Preparing for your anaesthetic and medical procedure should start early ! You can start to make plans around the following areas:
Exercise
In general the fitter you are the better your body will cope with the demands of the anaesthetic and procedure. Try to increase your level of activity in the weeks prior to your anaesthetic. If you are planning a hip replacement this may be difficult or impossible but in many instances it is possible to do a bit more exercise which will help.
Managing other medical conditions
Other medical conditions should be under good control prior to a planned medical or surgical procedure. This includes high blood pressure, asthma and diabetes to name a few common conditions.
Smoking
Everyone knows that smoking is not good for one’s health – that it causes cancer and chronic lung conditions. However it is also bad in the short term around the time of operations. Quitting a few weeks prior to your anaesthetic will allow your lungs to recover and help your breathing during your operation. It will also increase the levels of oxygen in your blood and improve wound healing. Remember also that hospitals are non-smoking establishments ! Nicotine patches can be used during your hospital stay.
Teeth
If you have loose teeth you are advised to see your dentist prior toyour anaesthetic.
Starvation
Experts disagree about the optimum time for starvation prior to elective surgery under anaesthesia. Please read these guidelines carefully prior to a general or regional (spinal/epidural) anaesthetic. Follow them and discuss with your anaesthetist in advance or at their pre-operative visit to clarify plans for your procedure. There is very strong evidence that over-long starvation has a deleterious effect on recovery after surgery. At all times our intention is to give you the highest quality care.
| Morning lists with an anticipated start time of 8:30am Patients may eat until midnight |
| Afternoon lists with an anticipated start time of 1.30pm Patients may have a light breakfast (toast or cereal) up to 7.30am |
| Evening lists with an anticipated start time of 5.30pm Patients should eat a normal breakfast and have a light lunch up to 11.30am |
Please note:
‘Clear fluids’ means only the following: plain water, black tea or coffee (inc sugar) and diluted fruit squash.
The following are not permitted: milk in tea or coffee, fruit juices, alcohol, chewing gum and sweets.
Solids in any form (other than pills and tablets – which should be taken as normal with a sip of water as required, see below) must not be taken within six hours of the anaesthetic. Milk is considered a solid.
These guidelines apply to anaesthesia for all elective surgery.
Medications and allergies
This is particularly important, please take time to read this carefully.
It is often easier to bring a list of your medications and allergies rather than committing them to memory.
We recommend that as a general rule you continue to take all your normal pills and medications (with a sip of water if required) at the normal times even on the day of surgery except in the following circumstances:
| 1. | you take any drugs that end with ….pril (eg enalopril, ramipril, lisinopril etc) – avoid these on the day of surgery |
| 2. | you take any drugs that end with …artan (eg losartan, valsartan, candesartan etc) – avoid these on the day of surgery |
| 3. | you take tablets to control your diabetes. All pills and tablets used to treat diabetes should be omitted on the day of surgery. |
| 4. | you are having spinal surgery. Please consult your surgical consultant. |
| 5. | you take warfarin. Warfarin should be stopped 5 days prior to surgery – with the exception of cataract surgery and cardioversion. If you take warfarin because you have a mechanical heart valve you will need specialist advice from your anaesthetist (tel:0238 0266570). |
| 6. | you are having a cardioversion. Digoxin is usually stopped a week or so prior to cardioversion. Warfarin is to be continued as are all other medications (i.e. disregard points 1. and 2. above) |
NB. Packs of pills often have trade names in bold type and the generic name in smaller type. EgBrufen is the trade name for ibuprofen; Cozaar is the trade name for losartan. We have only quoted the generic name.
There is often confusion about being asked not to eat and drink prior to an anaesthetic and at the same time being told to take pills with a sip of water as normal. Being starved does not mean that you should not take your pills – or to put it the other way, do take your pills (as outlined above) even though you are being starved.
Herbal and alternative therapies
The actual ingredients of many novel and alternative therapies are uncertain and in some circumstances will interact with anaesthesia. As a result we advise that all herbal and alternative medications are stopped at least one week prior to surgery. The following sites have further information.
http://www.asahq.org/patientEducation/herbPatient.pdf
http://www.anesthesia.wisc.edu/Clinic/providerinfo/herbals.html
Serious reactions to anaesthetics
Very rarely, due to genetic factors, there can be a potentially fatal reaction to anaesthesia. If you or any blood relative has previously had a severe reaction to an anaesthetic please investigate this and provide as much information as possible.
Information Sheets
www.youranaesthetic.info contains information sheets on a range of issues relating to your anaesthetic which you may find helpful.
