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Preparing for surgery frequently seems complicated. Patients are given a lengthy list of things that must be done or avoided before a scheduled operation and frequently forget to ask for explanations of preoperative procedures because they are preoccupied with the surgery itself.

Preparation

Preoperative procedures are designed to improve the outcome of the surgery, decrease the risk for complications, and make the surgery as safe and effective as possible.

Patients who receive general anesthesia, which renders them unconscious, must refrain from eating or drinking for at least 8 hours before surgery. Most instructions indicate that nothing is to be taken by mouth after midnight, on the night before the procedure. It may seem harsh, not to be able to have a sip of water, but this precaution minimizes the risk for complications such as vomiting during surgery.

Discontinuing prescription and over-the-counter medications that "thin" the blood, such as aspirin is necessary prior to surgery. Whether a drug is held or administered is based on the patient's medical condition, the type of drug, and the scheduled surgical procedure. Patients who take prescription medications on a regular basis must discuss this with the surgeon.

Preparation for surgery may begin days before the procedure. Surgeries involving the digestive system require special drinks, laxatives, and an altered diet. The digestive tract must be as empty as possible before surgery to prevent leakage of its contents into the abdominal cavity.

If surgery is being done on an outpatient basis, the patient must arrange for someone to be with them upon discharge. Even though the anesthesia has worn off, grogginess can last several hours and it is unsafe to drive. Also, the patient may need assistance when they get home.

If surgery is being done on an inpatient basis, the patient checks into a room. Most patients return to their room after surgery, but those undergoing complex surgical procedures and those who have complications may go to the intensive care unit (ICU). Outpatients usually go to an area designated for same day surgery.

After arrival, time is needed to prepare the patient for the procedure and sometimes, the time of surgery is changed due to cancellations or emergencies.

All patients must sign an informed consent form acknowledging that they are aware of risks and complications, that they know they will be receiving anesthesia, and that the surgeon has explained the operation to them. The surgery will not proceed unless the consent form is signed.

Patients are usually asked to remove personal items (e.g., jewelry, eyeglasses, hairpieces, contact lenses, dentures) before surgery. This policy protects the patient and prevents the items from being lost or damaged. Depending on the procedure, eyeglasses or hearing aids may be worn.

Different staff members may ask the same questions. The clerk who checks the patient in asks several questions, as does the admitting nurse and the anesthesiologist. These questions may be the same or similar and this may seem tedious, but the information must be checked and double-checked to avoid errors and omissions.

Before Surgery

The doctor who administers the anesthesia (anesthesiologist) performs a brief physical examination; takes a patient history; and obtains information regarding medication used on a regular basis, drug allergies, and prior adverse reactions to anesthesia. This information helps the anesthesiologist select the most suitable anesthetic agents and dosages to avoid complications.

Patients are usually taken to a preoperative or holding area before surgery. An intravenous line (IV) is started here if the patient does not already have one. A sedative may be given by injection, through the IV, or occasionally, orally, to help the patient relax.

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