Information for patients
Who are anaesthetists and what is anaesthesia?
The best Australian resources to explain who anaesthetists are and what we do come from the Australian New Zealand College of Anaesthetists (ANZCA) and Australian Society of Anaesthetists (ASA). Please find the links to patient information below
ANZCA
https://www.anzca.edu.au/patient-information/about-anaesthesia
ASA
Anaesthesia for open heart surgery
Australian New Zealand College of Anaesthetists has an excellent patient information sheet, the link is below:
https://www.anzca.edu.au/patient-information/about-anaesthesia/anaesthesia-for-cardiac-surgery
Every patient and every operation is different. I’ll talk with you beforehand to plan an anaesthetic approach that’s tailored specifically to you.
What is the heart and lung bypass machine?
During most open heart operations, the surgeon needs the heart to be still and empty of blood. To make this possible, a machine called a heart–lung bypass machine or cardiopulmonary bypass machine is used.
This machine temporarily takes over the job of your heart and lungs during the operation. Blood is diverted from your body into the machine, where it is given oxygen (just like your lungs normally do) and carbon dioxide is removed. The machine can also cool or warm the blood. The machine then pumps the blood back into your body, doing the work your heart would usually do. A dialysis circuit can also be added to the machine.
While the bypass machine is working, the surgeon can safely stop the heart and operate in a controlled, blood-free area. Throughout this time, your blood flow, oxygen levels, temperature, and blood pressure are carefully monitored by the anaesthetist and perfusionist.
Once the surgery is finished and your heart is ready to work again, blood flow is gradually returned to your heart and lungs, and the bypass machine is disconnected.
The heart–lung bypass machine is used only when needed, and it is closely managed by a highly trained team to keep you safe throughout the operation.
What is TOE?
A TOE (which stands for transoesophageal echocardiogram) is a heart ultrasound done from the inside, rather than from the chest.
It’s a test where a small ultrasound probe is gently passed down your throat into the food pipe (oesophagus) while you’re sleepy or under anaesthetic. Because the food pipe sits right behind the heart, this gives very clear pictures of the heart.
Why it’s done:
To look closely at heart valves
To check for infection, clots, or leaks
To guide doctors during heart procedures or surgery
What it feels like:
You’re usually asleep or very drowsy, so you don’t feel or remember it
The probe does not go into the lungs, and it doesn’t affect breathing
It’s removed at the end of the test
Afterwards:
You may have a mild sore throat for a short time
You’ll be monitored until the sedation wears off
Anaesthesia for lung surgery
Almost always, people will have a general anaesthetic, which means you’ll be completely asleep for the surgery. Before you go to sleep, a small plastic tube (a drip) is inserted into a vein in your hand, and another small tube into an artery at your wrist. This lets us give medications and closely monitor your blood pressure.
Once you are asleep, we’ll place a special breathing tube. For lung or chest surgery, this is usually a double-lumen tube. It has two channels in one tube, which allows us to ventilate one lung while the surgeon works on the other lung, which is temporarily deflated. You won’t feel or remember this, as it’s put in after you’re asleep and taken out before you wake up. A mild sore throat for a day or two is common after any breathing tube.
During the operation, you’ll be positioned on your side, with your arms and knees gently bent and well supported. You’ll be given medication to help prevent nausea and vomiting, as well as pain relief throughout the procedure.
At the end of surgery, the anaesthetic medications are stopped and you’ll wake up. You’ll first go to the recovery area (the post-anaesthetic care unit) before being transferred to the ward.
For pain relief, you may have a patient-controlled analgesia (PCA) pump using fentanyl or oxycodone, a local anaesthetic infusion near the surgical area, and regular oral pain medicines such as paracetamol and anti-inflammatory medications. Medication for nausea and vomiting will also be available if needed.
Every patient and every operation is different. I’ll talk with you beforehand to plan an anaesthetic approach that’s tailored specifically to you.
Anaesthesia for EPS studies
EPS (electrophysiology) procedures study the electrical conduction pathways of the heart. The type of anaesthesia depends on why you are having the procedure. Some people have sedation, where you are very relaxed and sleepy but still breathing on your own. Others need a general anaesthetic, where you are fully asleep.
Before the procedure starts, we will place a small drip into a vein in your arm or hand to give medications. We will also place a small drip into an artery at your wrist. This allows us to closely monitor your blood pressure during the procedure.
If your procedure is done under sedation, you may be aware at times and might feel your heart beating fast or fluttering. This is expected and helps the cardiologist find and treat the abnormal heart rhythm. We will keep you as comfortable as possible throughout.
If there is a need to check for a blood clot inside the heart, the procedure is usually done under general anaesthetic. Once you are asleep, a test called a transoesophageal echocardiogram (TOE) may be performed. This involves placing an ultrasound probe into the food pipe (oesophagus). Because the food pipe sits right behind the heart, this test gives very clear pictures of the heart’s structures and blood flow. You won’t feel or remember this.
At the end of surgery, the anaesthetic medications are stopped and you’ll wake up. You’ll first go to the recovery area (the post-anaesthetic care unit) before being transferred to the ward. For pain relief, a combination of oral paracetamol and anti-inflammatory is usually adequate, but if stronger pain relief is needed, it will be available. Medication for nausea and vomiting will also be available if needed.
We will discuss the anaesthetic plan with you beforehand and tailor it to your procedure and your individual needs.