PREPARATION FOR SURGERY AND ANAESTHESIA
Fasting Before Surgery
|
When you receive any sort of anaesthetic your ability to keep food out of your lungs is impaired. It is very important for your safety that your stomach is empty at the time that you have your procedure. You must follow these periods of fasting before your surgery.
|
|
Do I take my medications before surgery?
|
ALL medications unless mentioned below should be taken normally with a SIP of water.
DIURETICS (‘water tablets’ eg Lasix) DO NOT take on the morning of surgery. DIABETIC medications (see next FAQ; “I am a diabetic”) |
ANTICOAGULANT DRUGS (‘blood thinners’); It is very important that your surgeon knows that you are on these drugs as there may be an increased risk of bleeding depending on the type of surgery. Low dose aspirin is usually NOT a problem and is nearly always safe to continue as normal.
|
I am A Diabetic
|
It is important to have some insulin in your body but because of the fasting we need to be careful to avoid hypos.
|
I Am breast feeding
|
Most anaesthetic drugs will pass through into your breast milk but for modern anaesthetics the amount of drug that could reach your child is extremely small. The only possible effect from these drugs is a very slight sleepiness. If you are concerned, we advise expressing and storing breast milk just before your surgery and using this in place of your first feed after surgery.
|
It is also important to stay well hydrated so drink fluids right up to 2 hours before your operation and we will also often give you some intravenous fluids until you are able to drink again.
|
What to bring to Hospital
|
For same day surgery please bring:
It is better not to wear any make-up and remove any jewellery or body piercing if possible |
MY CHILD NEEDS AN ANAESTHETIC
|
It can be very distressing finding out that your child needs to have an operation. As well as worrying about the operation itself, it is very common to be worried about the anaesthetic, how your child will react and the risks involved.
Children are far less stressed on the day of surgery if they are given information beforehand. |
Several days before the procedure give your child a simple description of what needs to be done and what they can expect. Encourage them to ask questions, it is very important that no-one lies to your child about what to expect.
|
|
FASTING:
It is very important that your child has an empty stomach at the time of their anaesthetic. This is to reduce the slight risk of stomach contents regurgitating and entering your child’s lungs with serious consequences. It also helps to reduce the chance of your child feeling sick or vomiting after their anaesthetic.
|
If your child is under 6 months old, please contact the Anaesthetic Group Ballarat for specific fasting instructions. |
WHAT IF MY CHILD IS SICK BEFORE THEIR ANAESTHETIC?
Infections are very common in children. If your child has an infection or illness in the days before an operation could you please contact our Practice Nurse for advice (03) 5331 4888. Some infections may make your child's anaesthetic riskier and some may pose a risk of passing the infection on to other children.
Infections are very common in children. If your child has an infection or illness in the days before an operation could you please contact our Practice Nurse for advice (03) 5331 4888. Some infections may make your child's anaesthetic riskier and some may pose a risk of passing the infection on to other children.
|
PREMEDICATION
Refers to drugs given before surgery to make children sleepy before they even reach the theatre. This type of sedation is now only given very rarely as it tends to increase vomiting and make children take longer to wake up. If you think your child will be extremely upset and likely to need sedation before being taken to theatre, please let us know in advance as these drugs take some time to work effectively. Other medications are often given to your child before their operation. The two commonest are painkillers to help reduce pain after the operation (for example Panadol) and creams to numb the skin. |
The creams – EMLA or Angel cream – are local anaesthetic creams that are put on the back of the hands to deaden the skin before a needle is inserted at the beginning of the anaesthetic. These creams take 20 – 60 minutes to work and they work much better if your child is encouraged not to pull them off!
|
|
WHAT WILL HAPPEN IN THEATRE
In most cases, one parent will be invited to come into theatre and can stay with your child until they are asleep. There are two ways to start an anaesthetic for children. The first is to insert a needle into a vein in the back of the hand or at the elbow and inject drugs that send your child to sleep. This is very quick and simple but often children are scared of needles and some children have veins that are very difficult to find. The second way is to use the ‘gas’ or ‘mask’. A mask is held over your child’s face and they breathe a mixture of oxygen and anaesthetic gases until they fall asleep. |
This occurs quickly: 30-60 seconds. The gas is very sweet smelling and not unpleasant although many children don’t like something new that they don’t understand.
When your child loses consciousness, it usually happens very suddenly and they become very floppy. This is quite normal and does not mean anything is wrong. At this stage, one of the nursing staff will escort you out of the theatre and show you where to wait until your child awakens at the end of the procedure. Your Anaesthetist can give an approximation of how long the operation is likely to take. |
|
WHAT HAPPENS AFTER THE OPERATION
When your child’s surgery is completed, they are transferred to the recovery room where they will be given oxygen and the recovery nurses will observe your child until s/he is more awake. At this point they will usually call for you to be with your child. When your child is awake and comfortable, you and your child will return to the ward. How your child feels after the operation is variable. Most children will be relaxed, slightly sleepy and not in any pain. Some children can become distressed when they first wake up. This can be due to pain, but is often just a reaction to everything that has happened to them and usually settles down over the first hour. |
This occurs quickly: 30-60 seconds. The gas is very sweet smelling and not unpleasant although many children don’t like something new that they don’t understand.
When your child loses consciousness, it usually happens very suddenly and they become very floppy. This is quite normal and does not mean anything is wrong. At this stage, one of the nursing staff will escort you out of the theatre and show you where to wait until your child awakens at the end of the procedure. Your Anaesthetist can give an approximation of how long the operation is likely to take. |
I AM WORRIED, CAN I TALK TO SOMEONE?
|
When you come into hospital you will meet your anaesthetist who will assess your general health and talk to you about your anaesthetic.
Your anaesthetist will want to know about:
|
Depending on these questions your Anaesthetist may wish to examine your heart, lungs and mouth.
Please be honest with these questions; our objective is to provide the safest service we can for you. Your Anaesthetist will then discuss the risks and benefits of any planned anaesthetic technique. If you have particular concerns or you think something in your history is especially complicated please contact our Practice Nurse at the Anaesthetic Group Ballarat on (03) 5331 4888. She should be able to answer any questions that you may have, refer your query onto one of our anaesthetists or obtain information from other hospitals and labs. |
WHAT CAN I DO TO MAKE MY ANAESTHETIC SAFER?
|
There are things that you can do to reduce the risks of a procedure and to ensure that you return to your normal life as quickly as possible.
We suggest that you:
|
|
I TAKE A LOT OF PAIN KILLERS EVERY DAY
|
If you are taking a lot of prescription painkillers it can be difficult to manage the sudden increase in pain due to a surgical procedure. Please make sure you tell your anaesthetist about your use of these drugs on the day of surgery.
|
If you are concerned please contact our Practice Nurse on (03) 5331 4888 or discuss your upcoming surgery with your pain specialist or GP.
|
I SOMETIMES USE DRUGS NOT PRESCRIBED BY MY DOCTOR
|
Many non-prescription substances can interfere with anaesthetic drugs or increase the risks of surgery. This includes both “recreational” drugs and “natural remedies”. If you feel that you cannot stop these for a week before surgery, please let your anaesthetist know on the day of surgery.
|
CAN I TAKE HERBAL AND DIETARY SUPPLEMENTS?
|
The use of herbal medicines is common. Herbal medicine is defined as a plant-derived product used for medicinal and health purposes; commonly used herbal supplements include echinacea, garlic, ginseng, ginkgo biloba, St John's wort and valerian.
Herbal medicines can have a variety of effects on surgery and interact with anaesthetic drugs. Ginkgo, ginseng and garlic all impair blood clotting and promote excessive bleeding. Prolongation of action of anaesthesia drugs can occur with valerian and St John's wort. Herbal dietary supplements should be stopped two weeks prior to surgery. |
Fish oil supplements are also popular as a dietary supplement. They have potential in reducing cholesterol and hence may reduce the risk of heart attack and stroke. They also have anti-inflammatory properties and may be used to treat arthritis. The Therapeutic Goods Administration says that omega 3, which is found in fish oil, has no effect on bleeding and can be continued before surgery.
|
IS MY SMOKING A PROBLEM FOR THE ANAESTHETIC?
|
Use this as an opportunity to quit smoking; smoking increases the risk of breathing complications and wound infections. Nicotine puts the heart under stress, increased lung mucus and airway narrowing impedes lung function and the blood is unable to carry as much oxygen as in someone who does not smoke. Ideally stop smoking several weeks before your surgery but even 24 hours helps.
|
I HAVE A COLD OR OTHER ACUTE ILLNESS BEFORE MY OPERATION
|
Each case is different but generally it is better not to go ahead with surgery if you become unwell before the day of your operation. An anaesthetic slightly decreases your bodies immunity and complications may become more likely. Also, there is a risk of passing an infection to other people in the hospital.
We are more likely to not proceed with surgery if your operation is major, you have a fever, you are coughing or have diarrhoea. |
Minor procedures and a simple runny nose are usually OK but if you are concerned contact our Practice Nurse on (03) 5331 4888 or talk to your surgeon.
|
DO I HAVE TO REMOVE MY NAILS/PIERCINGS
Traditionally some hospitals still have policies against these but generally false nails/nail polish can remain. Piercings should be removed (if they can) from inside your mouth or if they are near where your operation is to be. While you are asleep you cannot safeguard your piercings so bulky, large or valuable jewelry is best removed.
