Covid-19 effectively stopped elective surgery as well as diagnostics and the country faces a massive waiting list. Thankfully we are operating more normally at all my hospitals. However, there is still Covid-19 virus in the community.  If a patient is infected at the time of the operation or becomes infected before the wound has… Read more »


  Here is a list of blogs on this site. You can also find them using the search function. I hope they are helpful.   Managing and preventing diabetes Diabetes and anaesthesia Breast feeding and anaesthetic drugs Preventing deep vein thrombosis (DVT) Anticoagulants and surgery Preassessment Anaemia and low iron Allergies under anaesthesia Nausea and… Read more »

Managing and preventing diabetes

  This blog will provide general advice about type two diabetes. There is another blog on my website describing how we manage diabetic patients in the perioperative period.   There are two types of diabetes: type I occurs when the insulin producing cells in the pancreas are destroyed. The reason is unknown although viral infections… Read more »

Diabetes and anaesthesia

  This is one of two blogs on diabetes and will explain how we prepare patients who are diabetic for operations and manage them during their hospital stay. There is a second blog which explains how we can prevent and manage diabetes   Diabetic patients have a higher surgical morbidity and mortality. They suffer from… Read more »

Breast feeding and anaesthesia

  If you need either general anaesthesia or sedation while you are breastfeeding I will always give you specific advice at the time but I thought a blog outlining some general principles might be helpful to patients before they come into hospital.   There are two separate issues: first caring for the mother and secondly… Read more »

Preventing deep vein thrombosis (DVT)

  1000 patients suffer a DVT each year in the UK. A clot forms in the large veins deep inside the leg causing swelling and pain. One in 10 of these clots will break off and spread to the lungs where it is called a pulmonary embolus. A pulmonary embolus can result in chest pain… Read more »

Anticoagulants and surgery

  In this blog I am going to discuss how anaesthetists manage patients who are already on anticoagulants. There is another blog on my website about using anticoagulants after operations to prevent deep vein thrombosis and other clotting problems   Patients who are on anticoagulants or blood thinners will not form clots and are more… Read more »


  Major changes occurred in hospitals in the 1980s. Driven by improvements in anaesthetic drugs and monitoring capabilities, we realised that not every patient needed to be admitted to hospital the night before surgery nor to stay until the following day. The development of day case surgery, also known as ambulatory surgery in the United… Read more »

Anaemia and low iron

  Anaemia is an abnormally low level of haemoglobin in the blood. Haemoglobin carries oxygen but the red cells also maintain the fluid balance around the body. Anaemia is relatively common and even in the developed world exists in up to 5% of the population. It is now agreed that the ideal haemoglobin for major… Read more »

Allergies during anaesthesia

  A number of my patients have been concerned about being allergic to an anaesthetic drug. Most allergic reactions are so mild that they need no treatment but the rare serious allergy is very serious. Working together, anaesthetist and patient can minimise the risk.   An allergy is an abnormal learned response of the immune… Read more »