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Anaesthesia for Gynaecological Procedures and Surgery

When you have a gynaecological procedure or surgery, you will usually need some form of anaesthesia. Anaesthesia means using medicines to control pain and keep you comfortable during a procedure. The type used depends on what operation you are having, your health, and your personal preferences.

In gynaecology, the three main options are:

  • Local anaesthesia
  • Sedation (sometimes called “twilight” anaesthesia)
  • General anaesthesia

Local anaesthesia

Local anaesthesia numbs a small area of the body. It is usually given as an injection into the cervix or vaginal wall. You stay fully awake and aware, but the area being treated should feel numb.

Used for:

  • Colposcopy with treatment (such as LLETZ/LEEP)
  • Hysteroscopy for small procedures
  • Insertion of intrauterine devices (IUDs) in some cases

What to expect:

  • You may feel a sharp sting as the anaesthetic is injected
  • The area quickly becomes numb
  • You might still feel pressure or movement, but not pain
  • You can go home soon after the procedure

Pros: Quick recovery, no drowsiness, usually safe for most people.
Cons: You remain awake, may still feel some cramping or discomfort.

Sedation (“Twilight” anaesthesia)

Sedation uses medicines given through a small drip in your arm. It helps you feel relaxed, sleepy, and less aware, but not fully unconscious. Pain relief medicines are often given at the same time.

Used for:

  • Hysteroscopy
  • Dilation and curettage (D&C)
  • Smaller day-surgery procedures

What to expect:

  • You’ll feel drowsy and calm within minutes
  • You may not remember much about the procedure
  • Your breathing and heart rate are monitored closely
  • You usually go home the same day, once fully awake

Pros: Comfortable, quick recovery, less nausea than general anaesthesia.
Cons: You will need someone to drive you home, and you may feel sleepy for several hours.

General anaesthesia

General anaesthesia is when you are put into a controlled, reversible sleep using medicines given through a drip and sometimes through a breathing mask or tube. You will not be aware of the procedure and will not feel pain.

Used for:

  • Laparoscopic (keyhole) surgery, such as for endometriosis, ovarian cysts, or hysterectomy
  • Major open gynaecological surgery
  • When procedures are too uncomfortable for local or sedation alone

What to expect:

  • You’ll have a drip placed in your arm and may be asked to breathe oxygen through a mask
  • Anaesthetic medicines will quickly make you fall asleep
  • Your breathing and heart rate are supported and monitored throughout
  • You’ll wake up in the recovery area, usually within 20–30 minutes after surgery ends
  • Some people feel drowsy, sore throat, or mild nausea afterwards

Pros: You are completely unaware and pain-free during surgery.
Cons: Recovery takes longer, there may be side effects such as nausea or sore throat, and it carries slightly higher risks than sedation or local.

Safety and preparation

New Zealand is one of the safest countries in the world to receive anaesthesia. Your safety is always the top priority.

Before your procedure:

  • You’ll be asked about your medical history, medications, and allergies
  • You may need to fast (no food or drink) before sedation or general anaesthesia
  • Your anaesthetist and I will explain which option is best and answer your questions

Recovery

  • Local anaesthetic: You can usually return to normal activities straight away.
  • Sedation: You’ll need a support person to take you home. Rest for the day, avoid driving or signing important documents until the next day.
  • General anaesthetic: You may need a night in hospital for bigger surgeries, or you may go home the same day for smaller ones. Rest and take it easy for a few days.

Key points to remember

  • Different procedures need different types of anaesthesia.
  • Local keeps you awake but numbs the area.
  • Sedation makes you relaxed and sleepy but not fully unconscious.
  • General anaesthesia puts you completely to sleep and pain-free.
Dr Sam Holford

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FAQs

Is anaesthesia safe?
Yes, modern anaesthesia in New Zealand is very safe. I work with specialist anaesthetists who are highly trained doctors. They will be with you throughout your entire procedure, continuously monitoring your wellbeing to ensure your safety.
Will I feel sick or nauseous afterwards?
Nausea can be a side effect of general anaesthesia, but it is less common with modern techniques. Your anaesthetist will give you medication during and after your surgery to minimise the chance of this happening.
Do I have to have a general anaesthetic for my surgery?
Not always. For many procedures like hysteroscopy or LLETZ, sedation or local anaesthetic are excellent options that avoid a full general anaesthetic. We will discuss the best and safest choice for your specific procedure and your personal comfort.
What is the difference between an anaesthetist and other doctors?
A specialist anaesthetist is a fully qualified medical doctor who has completed at least seven years of additional intensive training in anaesthesia, pain control, and managing medical emergencies. They are experts in keeping you safe and comfortable during surgery.
Why do I have to fast before my anaesthetic?
Fasting (not eating or drinking) is a crucial safety measure for sedation and general anaesthesia. It ensures your stomach is empty to prevent any fluid from entering your lungs while you are sleepy or unconscious. You will be given clear instructions on when to stop eating and drinking.

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Please note: This information is general in nature and not a substitute for medical advice tailored to your specific situation.