DR MICHAEL
ANGSUWAT
Dedicated to Clinical Excellence, Safety and Comfort
My name is Michael and your surgeon may have asked me to provide you with anaesthetic care. I am a specialist anaesthetist, and I write here to provide you some information about my background, and some general information about anaesthesia.
About Me
I graduated from The University of Melbourne’s Medical School in 2010 and undertook internship and residency in the western suburbs of Melbourne, before moving to Monash where I commenced postgraduate specialist training in anaesthesia. After completing five years of specialist training, I obtained Fellowship with the Australia & New Zealand College of Anaesthetists (ANZCA) in 2021.
I have a public appointment at Peninsula University Hospital (Frankston Hospital) and concurrently operate at several private hospitals around eastern Melbourne.
I hold memberships with ANZCA, ASA (Australian Society of Anaesthetists) and AMA (Australian Medical Association).
In my non-working time, I enjoy spending time with my family (including three small children), gardening, DIY and simply relaxing in nature.
Preparing for Your Anaesthetic
Ensuring your safety begins with proper preparation. Follow these guidelines to ensure a smooth surgical experience.
Prior to the day of your surgery, either my team at TCI Health or I will be in touch to ensure we have had communication regarding these aspects.
Most medication should be taken up until and including the day of your surgery (with a small sip of water on the day). It is especially important if you take pain medications for chronic pain that this is continued.
Medications that may need to be ceased or altered include:
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Blood thinning medication (eg aspirin, warfarin, apixaban, rivaroxaban etc).
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Diabetic medication including both tablets and insulin.
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Weight loss medication (eg Ozempic, Mounjaro etc). These medications can often be continued, however fasting guidelines may need to change - see downloadable resource below on "GLP-1 antagonists".
Please notify me before the surgery if you take any of these medications and we can discuss what we should do with them pre-operatively.
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Fasting is important before an anaesthetic to prevent the risk of food or fluid being regurgitated during the procedure which can result in potentially severe respiratory complications. Fasting should be for at least 6 hours for all solids (including milk or thick soups), and 2 hours for clear fluids (which includes water, clear apple juice and black coffee/tea).
These guidelines can change depending on your specific circumstances, for example in emergencies, if you have had prior gastric surgery, or are on medications such as Ozempic.
If you are having a day procedure and are expecting to return home that night, it is important that you have a responsible adult arranged to pick you up, escort you home and stay with you overnight. Even when you feel fully awake after an anaesthetic, your reflexes and decision-making may be impaired, so it will be unsafe to drive or make major decisions for about 24 hours.
If you use equipment such as CPAP overnight, it is essential that you use this the night after surgery.
What to Expect
Different types of surgeries and medical conditions require differing anaesthetic techniques. Anaesthesia doesn’t always involve “being asleep”! (But a lot of the time it does.) Irrespective of the anaesthetic
technique, I am always present for the entire duration of the surgery to ensure your safety and comfort.
Please also see below for further downloadable resources. If you are interested in learning more about anaesthesia, the following website is an excellent resource: www.anzca.edu.au/patient-information
General Anaesthesia
A general anaesthetic means you will be asleep for your surgery. To conduct a general anaesthetic, after our meeting and discussion, I will place an intravenous cannula in either your hand or arm. Once you are in the operating theatre, I will administer anaesthetic medications through the cannula and shortly after, you will be asleep.
The general anaesthetic usually also involves me helping you with your breathing with a breathing device which is placed after you are asleep. This can result in a temporary sore throat upon awakening. There is a very small risk of dental injury with the breathing device. Once the surgery is complete, I will watch over you until you are awake enough to bring you to the recovery room, which is where most patients remember waking up.
My aim is to have you awaken in the recovery room as comfortably as possible, however it is normal to feel drowsy for some time.
Serious risks of general anaesthesia are very rare, and if you are concerned, I can discuss these with you in
person or over the phone.
Spinal Anaesthesia
Spinal anaesthesia is where the anaesthetic medication is introduced into the fluid surrounding the spinal cord. In modern anaesthesia, spinal anaesthesia is conducted in a very safe manner. In all circumstances where it is offered, it can be either as safe or safer than a general anaesthetic. It is commonly used for Caesarean sections, orthopaedic and urological procedures.
This anaesthetic is performed while you are either awake or lightly sedated in order to minimise risks. After your back is sterilised with antiseptic, I will use some local anaesthetic to numb the skin in the middle of your lower back. Occasionally it can take a few minutes to find the correct position to place the anaesthetic, but once the anaesthetic is administered, the needle is removed. The
anaesthetic can take several minutes to work well, and I will be checking to ensure it is as expected prior to your surgery.
Risks of spinal anaesthesia are extremely rare. Sensations during the procedure such as light touch, pressure or stretching are expected, but at no time do I expect you to feel pain. Complications like a serious headache are uncommon and usually self-limiting (however in a very small number of patients, a further injection in the back is required to resolve this headache). Finally, nerve injury in the back or legs is extremely rare, with the rate of serious permanent nerve injury or paralysis being approximately 1 in 140,000.
Financial Considerations
The anaesthetic fee is separate from surgical and hospital fees. It is determined by factors including the type of surgery, complexity and duration, and patient aspects such as health status. The Australian Medical Association (AMA) recommended fees for anaesthesia are often higher than the rebates from insurers and Medicare; it is for this reason that an out-of-pocket gap fee is applicable. Please see above downloadable resource from the ASA for more information about how rebates and fees are established.
In most circumstances, this gap fee is capped at a level determined by your insurer.
My team at TCI Health will be in touch regarding an approximate quote for the anaesthetic fee. Depending on your insurance fund and Medicare status, different rebates and out-of-pocket gaps are applicable for even the same surgery and anaesthetic.
Special Financial Note
In some circumstances, a capped out-of-pocket gap fee is not possible due to the nature of your surgery and insurance. You may be asked to pay the full anaesthetic fee, and to claim the rebate back from your insurer and Medicare after the procedure.
This may include procedures which are anticipated to be an extended duration, if you are uninsured, insured by an overseas fund, or do not have Medicare.
Get in Touch
I am dedicated to providing you with a safe and comfortable journey through theatre. If you have questions about my practice, preparation guidelines, or financial considerations, I am here to help.
Email: info@drmichaelangsuwat.com