Before the Operation

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The anaesthesiologist will conduct a pre-operative visit on the morning of your planned surgery to ensure that you are fit to undergo surgery based on your history, examination and results of any investigations. At this time the anaesthesiologist will also decide on and discuss the type of anaesthesia that is optimal for your surgery and medical history. This is the best time to discuss concerns about the anaesthetic and other techniques that may be employed with your anaesthesiologist.

The anaesthesiologist will try to see you in the ward for the pre-operative visit, BUT is it is NOT always possible and you may only be seen by the anaesthesiologist in the theatre reception area.

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History

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You will need to know about your medical history and may be asked about the following:

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1. Current and previous medical conditions

e.g. hypertension, diabetes, cholesterol, cardiac disease, asthma, epilepsy and thyroid conditions

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2. If you have a family history of medical conditions especially those that may be anaesthetic related

e.g. porphyria, scoline apnoea and malignant hyperthermia.

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3. Problems with previous anaesthetics

4. Allergies

5. Current medication including homeopathic meds and supplements

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It is useful to bring along the actual medication or a list of the medication you are taking. This includes prescribed and over-the-counter drugs. You should continue taking your chronic medication up to and including the day of surgery (with a small sip of water) unless your anaesthesiologist or surgeon has asked you not to e.g., diabetic meds, blood thinning meds and some herbal remedies.

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Examination

A medical examination will be done by the anaesthesiologist, looking in particular at your:

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General condition

Airway (most anaesthetics require that a breathing tube be inserted)

Cardiovascular system (heart)

Lungs and chest

Any weakness or numbness, especially if you are having a regional block, local anaesthesia or lines inserted.

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Further investigations may have to be ordered. This will be guided by your history and examination. (These may entail additional costs and delays that prevent surgery being done at the time planned). At times another specialist may be required to assess your condition further.

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Blood tests e.g. full blood counts, haemoglobin, infection markers, kidney, liver and thyroid function.

X rays (chest or other)

Heart examination (ECG or an ECHO)

Using the above information the anaesthesiologist will discuss the best anaesthetic options available to you for the planned surgical procedure.

At times your anaesthesiologist might have to postpone your surgery based on the preoperative consultation and investigations. This is done to improve your condition in an attempt to decrease the risks of anaesthesia and surgery. This delay is usually until the problem is corrected or brought under control.

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Pre-medication

Medication may need to be given to you before the operation in an attempt to make you less anxious, decrease nausea, or for pain control. These may not be routinely used and are guided by the surgery and patient medical history. In the case of short day surgery they may keep you drowsy after the operation and delay your discharge home.

Fasting

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YOU NEED TO BE STARVED FOR ALL ANAESTHETICS AND SEDATION.

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All patients including children must have no food or milk products from 6 hours before admission, but may have clear fluids (water, black tea, clear apple juice or clear energy drinks) up to 2 hours before you report to the hospital on the day of your operation. Failure to adhere to these guidelines significantly increases the risks of aspirating (choking) and suffocating during the procedure which can have dire consequences.

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Morning surgery – No food or milk products after midnight. Clear fluids up to 5am.

Afternoon surgery – No food or milk products after an early light breakfast (before 7am). Clear fluids up to 10am