Before your Operation

Answer the questionnaire

The pre-operative questionnaire contained in this website contains the information your anaesthetist needs to know to help get a clearer picture of your health.  This would enable your anaesthetist to plan the most suitable anaesthetic procedure and minimise the risk for you.  Anaesthetists are interested to know:

• your medical history (eg. heart, respiratory, kidney problems)
• your previous operations, and whether you had problems with anaesthesia before
• whether you are taking any medications (eg. aspirin, clopidogrel, warfarin) including herbal medicines
• your lifestyle (eg. drinking alcohol, smoking, recreational drugs)
• your physical fitness level when performing normal activities (eg. walking upstairs)
• your physical condition (eg. back and neck mobility)
• your dental condition (eg. any loose, capped or crowned teeth, implants, dentures)

You should answer all the questions asked honestly – it is all about minimising the risk to you.

Consult your anaesthetist

Prior to the your operation, the anaesthetist will meet with you.  Based on the answers you submitted in the questionnaire, you may be asked further questions and/or undergo additional relevant examination.  Do not worry, as this is all part of better understanding your health and to minimise the risk.

During the meeting, the anaesthetist will describe the conduct of the anaesthesia, post-operative pain management, potential complications and risks, and provide an opportunity for you to ask questions.  You should also inform the anaesthetist if you have any issues with blood transfusions.

When meeting your anaesthetist for the first time, bring with you:

• list of your current medications (if you did not complete the questionnaire)
• any letters received from previous anaesthetists
• any letters from specialists for the operation you are about to have
• any blood test results performed by your local doctor in the last 6 months

Increase your fitness and health

There are some things you can do which will make your anaesthetic safer.

• Get a little fitter (eg. regularly walk)
• Stop smoking (ideally stop 8 weeks before surgery)
• If you are overweight, make a serious attempt to reduce your weight before your procedure
• Minimise alcohol consumption
• Avoid any type of recreational drugs as these may negatively interact with the anaesthetic drugs

Follow fasting guidelines

Patients who are having an anaesthetic will be advised of fasting times for solid food and liquids and it is important to follow the instructions provided by the anaesthetist.  This is to minimise the risk of food or fluid in the stomach being aspirated (inhaled) into your lungs while you are unconscious.  If you have food or water during this period, the operation may be postponed in the interests of your safety.

In general, the following guidelines will apply, however it is essential to follow the instructions of your anaesthetist, which may vary depending on the patient and the procedure.

• Solid food (including milk) must not be taken for up to six hours prior to the operation
• Drinks must not be taken for up to four hours prior to the operation
• Water must not be taken for up to two hours prior to the operation

Follow instructions on medication

Continue to take medications which have been prescribed previously but inform your anaesthetist and surgeon on what they are.

The anaesthetist may, where relevant, give instructions regarding your medications that can be allowed prior to and/or on the day of surgery.  These include and are not limited to:

• blood thinners such as aspirin (Astrix, Cartia), clopidogrel (Plavix, Iscover), and warfarin, which may need to be stopped for up to 10 days before the date of surgery
• insulin or tablets for diabetic patients, which should not be taken on the day of surgery
• non-steroidal anti-inflammatory drugs, which should not be taken for up to two days prior to surgery
• herbal products, which may need to be stopped for up to two to three weeks prior to surgery

You should obtain instructions from your anaesthetist regarding the stopping and starting of such medications.

Occasionally patients may be prescribed medications (such as anti-reflux medicine) to be taken the night prior and on the morning of surgery.

On the day of surgery, you should only take instructed and/or prescribed drugs with a small sip of water only, and only those medications ordered by the anaesthetist should be taken (with a little water if required) less than two hours prior to the anaesthetic being given.