Anaesthesia

Please complete the anesthesia registration form with accurate health information. The form will be given to you in paper form or sent electronically. For existing conditions and/or major past surgeries, we generally require a written report from your GP.

An unclear health status must be clarified in advance for your safety.

If you wish to have a pre-surgery consultation with an anesthetist, please contact us:

• Main number Tel:  052 320 01 20
• Eulachklinik  Tel:  052 320 01 20
• Limmatklinik Zurich  Tel:  044 448 30 30
• Klinik Hohmad  Tel:  033 225 25 80
• Mail info-winterthur@narkose.ch

If the health questionnaire and/or submitted documents from your GP indicate the need for an anesthesia consultation, we will schedule one with you.

Your responsible anesthetist will typically contact you no later than the day before the scheduled procedure to discuss the anesthesia method and answer any questions. (Exception: Cataract surgery and certain hand surgeries)

Please indicate your availability (time range, phone number) on the registration form. Contact is usually made between 1:00 PM and 8:00 PM. If you prefer a different time frame, please let us know.

Please adhere to these periods regardless of the anesthesia type:

• Up to 6 hours before your appointment: solid food (including chewing gum, candies, etc.) and milky or cloudy beverages
• Up to 2 hours before your appointment: clear liquids like tea, black coffee (even sweetened), syrup, and water

After that, you should not consume anything. This rule must be strictly followed.

• Take your medications as usual before surgery, unless otherwise instructed (e.g., blood-thinning medications).
• Remove rings, jewelry, and artificial hairpieces.
• Do not apply cosmetics (facial creams or makeup) on your face.
• Inform us if you use hearing aids, contact lenses, removable dentures, or body jewelry (piercings).
• Bring all medical IDs such as allergy cards, pacemaker checks, or blood-thinning cards.
• Wear comfortable, practical, and loose-fitting clothing.

• Avoid walking alone or driving a car. Have a companion or taxi take you home after discharge.
• Do not stay alone at home to ensure immediate help in case of sudden discomfort, weakness, or dizziness.
• Do not make important decisions or sign contracts during this period.
• Wear comfortable, practical, and loose-fitting clothing.

For questions about the anesthesia performed or related issues like pain or nausea and vomiting, we are available at 052 320 01 20. 

Generally, you will receive a separate bill from narkose.ch for the anesthesia performed. Exceptions are made for different agreements with the operating person, an operations center, or a clinic. If you have any questions, we are happy to assist you.

We strive to meet your expectations and ensure you are completely satisfied with our services. Your feedback allows us to continuously improve and exceed your expectations. Feel free to contact us by phone, post, or email at one of the addresses listed.

Vital functions such as breathing, heart, and circulation are continuously monitored by the anesthesia team, making significant incidents and complications very rare with all modern procedures.

The risk primarily depends on the patient's age, lifestyle, pre-existing conditions, the type of surgery, and its duration. From the medical history, specific pre-existing conditions, rare hereditary diseases, and other complicating factors can be identified, and the anesthesia procedure, medications, and infrastructure can be appropriately adjusted.

Serious complications such as heart, circulatory, or respiratory failure, leading to organ damage or death, are very rare today and can generally be prevented by precise monitoring.

Common side effects

• Bruising at the injection site
• Sore throat and/or mild hoarseness due to intubation
• Irritation/injury to nasal or throat mucosa due to intubation
• Feeling cold, shivering
• Nausea and vomiting

Less common side effects

• Vomiting during anesthesia induction (risk of lung damage)
• Hypersensitivity or allergic reactions to medications or latex
• Skin and/or nerve damage due to positioning

Rare side effects and complications

• Dental damage due to intubation
• Impaired spontaneous breathing/ventilation during anesthesia due to pre-existing respiratory conditions
• Injury to the tonsils or nasal turbinates when inserting the tube during nasal intubation (especially in children)

In RA, anesthesia is achieved by injecting an anesthetic near a nerve or a nerve plexus, reducing or eliminating pain sensation in the operated body part.

Pure RA is rarely used in children. For adolescents and adults, the above procedures can be applied depending on the surgery, health condition, and the patient's preference.

In local anesthesia, the anesthesia is achieved by injecting a medication (local anesthetic) directly into the area surrounding the surgical site.

• Minimal risk of thrombosis or embolism
• Possibility of inadequate effect due to incomplete distribution of the injected anesthetic; general anesthesia (GA) may be required depending on the procedure.
• Very rare allergic reactions to the injected anesthetic
• Very rare nerve damage due to direct injury, bruising, or infection (inflammation), potentially causing permanent paralysis and sensory disturbances in the affected area.
• Very rare agitation, seizures, and cardiovascular failure if the anesthetic is inadvertently injected into a blood vessel.

In this type of anesthesia, the anesthetic is administered on the side of the neck (on the operated side) into the vascular-nerve sheath (as a single shot or via catheter placement for repeated intervals).

Both techniques aim to eliminate pain after surgery. 

An electrical nerve stimulator and/or ultrasound device is used to locate the nerves accurately.

• Very rare pneumothorax: during the nerve region injection, the pleura can be injured, causing air to enter the space between the chest wall and the lung.
• Rarely, there may be one-sided vocal cord paralysis (hoarseness), diaphragm elevation, or drooping of the eyelid; all these symptoms usually resolve.
• Very rare injuries or expansions of the arm artery.

Spinal and epidural anesthesia is suitable for procedures in the lower abdomen, pelvis, and legs. 

In the side-lying or sitting position, after locally numbing the skin at waist level, a special needle punctures the midline of the back.

The anesthetic is injected into the spinal space, filled with fluid surrounding the spinal cord and nerve roots. This results in rapid anesthesia of the nerves in the lower body. It causes quick numbness, a warm feeling, and temporary leg movement restriction, which can last a few hours after the injection.

In epidural anesthesia, also known as epidural anesthesia, the needle is inserted into the space between the spinal sheath and the vertebral canal rather than into the spinal space. A thin catheter can be placed before or after the anesthesia injection. This catheter allows additional injections to extend anesthesia or manage pain after surgery.

• Occasionally: temporary drop in blood pressure, slowed heart rate, nausea, headache, dizziness, vision and hearing disturbances, or back pain
• Extremely rare: bladder emptying disorder, requiring temporary bladder catheterization.

Before surgery, a fine catheter is inserted into the vascular-nerve sheath in the groin area on the operated side. Continuous administration of anesthetics aims to relieve post-operative pain. The catheter typically remains in place for the first 48 hours after surgery. 

This method is often used for knee surgeries such as knee prostheses or ligament repairs. Electrical nerve stimulators and/or ultrasound devices are used to locate the nerve sheath accurately.

• Typical side effects include numbness in the front and outside of the thigh and occasional muscle weakness in this area.

Near the pubic bone, an anesthetic is injected next to the obturator nerve. This is usually done in combination with spinal anesthesia. This method prevents uncontrolled thigh movements during surgical procedures such as bladder sidewall tumor removal. A nerve stimulator helps locate the nerve.

• Insufficient blockade during surgery could lead to potential bladder wall injury.
• Very rare nerve damage due to direct injury.

In this type of local anesthesia, after applying a tourniquet, a local anesthetic is injected directly into a blood vessel in an extremity to create a pain-free region. For longer surgeries, additional pain management medication may be given to help tolerate the tourniquet pressure.

After the surgery, sensation and movement typically return within 5 to 10 minutes.

• Bruising at the injection site; rarely, more than one injection may be necessary due to difficult vein conditions.
• Rare pressure marks on the skin
• Very rare nerve or blood vessel injuries due to tourniquet pressure
• Initial warm to hot feeling, which quickly disappears
• Intravenous pain management can cause drowsiness
• Occasional dizziness and nausea after releasing the tourniquet

In axillary plexus anesthesia (anesthesia of the nerve plexus in the armpit), the anesthetic is injected into the vascular-nerve sheath in the armpit, numbing the nerves that supply the arm. The effect takes place within 20-40 minutes.

• Very rare pneumothorax: during the nerve region injection, the pleura can be injured, causing air to enter the space between the chest wall and the lung.
• Rarely, there may be one-sided vocal cord paralysis (hoarseness), diaphragm elevation, or drooping of the eyelid; all these symptoms usually resolve.
• Very rare injuries or expansions of the arm artery.

For eye surgeries, the following local anesthesia methods are suitable:

• Local anesthesia with eye drops
• Local anesthesia with an injection around the eye
• Local anesthesia with an injection around the eye under short sedation

• Minimal risk of thrombosis or embolism
• Very rare allergic reaction to the injected anesthetic

In this method, the eye's surface is numbed with eye drops of a local anesthetic. The patient is operated on while awake, and the anesthetist monitors the cardiovascular and respiratory functions.

Before the treatment, a thin cannula is placed in the patient's hand or forearm to administer medication if needed.

• Possibility of inadequate effect due to incomplete distribution of the eye drops; in rare cases, general anesthesia (GA) may be required.

During the injection and throughout the surgery, the cardiovascular and respiratory functions are monitored. 

Before the treatment, a thin cannula is placed in the patient's hand or forearm to administer medication if needed.

• Possibility of inadequate effect due to incomplete distribution of the injected anesthetic; general anesthesia (GA) may be required.
• Very rare nerve damage due to direct injury, bruising, or infection (inflammation), potentially causing permanent paralysis and sensory disturbances in the affected area.

Certain eye surgeries, such as cataract operations, can be performed under local anesthesia with an eye injection. The injection numbs the eye nerves.

To make the injection as painless as possible, a sedative medication is often given for this purpose.

After administering the local anesthetic, the patient wakes up, and the surgery on the numbed eye is performed.

This method effectively minimizes the risks and side effects of general anesthesia.

• Bruising at the injection site
• Rare nausea and vomiting
• Possibility of inadequate effect due to incomplete distribution of the injected anesthetic; general anesthesia (GA) may be required.
• Very rare nerve damage due to direct injury, bruising, or infection (inflammation), potentially causing permanent paralysis and sensory disturbances in the affected area.
   

Typically, the same medications used in general anesthesia (GA) are administered for sedoanalgesia. However, the dosage is significantly lower, allowing the patient to control their breathing.

In addition to sedoanalgesia, a local anesthetic is often used to achieve complete pain relief depending on the type of surgery.

It is important to note that pain relief with this method may not be fully achieved for certain procedures. Transitioning to general anesthesia (GA) is generally possible, but it carries increased risks depending on the surgery type and location.

Common side effects

• Bruising at the injection site
• Feeling cold, shivering
• Nausea and vomiting

Common side effects in the case of necessary intubation

• Sore throat and/or mild hoarseness due to intubation
• Irritation/injury to nasal or throat mucosa due to intubation

Less common side effects

• Vomiting during anesthesia induction (risk of lung damage)
• Hypersensitivity or allergic reactions to medications or latex
• Skin and/or nerve damage due to positioning

Rare side effects and complications

• Impaired spontaneous breathing/ventilation during anesthesia due to pre-existing respiratory conditions

Very rare side effects and complications in the case of necessary intubation

• Dental damage due to intubation
• Injury to the tonsils or nasal turbinates when inserting the tube during nasal intubation (especially in children)