Preoperative Information
FREQUENTLY ASKED QUESTIONS
Do any of the following apply to you?
If you are unsure of anything, please contact us
Are you currently feeling unwell?
- This relates to symptoms such as chest pain, shortness of breath, palpitations or dizzy spells in particular.
- Please discuss this with the surgeon or anaesthetist prior to hospital admission.
Is your child not well just before surgery?
- You should contact the surgeon or the anaesthetist if your child develops a significant cough or cold within two weeks of the operation, or diarrhoea or vomiting within a few days of the day of the operation. It may be necessary to delay the operation until your child is better.
- Recent vaccination is not normally a problem for children having an anaesthetic unless they develop a high temperature just before they are due to have surgery, in which case it is sometimes better to delay surgery.
Are you taking medication for a chronic medical illness?
- Please inform the surgeon if you are taking blood thinning medication.
- Please bring your medication with you on the day of admission.
- Please bring it in the original packaging, if possible.
- Alternatively, please bring a copy of the prescription or a written list of the medication you are taking.
- Should I drink my medication on the day of surgery? Follow the link for more information LINK (page 3).
Are you taking blood thinning (anticoagulants) medication such as Disprin, Xarelto, Plavix & Warfarin?
Please inform the surgeon prior to hospital admission.
Do you use Viagra?
- The Viagra (Sildenafil), Cialis (Tadalafil) and Levitra (Vardenafil) can lead to dangerously low blood pressure, when combined with certain other medication.
- Anaesthetists advise Viagra users to exercise caution and not take it for at least 24 hours before surgery.
Are you taking Depnil (Moclobemide)?
Depnil interacts with certain medication routinely used during anaesthesia, with potentially life-threatening complications. Please inform the anaesthetist prior to undergoing anaesthesia.
Are you taking herbal medication?
- People believe that if something is natural, it is automatically safe. This is not necessarily true.
- Herbal products may interact with anaesthetic medication. Some of the potential side effects are increased surgical bleeding, heart and blood pressure effects, reactions with sedatives and changes in the body’s interactions with other medications.
- Anaesthetists recommend that you stop taking herbal products at least one week prior to undergoing surgery.
Are you using recreational (street) drugs such as Cannabis, Heroin, Cocaine, Amphetamines (Ecstasy)?
- Anaesthetists recommend that street drugs not be taken for at least a week prior to surgery.
- These drugs can have a significant impact on your health and also interact with the anaesthetic medication.
- Please inform the surgeon and anaesthetist of any street drug use prior to admission. This is to ensure your well-being, not inform your personal choices.
Do you smoke cigarettes?
- It is advisable to stop smoking at least 8 weeks prior to your surgery, so as to experience the maximum health benefits.
- Anaesthetists recommend that you not smoke for at least 8 hours before your procedure.
Do you drink alcohol every day?
- Please inform your surgeon and the anaesthetist prior to hospital admission. This is to ensure your optimal healthcare.
- Anaesthetists recommend that you not drink alcohol for at least 24 hours before your operation / procedure.
Do you snore at night or have you been diagnosed with sleep apnoea?
Are you using a nasal CPAP (sleep apnoea) machine at night or has this been recommended to you by your doctor?
- Please inform the surgeon and anaesthetist of this fact.
- Please bring your sleep apnoea machine, if you have one, with you on the day of admission.
Have you or a blood relative experienced excessive or prolonged bleeding after surgery or having a tooth pulled (extracted)?
Please inform the surgeon and anaesthetist.
Have you or a blood relative developed a blood clot in the leg or lung before?
Please inform the surgeon and anaesthetist.
Have you or a blood relative experienced a serious anaesthesia-related problem such as Malignant Hyperthermia or Scoline (Suxamethonium) Apnoea?
Please inform the anaesthetist.
Have you or a blood relative been diagnosed with a hereditary disease, birth defect or syndrome?
- Many birth defects and heritable diseases have anaesthetic implications.
- Please inform the anaesthetist.
Do you have a Pacemaker or Implantable Defibrillator?
Please bring your identity card to hospital with you. Advise your anaesthetist if you have an implantable defibrillator well in advance of surgery. In most situations, arrangements will need to be made with the device technician to have this deactivated for the duration of the planned surgery.
Do you have any objections to receiving a blood transfusion?
- Bleeding is a common surgical complication and blood transfusion may be a life-saving therapy.
- Please discuss any concerns that you may have with the surgeon and the anaesthetist.
What should you not do for 24 hours after the anaesthetic?
- One may not be able to think clearly after an anaesthetic or after sedative medication for up to 24 hours.
- During this time, one should not:
- supervise children or other people
- drive a vehicle or ride a bicycle
- cook or use any machinery
- make any important decisions, even if you feel fine
- post anything on social media
- drink alcohol.
What should I do if I am pregnant or breastfeeding?
- It is very important that you let the anaesthetist and know if you are pregnant or breastfeeding.
- Your anaesthetist will try to use the drugs that are thought to be the safest available for you and your baby.
- General anaesthetics do not normally have an effect on breastfed babies. It is recommended that you breastfeed up until your operation and continue breastfeeding as soon as you are awake and feel ready to do so afterwards. Very small amounts of anaesthetic medication may pass into breast milk but there is no need to ‘pump and dump’. Some painkillers can make your baby sleepy so it is important that your anaesthetist knows that you are breastfeeding so that they can prescribe the most appropriate medication.
- Just as you should have a responsible adult with you for 24 hours following a general anaesthetic, it is also important that you are not the primary carer for your child for the first 24 hours. It is important to be aware that the risks of co-sleeping may be increased following anaesthesia due to residual sedation.
Sundry items of a personal nature
- You can normally wear glasses, contact lenses, hearing aids or dentures.
- You do not need to remove gel nails or nail varnish.
- Ideally you should remove jewellery and piercings. They may be damaged or get caught on things and cause injury. If they cannot be removed, they will be covered with tape to try and prevent injury.
- If you have loose teeth or crowns, a visit to the dentist may reduce the risk of damage to your teeth during an operation.
- If you return home on the same day having had a general anaesthetic or sedation, you will need to organise a responsible adult to take you home by car or taxi and stay with you for up to 24 hours.
FREQUENTLY ASKED QUESTIONS
Do any of the following apply to you?
You must not have anything to eat or drink for a designated period before undergoing anaesthesia. These instructions are there to ensure your safety while under anaesthesia.
The recommendations are as follows
- Adults as well as children 12years of age and older:
- Solid food may be taken up to 6 hours prior to undergoing anaesthesia
- Water may be taken up to 2 hours prior to undergoing anaesthesia
- Children between 6 months and 12years of age:
- Please do not give formula feed, milk drinks, food, lollies or chewing gum for 6 hours before anaesthesia.
- Please plan for the last breast feed to finish no later than 4 hours before the anaesthetic.
- Please offer water up to 1 hour before anaesthesia.
- Children under 6 months of age:
- Please plan for the last breast feed to finish no later than 3 hours before anaesthesia.
- Please plan for a formula feed to finish no later than 4 hours before anaesthesia.
- Please offer water up to 1 hour before anaesthesia.
Exceptions to guideline:
- Patients at increased risk are those with delayed stomach emptying or gastro-oesophogeal reflux.
- Discuss this with the surgeon or anaesthetist if you are uncertain.
TO TAKE OR NOT TO TAKE?
drugs / medication on the day of surgery
Most chronic medication should be taken on the day of surgery and pre-operative fasting is not a contra-indication.
Drugs may be taken with a small amount of water at any time during the NBM (nil by mouth) period.
A few exceptions are listed below:
take
- All “cardiac” or blood pressure drugs
- EXCEPTACE inhibitors, AT2 antagonists and diuretics (see below)
- All epilepsy or Parkinsons’ drugs
- All asthma drugs or inhalers
- All tablets which reduce gastric acid (omeprazole, lansoprazole, ranitidine)
- All thyroid drugs
- All major and minor tranquilisers, which are taken regularly at home.
- Also antidepressants and nicotine patches, except for Lithium (Camcolit)
- All steroids taken regularly, including inhalers
- All immunosuppressants and cancer drugs (eg. azathioprine, tamoxifen)
- All analgesics can be given before surgery – EXCEPT NSAID’S (see below)
omit
- ACE inhibitors: ramipril (Ramiwin, Titrace), enalapril (Enap-co), perindopril (Coversyl, Coveram, Prexum), captopril (Capoten), lisinopril (Zestril, Zestoretic)
- Angiotensin 2 antagonists: candesartan (Atacand), losartan (Cozaar)
- All diuretics (water tablets): furosemide (Lasix), amiloride (Dapamax), spironolactone (Spiractin).
- Diabetic treatment: omit on the morning of surgery
- Anticoagulants (blood thinners): Aspirin, clopidogrel (Plavix, Clopiwin), rivaroxiban (Xarelto), warfarin. You must make the surgeon aware of the fact that you are taking “blood thinning” medication prior to hospital admission.
- Drugs which are not essential in the short term: eg. vitamins, iron, laxatives, osteoporosis treatment, liquid antacid medicines (eg gaviscon), hormone replacement therapy, anti- histamines, herbal remedies or homeopathic medicines.
- Lithium (Camcolit)should be omitted.
- Non-steroidal anti-inflammatory drugs: diclofenac (voltaren), indomethacin (Indocid), ibuprofen (Brufen)
TO TAKE OR NOT TO TAKE?
drugs / medication on the day of surgery
Most chronic medication should be taken on the day of surgery and pre-operative fasting is not a contra-indication.
Drugs may be taken with a small amount of water at any time during the NBM (nil by mouth) period.
A few exceptions are listed below:
take
- All “cardiac” or blood pressure drugs
- EXCEPTACE inhibitors, AT2 antagonists and diuretics (see below)
- All epilepsy or Parkinsons’ drugs
- All asthma drugs or inhalers
- All tablets which reduce gastric acid (omeprazole, lansoprazole, ranitidine)
- All thyroid drugs
- All major and minor tranquilisers, which are taken regularly at home.
- Also antidepressants and nicotine patches, except for Lithium (Camcolit)
- All steroids taken regularly, including inhalers
- All immunosuppressants and cancer drugs (eg. azathioprine, tamoxifen)
- All analgesics can be given before surgery – EXCEPT NSAID’S (see below)
omit
- ACE inhibitors: ramipril (Ramiwin, Titrace), enalapril (Enap-co), perindopril (Coversyl, Coveram, Prexum), captopril (Capoten), lisinopril (Zestril, Zestoretic)
- Angiotensin 2 antagonists: candesartan (Atacand), losartan (Cozaar)
- All diuretics (water tablets): furosemide (Lasix), amiloride (Dapamax), spironolactone (Spiractin).
- Diabetic treatment: omit on the morning of surgery
- Anticoagulants (blood thinners): Aspirin, clopidogrel (Plavix, Clopiwin), rivaroxiban (Xarelto), warfarin. You must make the surgeon aware of the fact that you are taking “blood thinning” medication prior to hospital admission.
- Drugs which are not essential in the short term: eg. vitamins, iron, laxatives, osteoporosis treatment, liquid antacid medicines (eg gaviscon), hormone replacement therapy, anti- histamines, herbal remedies or homeopathic medicines.
- Lithium (Camcolit)should be omitted.
- Non-steroidal anti-inflammatory drugs: diclofenac (voltaren), indomethacin (Indocid), ibuprofen (Brufen)
FREQUENTLY ASKED QUESTIONS
Do any of the following apply to you?
You must not have anything to eat or drink for a designated period before undergoing anaesthesia. These instructions are there to ensure your safety while under anaesthesia.
The recommendations are as follows
- Adults as well as children 12years of age and older:
- Solid food may be taken up to 6 hours prior to undergoing anaesthesia
- Water may be taken up to 2 hours prior to undergoing anaesthesia
- Children between 6 months and 12years of age:
- Please do not give formula feed, milk drinks, food, lollies or chewing gum for 6 hours before anaesthesia.
- Please plan for the last breast feed to finish no later than 4 hours before the anaesthetic.
- Please offer water up to 1 hour before anaesthesia.
- Children under 6 months of age:
- Please plan for the last breast feed to finish no later than 3 hours before anaesthesia.
- Please plan for a formula feed to finish no later than 4 hours before anaesthesia.
- Please offer water up to 1 hour before anaesthesia.
Exceptions to guideline:
- Patients at increased risk are those with delayed stomach emptying or gastro-oesophogeal reflux.
- Discuss this with the surgeon or anaesthetist if you are uncertain.
