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Preoperative Care

Physician-developed and -monitored.

Original Date of Publication: 01 Nov 2001
Reviewed by: Stanley J. Swierzewski, III, M.D.
Last Reviewed: 01 Nov 2001

Original Source: http://www.surgerychannel.com/herniarepair/preop.shtml

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Preoperative Care



Most hernia repairs are same day surgeries, which means that patients can go home on the same day that they undergo the operation. If a patient needs to remain in the hospital, they are usually discharged the following day.

The most common preoperative tests are blood and urine tests, but a chest x-ray and EKG may also be required, depending on the patient's health history. These tests are normally done a few days prior to surgery.

Medications that "thin" the blood, including aspirin, are usually discontinued before a scheduled surgery. Some drugs, such as the prescription medication CoumadinĀ® (warfarin), usually are discontinued at least 3 or 4 days prior to a surgical procedure. This is done to avoid abnormal or excessive bleeding during the surgery.

On the day of surgery, other prescription drug regimens may also be interrupted. The anesthesiologist may instruct the patient to take regular medications with a sip of water. The proper timing of discontinuing medications needs to be discussed with the physician before the operation.

Dietary Restrictions

If general anesthesia is going to be used, nothing is permitted to be eaten from midnight on the evening before surgery until the procedure is completed. This includes food, water, chewing gum, and candy. This necessary precaution is taken to decrease the possibility of vomiting during and after surgery.

For local and spinal anesthetics, dietary restrictions may vary. Some doctors require their patients to follow the guidelines for general anesthesia, regardless of which anesthetic they are receiving. One reason for this is that it may be necessary to switch to a general anesthetic during surgery. Dietary preparations should be discussed with the physician in advance.

Consent

Check-in is usually the same day as the surgery, and at this time the patient must sign an informed consent form. By signing this legal document, the patient acknowledges that they understand the procedure, that the doctor has discussed the operation and its potential risks, and that they know what medications they will be receiving.



The anesthesiologist (the doctor who administers the anesthesia) performs a brief physical examination and takes a patient history. It is important the anesthesiologist is aware of all medications that the patient is taking, any allergies, and if there has been a prior adverse reaction to anesthesia. This information helps the anesthesiologist select the most suitable anesthetic agents and dosages and avoid possible complications.

Hospitals usually have an area reserved for same day or ambulatory surgical patients. Instead of checking into a room, all same day patients go to this unit prior to and after their procedure.

In preparation for surgery, patients have an intravenous line put in to receive both fluids and medication during and after surgery. They also receive a sedative, by injection or through the intravenous line, to help them relax.

Same day surgical patients may go directly from this area to the operating room, or they may be taken to the preoperative or holding area for a short time. Sometimes the intravenous is started here, depending on hospital protocol. Anesthesia, regardless of type, is administered in the operating room.


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