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The majority of spinal operations are performed under general anaesthesia, although
nerve root blocks and facet joint injections usually take place under sedation, with only a
light anaesthetic being administered. In the latter case, it is rare for the patient to lose
Fitness for anaesthesia is broadly assessed at the initial consultation with Mr. Harding,
when any existing medical problems can be discussed and assessed, especially those
affecting the cardiovascular and respiratory systems. Routine investigations are arranged
at this point, and specific problems relating to anaesthesia will be flagged up and relayed
to myself. Occasionally, further specialized investigations are required, and, rarely, I will
arrange a consultation with you if there any specific risks that need discussing. Where
You will be anaesthetised in the anaesthetic room, which is an annexe to the operating
theatre itself. An intravenous cannula will be inserted into a vein in the hand, and this
will then be the route of administration for the various drugs that comprise the
anaesthetic. These will vary depending on your particular operation, but may include
analgesics (pain-killers), anti-emetics (drugs that may reduce or prevent post-operative
nausea and vomiting) and antibiotics. Following surgery, you will spend some time,
usually about an hour, in the Recovery room adjoining the theatre suite. Once the
Recovery nurses are happy that you are awake, your vital signs are stable and you are
comfortable, you will be returned to your room.
You may eat and drink in the first few hours following surgery, although it is usually
advisable to start by drinking water first, before progressing to a light diet. Pain relief
Pain relief is provided by several means. A combination of different types of pain-killers
is used to minimize post-operative discomfort. The mainstay drug is still morphine, but
this is used in combination with paracetamol, non-steroidal drugs (such as Voltarol,
Ibuprofen) and local anaesthetic used during surgery to ‘freeze’ the tissues. For more
extensive surgery, an epidural may be inserted whilst you are asleep and used to control
pain during the first 48 hours following surgery.
Occasionally a patient-administered infusion of morphine is used, and this involves an
infusion pump containing morphine being connected to the intravenous infusion line
(‘drip’). This is activated by a simple handset and is useful in that you will be able to
adjust the amount of morphine you receive to your individual requirement. The pump
has safety features built in such that it is not possible to accidentally overdose on it.
Modern anaesthetic agents wear off quickly and usually don’t leave a ‘hangover’ effect,
although most patients undergoing major surgery will, for a variety of reasons, not feel
entirely themselves for a variable period of time.
Dr. Richard Dell MB.BS, FRCA
Dr. Dell trained at St. Bartholomew’s Hospital, London, qualifying in 1986. Following a
broad-based training both in Britain and Australia, he specialised in Anaesthesia in 1988,
gaining experience in training programmes in London and the South-West of England.
Following completion of his anaesthetic training, he spent a year at the Hospital for Sick
Children, Toronto, specialising in anaesthetising children with spinal conditions. On his
return to Britain, he obtained a Consultant post at Frenchay Hospital, Bristol in 2001. He
continues to work there, specialising in anaesthesia for neurosurgery, and emergency and
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