Anaesthesia for the procedure

There are three options for anaesthesia for port implantation.

1. local anaesthesia only,
2. sedation and local anaesthesia,
3. being put to sleep and local anaesthesia.

Local anaesthesia

The simplest, and the least comfortable for the patient. Injecting any fluid under the skin is painful; the anaesthetic only starts working after a few minutes of pain. Even a patient who is asleep reacts to the pain of the injection, let alone a conscious one… It may also happen that not every place where something will happen during the procedure gets anaesthetised. And there are places that cannot be anaesthetised locally at all. Besides, a conscious patient, even if properly anaesthetised, still has an active imagination, which registers sensations it has never known before and suggests all sorts of things. This is certainly far from comfortable.

Sedation and local anaesthesia

In my view a step in the right direction, but not enough.

Being put to sleep and local anaesthesia

Being put to sleep and local anaesthesia: I am in favour of combining sleep with local anaesthesia. Apart from one port removal in a breastfeeding patient who insisted on having the procedure under local anaesthesia, all of the other 4,500 anaesthetics for port implantation that I gave up to 30.09.2025 were done this way. Since we have an operating theatre, the right monitoring equipment and qualified, experienced staff at our disposal, what we do should give patients proper comfort, not just less discomfort.

Patients are simply entitled to this comfort.

There is no need for patients to be conscious during the procedure. What for? The patient cannot help me, and I will not be able to talk things over with the patient. It is not the time for a chat but for carrying out the procedure. Besides, not every patient wakes up without problems. Some are confused and try to get up, it can even come to a “struggle”, and patients are sometimes convinced that they are at home and are therefore worried that this home is somehow different from usual. Only after several minutes of explanation do they realise where they are and what is being done. This simply disrupts the procedure and does no one any good.

That is why the patient sleeps during the procedure. Only once they are asleep is the local anaesthetic given. After the procedure we give an agent that reverses the effect of the sleeping agent, and within a minute the patient wakes up. They wake up without pain, though, because the local anaesthetic is working. After the procedure patients are taken to the recovery room, where, with the help and under the supervision of a nurse, they get back on their feet and back to how they were before the procedure.