What do you need to know about Anaesthesia for ENT Surgery?

The different procedures

General practice

Ear, Nose and Throat surgeons undertake an enormous range of procedures, which have very different requirements in terms of anaesthetic care. The anaesthetist who looks after you will be paying particular attention to these specific needs, before, during and after your operation. 

As with most areas of anaesthetic practice, familiarity with the surgical procedure is of paramount importance, allowing the anaesthetist to anticipate the surgeon's requirements and ensure that you are well informed, safe during the procedure and have good pain control afterwards. For some operations, this will mean using a particular combination of anaesthetic drugs to ensure that the surgeon has optimal conditions for very fine endoscopic surgery, in other cases it may mean using special techniques to manage your airway and breathing whilst you are asleep, to allow the operation to proceed safely. In the vast majority of cases, all of these elements of your care will be done whilst you are asleep. 

Although some ear, nose and throat procedures are lengthy and require delicate techniques, they mostly result in only mild pain afterwards, which can be managed in most cases with analgesics taken by mouth. Adult patients having tonsillectomy, however, can have considerable pain and may require more pain relief to reduce this to a tolerable level.

Advanced procedures

Certain procedures such as tonsillectomy, middle ear and cochlea surgery carry a higher risk of nausea afterwards. However, it is routine in modern anaesthesia to give medicines to combat this, and your anaesthetist will be able to discuss this with you, in addition to your pain relief. 

With most anaesthetics, the anaesthetist will place an intravenous cannula, or 'drip', often in the back of your hand or wrist. The anaesthetic usually starts off with an injection of drugs directly into the bloodstream, and will move on to breathable anaesthetic gases once you are asleep. The anaesthetist may choose to avoid anaesthetic gases, and use intravenous anaesthetic drugs only. However the general anaesthetic is given, you will be kept asleep until it is time to wake up at the end of your operation. 

In order to keep you breathing under the anaesthetic, the anaesthetist will usually place a breathing tube in through your mouth once you are asleep. It will be removed as soon as you wake up, but it can leave you with a slightly sore throat afterwards.

Modern anaesthetics are very safe, and are not associated with a prolonged 'hangover' period, as was the case some years ago. If you have any specific questions about your anaesthetic, you will have time to discuss these with your anaesthetist when they see you before your operation.