Preparing for surgery

Posted on 7 February 2014

Psyching yourself up for elective surgery is a challenge but there are some vital things to remember on the day, says Dr Gert van der Merwe, a general surgeon at Mediclinic Tzaneen.

Do I have to be honest on my answers to the pre-surgery questionnaire?
It’s imperative that you answer these questions as honestly as possible. This information is invaluable in determining your risk for complications during the operation. It also informs us what we should be on the lookout for. It will determine the level of monitoring that you’ll require during your procedure, as well as the level of care that you’ll need post-operatively. Remember to inform your surgeon or anaesthetist of any prior bad experiences you’ve had after surgery (such as nausea and vomiting, allergies to medications, etc), as well as whether you’re on any chronic medication.

Are there any medications I shouldn’t take before surgery?
Blood thinners like Warfarin or aspirin-based medications should be stopped a week before surgery to minimise the risk of bleeding during the operation. Having said this, there’s a reason why you’re on these blood thinners and the risk for developing thrombosis (or clots) during surgery is in fact increased. The problem with these medications is that some of them have a very long action and there’s no antidote to use for them. You should inform your surgeon well in advance and your anaesthetist if you are on any of these, so that the appropriate measures may be taken to ensure you don’t have undue risk for either bleeding or thrombosis in the time around your surgery. Certain blood pressure medication is also best avoided prior to surgery, so tell your physician about those too. Malaria tablets and/or drugs containing quinine can cause abnormalities in the heart’s conduction of electrical impulses and, as such, are best avoided prior to surgery.

Why can’t I eat a few hours before? Is a sip of water ok?
When you’re put to sleep under anaesthetic, you lose all your protective reflexes, like coughing or responding to pain. For a brief period after putting you to sleep, we have to breathe for you using a mask that fits over your face and nose. During this time, it’s possible to inflate the stomach with air. If this air comes up through the gullet, it can be accompanied by food or drink, which can go into your lungs, causing a severe reaction and possible lung infection. In short, the emptier your stomach, the less the chance of having such a problem. The general rule is nothing to eat or drink for eight hours prior to surgery, but clear fluid can be taken in small amounts up to four hours before surgery for adults and two hours for babies. Check with your all your physicians first.

Why mustn’t I wear nail polish on my toes and fingers?
While under anaesthetic, you’ll be monitored in various ways because we need to see very quickly how your body responds to the stress of the anaesthetic, as well as the surgery. Pulse oximetry is a fairly complicated instrument that measures the spectrum of light as red light passes through a finger or toe (in general). The spectrum of light gives us information regarding what percentage of the hemoglobin in your blood is saturated with oxygen. This means we need to be able to see under your nails as this measurement is influenced by the nail polish.

 

Published in Surgery

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