Anaesthesia: what happens before, during and after the procedure?

Anaesthesia is the question people most often have before an operation and least often ask out loud. This page explains what really happens — from the assessment before the procedure to waking up.

What is the anaesthetic assessment and why is it done before the procedure?

The anaesthetic assessment is a conversation and a clinical examination with the anaesthetist before the operation. It is done for all procedures under general anaesthesia and for most of those under potentiated local anaesthesia or deep sedation.

Any anaesthetist can carry out the anaesthetic assessment, but it is usual for it to be done by the one who will also be with the patient during the procedure itself.

The assessment has two parts. The first is a longer conversation about your health, earlier illnesses and problems, lifestyle and habits, and the medicines and preparations you take. The second is a shorter, targeted examination with measurement of basic physical parameters.

This conversation also deals with the doubts, worries and fears that usually weigh on people before anaesthesia and an operation. That is part of the anaesthetic assessment, not an addition to it.

After the assessment the anaesthetist draws up a plan for the time until the procedure, so that the risk from anaesthesia is as low as possible. The plan may include additional laboratory tests, a change of medication, getting blood pressure or blood sugar under control, treatment of an unrecognised inflammation or correction of anaemia. If information is needed that the anaesthetic assessment cannot provide, the opinion of another specialist is requested.

If nothing needs to be resolved before the procedure, the exact date of the operation is agreed. If something does — the date is moved until it is resolved.

What types of anaesthesia are there?

Poliklinika Barbel uses local anaesthesia, monitored anaesthesia care, sedation, local anaesthesia with sedation and general anaesthesia. They differ in depth and in what is monitored during the procedure.

Local anaesthesia. With local anaesthesia, the anaesthetic is given into the tissue in and around the operating area. The area is temporarily numb, and the patient is awake. The effect of a local anaesthetic lasts about two hours.

Monitored anaesthesia care. With monitored anaesthesia care, the anaesthetist monitors blood pressure, pulse and oxygen level throughout, with the option of light sedation.

Sedation. With sedation, small doses of a sedative are given through a vein. With conscious sedation the patient is relaxed and conscious, with protective reflexes intact. With deep sedation the patient is not conscious and protective reflexes may be absent.

Local anaesthesia with sedation. Local anaesthesia with sedation combines an anaesthetic in the operating area with a sedative given through an intravenous cannula.

General anaesthesia. General anaesthesia achieves absence of pain, sleep, no memory of the procedure, muscle relaxation and a reduced stress response of the body. The airway is protected with an endotracheal tube, a laryngeal mask or a face mask.

Which type of anaesthesia is suitable for a given procedure is decided at the anaesthetic assessment — according to the type of procedure and the patient's health.

Who may give anaesthesia?

Regional anaesthesia, peripheral nerve blocks and general anaesthesia are given only by doctors who are specialists in anaesthesiology, resuscitation and intensive care. They are trained to monitor vital functions and to work with equipment that monitors vital organ function.

Local anaesthesia may be given by any doctor with a valid licence to practise in healthcare in the Republic of Croatia.

At Poliklinika Barbel the anaesthetist is a full-time member of staff, so the same doctor examines you before the procedure, leads the anaesthesia and monitors you as you wake up.

Why does it matter that the anaesthetist is a full-time member of the clinic's staff?

Because anaesthesia determines not only whether you get through the procedure without pain, but also how safe the procedure is and how you feel after it. During the procedure the surgeon looks at the operating area. The anaesthetist looks at you the whole time: your breathing, blood pressure, heart rate and depth of anaesthesia.

A full-time anaesthetist means four things for the patient.

• They know you before the procedure. The doctor who examined you, read your results and asked about your medication, allergies and earlier experiences with anaesthesia is the same one who gives you the anaesthesia. None of this is passed to another doctor on paper.
• They plan the anaesthesia in advance. The type of anaesthesia is chosen at the assessment, according to your health and the procedure, not on the day of the procedure. If the assessment shows that another test or an adjustment of medication is needed before the procedure, there is time to do it.
• They work in a permanent team. The anaesthetist, the surgeon and the nurses work together, in the same theatres and with the same equipment. If something goes differently from planned during the procedure, everyone knows what to do.
• They are with you after the procedure too. The same doctor monitors you as you wake up and decides on pain and nausea treatment. That affects how you feel in the first hours, how quickly you get up and when you go home.

Wherever you have surgery, it is worth asking three things: who will examine you before the anaesthesia, whether it is the same doctor who will give it, and whether they stay with you until you wake up.

What are the risks of anaesthesia?

The risks of anaesthesia exist and are not the same for all patients. Here they are divided by how common they are, according to the data Poliklinika Barbel publishes.

Common (1–10%) — nausea, vomiting, sore throat, drowsiness, temporary dizziness and ringing in the ears (tinnitus).

Rare (0.1–1%) — muscle pain, headache, aspiration pneumonia, damage to teeth, awareness during anaesthesia.

Very rare (below 0.1%) — allergic reaction, convulsions, thrombosis, breathing disorder, malignant hyperthermia.

Death or permanent disability attributable solely to anaesthesia is recorded in 1 to 5 cases per million.

What most changes these figures in an individual case is what the anaesthetist knows about the patient before the procedure: earlier illnesses, earlier anaesthetics, allergies and medication. Information that does not reach the anaesthetist cannot enter the anaesthetic plan.

What happens after anaesthesia?

After sedation and general anaesthesia, you should not drive or drink alcohol for the first 24 hours. That is why arrival at and departure from the clinic are planned in advance.

After general anaesthesia the patient stays in the clinic for at least six hours, and longer if needed.

Who is the anaesthetist at Poliklinika Barbel?

The anaesthetist at Poliklinika Barbel is Dr. Dražen Matleković, specialist in anaesthesiology, resuscitation and intensive care, a full-time member of the clinic's staff.

Dr. Matleković trained as a specialist at Merkur University Hospital (KB Merkur), where from 1999 to 2009 he took part in about two thirds of more than 300 liver, kidney and pancreas transplants. At Poliklinika Barbel he provides anaesthesia for day surgery and fast-track surgery; with his method, nausea and vomiting after anaesthesia are kept to the lowest possible level.

→ Biography of Dr. Dražen Matleković

Frequently asked questions about anaesthesia

Will the anaesthetist who gives me the anaesthesia also examine me before the procedure? Yes. At Poliklinika Barbel the anaesthetist is a full-time member of staff, so the same doctor leads the anaesthetic assessment, gives the anaesthesia and monitors you as you wake up.

Will I feel pain during the procedure? The aim of every type of anaesthesia is no pain during the procedure. With local anaesthesia the patient is awake and may feel touch and pressure, but not pain in the operating area. With general anaesthesia the patient sleeps and has no sensation or memory of the procedure.

Can I wake up during the operation? Awareness during anaesthesia is in the group of events recorded in 0.1 to 1% of cases. The anaesthetist monitors the depth of anaesthesia and vital functions throughout the procedure.

Will I feel sick after the anaesthetic? Nausea and vomiting are in the group of events recorded in 1 to 10% of cases and are the most common side effects after general anaesthesia. With the method of general anaesthesia used by Dr. Dražen Matleković, they are kept to the lowest possible level.

Do I need someone with me on the day of the procedure? After sedation and general anaesthesia you should not drive for the first 24 hours, so departure from the clinic is planned in advance. After general anaesthesia the patient stays in the clinic for at least six hours.

Is anaesthesia paid for separately? Anaesthesia is included in the price of most operations at Poliklinika Barbel.

Medical review: doctors of Poliklinika Barbel · October 2026.