Bathing and Showering
Please bathe or shower with soap and wash your hair before the operation. This reduces the risk of developing an infection. You are required to shower both the night before and the morning of your surgery. Shower with a special soap called chlorhexidine, or a similar antibacterial product.
Smoking
Do not smoke on the morning of your surgery. If possible, try to give up smoking altogether, or cut down before you are due to come into hospital. The longer you can give up beforehand, the better. It is very important that you try to stop smoking at least 4 to 6 weeks before the date of your operation, if possible. Smoking reduces the amount of oxygen in your blood and increases the risk of breathing problems during and after an operation.
Smokers:
- Need more anaesthetic during surgery
- Need more oxygen therapy in the recovery room
- Have slower wound healing.
- Have a higher risk of developing chest infections after surgery
- Have a higher risk of developing deep vein thrombosis (DVT)
- Have a higher risk of non-union of the bone, especially after fracture
Your Weight
If you are very overweight, many of the risks of having an anaesthetic are increased. Reducing your weight before the operation will help to mitigate these risks.
Being overweight increases your chance of experiencing side effects and complications during surgical procedures, such as:
- Difficulties locating veins for anaesthesia and medications
- Complications determining the right dosage of medications and anaesthesia to give
- Challenges with providing the amount of oxygen and airflow during surgery, which increases the risk of breathing problems
- Increased time to regain consciousness after surgery and recover from surgery (as well as any complications, if they are experienced)
Teeth
If you have loose or broken teeth or insecure crowns, you may want to visit your dentist for treatment before your operation. The anaesthetist may need to put a tube in your throat to help you breathe, and if your teeth are insecure, they may be damaged.
Problems with your teeth and gums can be a major source of bacteria and lead to infection. Bacteria can enter the bloodstream or the lungs, causing complications during or after surgery.
- We recommend brushing your teeth for two minutes last thing at night before you go to bed and on one other occasion every day to reduce the amount of bacteria in your mouth.
- You should use a pea-sized amount of toothpaste
- We encourage you to use a dry, small-headed, medium-bristle toothbrush. If you use an electric brush, we recommend one with an oscillating or rotating head.
- DO NOT wet your toothbrush before brushing. After brushing, spit and DO NOT rinse with water or mouthwash. This gives your toothpaste time to work at protecting your teeth.
- Make sure you brush all the surfaces of all your teeth, which should take about two minutes. Remember to brush the inside surfaces, outside surfaces and the chewing surfaces of your teeth. Try and angle your toothbrush at the gum and use a small gentle, circular motion when brushing – there is no need to scrub
Medical history
Suppose you have long-term medical problems such as diabetes, asthma or bronchitis, thyroid problems, heart problems or high blood pressure (hypertension). In that case, you should ask your doctor for a check-up before your operation.
Health check before your anesthetic
Before your anesthetic, we need to know about your general health. We will conduct a health check by asking you questions at the Pre-operative Assessment Clinic. You may also need some tests, such as an ECG, to ensure you are fit enough for the anaesthetic.
Admission time
You will be asked to arrive at a specific time of day, according to where you are on the surgeon’s operating list. It is very important to arrive at the time you have been given. If you arrive too early, they may not have room for you to wait, and if you arrive too late, your operation may be cancelled.
If you have a general anaesthetic and are leaving the hospital on the same day, you will need to have a responsible adult with you overnight and for the next day. This is because it can be risky for you to be alone after having a general anaesthetic.
Eating and Drinking
We will give you specific and clear instructions about eating and drinking before your operation when you come for your Pre-operative Assessment appointment.
In brief – you must not eat any food, chew gum or suck sweets for 6 hours before a general anaesthetic or sedation.
You may drink clear fluids only (such as water or squash) up to 2 hours before having general anaesthetic. Drink plenty of fluids (preferably water) the day before your operation to help keep your body hydrated.
Clear, see-through liquids include:
- Water
- Clear fruit juices such as apple juice and white cranberry juice
- Plain tea or black coffee (NO milk or creamer)
- Clear, electrolyte-replenishing drinks such as Pedialyte, Gatorade, or Powerade (NOT yogurt or pulp-containing “smoothies”)
- Ensure Clear or Boost Breeze (NOT the milkshake varieties)
- If you are asked to arrive between 7.30 am and 12 noon do not have anything to eat, chew gum, suck sweets, or have any drink with milk in it after midnight the night before. You can drink water or clear non-milky beverages (e.g., squash, black tea/coffee) up to 2 hours before admission.
- If you are asked to arrive after 12 noon, you may have a light breakfast of tea or coffee with a piece of toast before 7 am. Do not have anything more to eat, chew gum, suck sweets or have any drink with milk in it after this time. You may drink water or clear, non-milky beverages (e.g., squash, black tea/coffee) until 11 am.
- Certain procedures may require special preoperative fasting instructions. For example, patients undergoing colonoscopy, bariatric (obesity) surgery, or colorectal surgery may be instructed to be on a clear liquid diet before surgery for a day or more prior to their procedure.
For your own safety, it is very important that you do not have anything to eat or drink after the times stated. If there is any food in your stomach when you have a general anaesthetic or sedation, it could come up into the back of your throat and then go into your lungs. This would cause choking or serious damage to your lungs. If you do have something to eat or drink after.
The relaxation of the body’s muscles that occurs under anesthesia increases the risk of food regurgitation and potential aspiration. The fasting guidelines, while seemingly strict, are necessary to try to mitigate this risk as much as possible. Adhering to these guidelines contributes to our common goal of a smooth anesthetic and procedure.
If food is had then, your operation will have to be delayed or even postponed to another day.
Bowel Surgeries
Suppose you are undergoing a colorectal procedure/surgery requiring bowel cleansing. In that case, you will be given specific instructions related to fasting, clear fluids, and additional bowel preparation.
Medicines
Before a general anaesthetic, we need to know all about your medicines, including any inhalers or creams and off-the-shelf medicines. You should continue to take your regular medicines up to and on the day of your surgery, unless your anaesthetist or surgeon has asked you not to.
If you take drugs to thin your blood (such as Warfarin, Aspirin, Clopidogrel etc.), medications for diabetes, or any herbal remedies, you will be given specific instructions about when to stop taking these at your Pre-operative Assessment visit.
Please bring all your medicines with you to hospital in their original containers.
