various ways and does not always make you completely unconscious.

Local and regional anaesthesia involves injections which numb a part of your body. You may stay conscious but free from pain. Alternatively, this may be used with a general or sedation anaesthetic to make sure you remain free from pain for a period of time once you have regained consciousness.

General or sedation anaesthesia gives a state of controlled unconsciousness. You may be sleepy and relaxed and able to communicate or unconscious. It is essential for some operations. You will not feel anything during this anaesthesia.

The choice of anaesthetic depends on:

• the operation
• answers to the questions you have been asked at pre-assessment
• your physical condition
• your preferences and the reasons for them
• the anaesthetist’s recommendations for you and the reasons for them
• equipment, staff and other resources at your hospital.

As your preferred option is to be asleep during surgery – sedation or general anaesthesia – please carefully read the following information.

Anaesthetists

An anaesthetist is a doctor with specialist training who is responsible for giving you your anaesthetic and caring for you while you are drowsy or asleep.

Your anaesthetist will meet you before your operation and will:

• ask you about your health
• discuss with you the benefits and risks
• decide with you which anaesthetic would be best for you
• decide for you, if you would prefer that.

You will be asked some questions to check your health before your operation. This would have been done at your pre-assessment clinic, by filling in a questionnaire.

It is important for you to inform staff of:

• all the pills, medicines, herbal remedies or supplements you are taking, both prescribed and those that you have purchased over the counter
• any allergies you may have.

Before your operation

Here are some things you can do to prepare yourself for your operation.

• If you smoke, giving up for several weeks before the operation reduces the risk of breathing problems and makes your anaesthetic safer. The longer you can give up beforehand, the better. If you cannot stop smoking completely, cutting down will help.
• If you are very overweight, reducing your weight will reduce many of the risks of having an anaesthetic.
• If you have loose teeth or crowns, treatment from your dentist may reduce the risk of damage to your teeth if the anaesthetist needs to put a tube in your throat to help you breathe.
• If you have a long-standing medical problem such as diabetes, asthma or bronchitis, thyroid problems, heart problems or high blood pressure (hypertension) you should ask your GP if you need a check-up.

Preparing yourself on the day of surgery

Have nothing to eat or drink – fasting (‘nil by mouth’). If there is food or liquid in your stomach during your anaesthetic, it could come up to the back of your throat and damage your lungs.

There are clear instructions about fasting. It is important to follow these:

• six hours before your appointment – stop eating. You must not have milk, fizzy drinks or juice with pulp. You must not suck sweets either.
• six to two hours before your appointment – you can drink sips of clear liquids (water, black tea and black coffee without sugar only). You can chew gum.
• two hours before your appointment – stop drinking sips of clear liquids and stop chewing gum.

You will be able to eat and drink normally after your treatment.

• If you are a smoker you should not smoke on the day of your operation. This will help avoid breathing problems during your anaesthetic.
• If you are taking medicines, you should continue to take them as usual, unless you have been asked not to at your pre-assessment. For example, if you take drugs to stop you getting blood clots (anticoagulants), aspirin, drugs for diabetes or herbal remedies, you will need specific instructions.
• If you feel unwell when you are due to come into hospital, please phone us for advice.
• Do not drink alcohol for 24 hours before your appointment.
• Please shower or bath but do not put any creams, lotions or talcum powder on your feet.
• Remove nail varnish and artificial nails from fingers and toes.
• Please wear loose fitting clothing, such as a skirt, shorts or wide legged trousers as the dressing applied to your foot or feet after surgery will be bulky. There is no need to bring nightwear as a hospital gown and dressing gown will be provided. Please bring slippers or similar footwear.
• Jewellery and decorative piercings should ideally be removed and left at home. If you cannot remove your jewellery, it can be covered with tape to prevent damage to it or to your skin.

On arrival

You will be welcomed to the ward where a nurse will complete your admission details and take your sandwich order, as following surgery we provide you with refreshments before you are discharged. Females under the age of 55 may be asked to do a pregnancy test.

You are welcome to have one friend or relative accompany you on the ward. Some waiting is expected. Please be patient and bring something to occupy yourself with during this time.

Your surgery

When you are called for your operation you will go to theatre on the bed or trolley.

A team member will check your identification bracelet, your name and date of birth, and will ask you about other details in your medical records as a final check that you are having the right operation.

Your foot or feet will be cleaned with an antiseptic solution.

You can wear your glasses, hearing aids and dentures until you are in the theatre.

A team member will accompany you into theatre.

Your anaesthetic will start in the operating theatre. The anaesthetist will attach machines which measure your heart rate, blood pressure and oxygen levels. Anaesthetic drugs are injected into a vein, usually in the back of your hand, through a cannula (a very fine plastic tube). The anaesthetist will stay with you throughout your procedure to make sure you are safe and well.

As soon as the operation is finished, the drugs will be stopped or reversed so that you regain consciousness.

Following surgery

After your treatment, you will wake up or come around in the recovery area on the ward. Specially trained staff will look after you and when they are happy you have recovered from your anaesthetic, you will be moved to another part of the ward.

From this point you will be ready for discharge after one hour, during which time you will be given a refreshment, observations will be taken, a postoperative shoe fitted (if required), painkillers prescribed and relevant verbal and written information given.

Getting home

You must not drive yourself home after surgery. If you intend to drive, the surgeon or anaesthetist may refuse to treat you. Driving during that time may mean prosecution under Section 4 of the Road Traffic Act 1988 relating to driving under the influence of drugs.

Please travel directly home on the back seat of a car with your foot elevated.

Someone must accompany you home and stay with you for 24 hours after your treatment. This should be an adult who can look after you. You should not operate any equipment or machinery for 24 hours after your anaesthetic.