Preparing for surgery

You should avoid smoking for as long as you can before and after surgery. It is especially important not smoke the morning of surgery. This will help you achieve the best possible results from your surgery and also reduce the chance of anaesthetic complications. For example, quitting will reduce the chances of problems like a wound infection after the operation. Surgery can also be an excellent opportunity to quit smoking for good.

Most anaesthetists require six hours of strict fasting from both food and fluids including water prior to an operation. The reason for not eating or drinking prior to your operation is to prevent possible regurgitation of your stomach contents into your lungs. This event is a complication known as aspiration which is potentially life threatening. Your surgeon and/or your anaesthetist may have specific changes to these guidelines in certain operations or if you suffer from specific medical conditions. Please contact our office if you have any questions.

Nausea after an operation is a multifactorial problem. There are patient factors, surgical factors and anaesthetic factors contributing to the risk and severity of any nausea that you might suffer after your operation. Nausea often occurs with Gynaecological, Ear Nose & Throat, Breast and abdominal surgeries. Patient factors such as previous nausea, predisposition to motion sickness and preoperative anxiety also contribute to postoperative nausea. Women are generally at slightly higher risk of nausea after operation than men. There have been significant advances in the treatment of postoperative nausea and vomiting in the last few years. If you are prone to nausea and vomiting you should inform your anaesthetist before your operation.

Around the time of operation diabetics may suffer lower sugar levels than normal due to both pre-operative fasting and the body’s natural response to undergoing surgery. An adjustment to diabetic medication generally needs to be made before operations to reduce the risk of low blood sugar levels. Axxon anaesthetists have different protocols to manage the risk of low blood sugar in the perioperative period – please either contact your surgeons rooms (they have access to your anaesthetist’s protocol), or if you have any further questions or concerns contact Axxon directly.

If you are taking anticoagulant medication (warfarin, heparin, clexane, dabigatran, rivaroxaban) or antiplatelet medication (aspirin, clopidrogel, dipyridamole) you should check with your surgeon well in advance of your surgery. Many of these drugs last in the body for days or weeks and may need to be ceased or altered prior to surgery. It is imperative your anaesthetist is aware you are taking any of these medications especially if you are to undergo epidural or spinal anaesthesia. If you are unsure about whether any of your medications are blood thinners or how they or any of your other medications should be managed perioperatively please contact our office.

Having oxygen immediately before the induction of general anaesthesia can be likened to filling up the fuel tank of a car before going for a drive. A mask administering oxygen is generally placed lightly over your mouth and nose. Space can be allowed if you suffer claustrophobia, however the greater the amount of oxygen you receive at this time, the greater your safety as the anaesthetic begins. The masks we use may smell unpleasant as they are made from various plastics and have never been used prior to your anaesthetic. They are non-toxic. Some hospitals have scented masks available.

A small needle is used to guide a tiny plastic tube known as an intravenous cannula into a vein prior to the start of the anaesthetic. This generally occurs in a vein on your arm, back of your hand or in your elbow, but can occur anywhere on the surface of your body. This cannula, sometimes known as a drip, allows the anaesthetist to very carefully and closely control your anaesthetic. Having your safety in mind, most anaesthetists will insist on inserting a needle or drip before putting you to sleep. Axxon’s anaesthetists each have slightly different guidelines relating to the requirement for cannulas prior to general anaesthesia. Generally, babies and small children do not require a needle before they go to sleep.

Generally speaking, it is possible for your anaesthetist to take blood tests whilst you are under anaesthetic. Exceptions to this are very short (less than 30 minutes) operations. Taking of a blood test by your anaesthetist must be prearranged. Your general practitioner should write the blood test request form so that they can follow up the results. Not all hospitals have access to the appropriate blood sample tubes, so you may need collect them from the appropriate laboratory before coming to hospital. The hospital can generally arrange for the samples to be collected from the hospital and sent to laboratory whilst you are recovering from your operation. Please contact our office as soon as possible if you wish to determine whether blood tests can be taken whilst you are under anaesthetic.

In general, you should continue to take your usual prescribed medication with a sip of water before your anaesthetic. It is especially important that you continue to take your usual heart medications. Diabetic and blood thinning medication sometimes need to be reduced or ceased prior to operations. Please discuss this with your surgeon or call our office for further instructions