Preparation for your surgery

Medical Conditions

Many patients have other illnesses or medical conditions in addition to their reason for surgery. It is important to have these conditions treated and adequately optimised before you have elective surgery.

If things have changed recently (e.g. you have been getting new chest pain or becoming more short of breath than usual), it is important that you tell me or your surgeon. Most importantly, as soon as you notice any changes, you need to let your GP know so that a proper assessment can be done, even if you are not having surgery.

Medications

If you take medications, it is important for the surgeon and me to know. It is especially important if they are blood thinners, inhalers, heart, blood pressure or diabetes medications.

There are some drugs that you can continue to take (most of them) and others that we will need you to stop some days before surgery.

It is very useful if you can provide me with a current list of the drugs’ names and doses you take.

Smoking

Smoking causes many problems with anaesthesia, mainly related to the respiratory system. If you are a smoker you have a higher chance of having complications during and after your surgery. These might commonly include complications such as low oxygen levels, increased secretions, cough, postoperative pneumonia, bronchospasm, among others.

Ceasing smoking before your surgery is extremely beneficial to avoid these respiratory complications. It is ideal if you quit a minimum of 6 weeks prior to your surgery. I do understand that this is not an easy task, however, even if you do not smoke for 48 hrs. before your procedure, there are already some significant benefits in terms of oxygen delivery to your organs during your surgery.

If you need help with quitting, talk to your GP. The success rate is higher if you get help rather that doing it yourself or going “cold turkey”.

Fasting and Hydration

For elective surgery, you should not have any food for at least 6 hours and no water for at least 2 hours before your anaesthetic.

This international recommendation is vital. Not fasting for an anaesthetic can cause an aspiration of gastric contents into your lungs which can be fatal.

This does not mean that you should fast for longer (e.g. more than 12 hrs.) as this can cause other problems. It is especially important not to become dehydrated. It is beneficial if you continue to drink water up until your fasting time. The best way to assess this is to obey your thirst.

Acute Illness

In surgery and anaesthetics, we don’t take any unnecessary risks. This includes, in elective surgery, only operating on people who are as optimised and fit as possible. For this reason, it is very important that you let the surgeon, me or the hospital know if you are suddenly not feeling well. Not everyone who has “a bit of a head cold” or “runny nose” will be cancelled, however, there are some symptoms and signs that tell us that your risk has gone up. Ultimately, any decision is not made lightly and will always be in your best interest, with the best outcome as our goal.

Preoperative assessment

Depending on the type of surgery that you are having, as well as your age and other pre-existing medical conditions, I might contact you a couple of days prior to your surgery. Occasionally, it might be necessary to schedule an appointment so that I can see you in person.

I will mainly be interested in:

• Any medical history (e.g. heart disease, breathing problems, diabetes, strokes)
• Medications you take (any, including non-prescription)
• Previous problems with anaesthetics (e.g. nausea and vomiting, allergic reactions, unexpected admission to ICU)
• Known drug allergies