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  Before Surgery  



In today’s busy world, most patients arrive at the hospital on the day of their scheduled surgery. The following section is designed to provide patients with answers to some of the more commonly asked questions about this part of the hospital process.

Can I eat or drink before the surgery?
It is important to have an empty stomach prior to surgery, and some foods take longer to digest than others. For this reason, guidelines for healthy patients have been established to give food and liquid time to be digested. Conditions like diabetes, acid reflux disease, hiatal hernia, pregnancy, obesity, nausea or bowel obstruction may slow the normal emptying of your stomach. If you have any doubts, please contact your surgeon or anesthesiologist for advice.

N.P.O. (Nothing By Mouth) Guidelines

These guidelines keep our patients safe. If these guidelines are not followed, procedures may be delayed or cancelled.

For HEALTHY ADULTS AND CHILDREN, 6 years old and up:
1. PILLS & CLEAR LIQUIDS: Up until 2 hours before surgery, patients may drink up to 2 ounces or less of clear liquids, such as water, tea, black coffee (NO CREAM), or clear fruit juice. Fruit juices with pulp are not allowed.
2. ANYTHING ELSE: Your surgery may be done earlier in the day than originally scheduled, so please do not eat or drink anything the day of your surgery unless you speak to your surgeon or anesthesiologist first.

HEALTHY YOUNGER CHILDREN, younger than 6 years old:
1. CLEAR LIQUIDS: Your child may drink clear liquids up until 2 hours before the time of surgery. Examples of clear liquids are water, tea, apple juice, Pedialyte, clear broth, jello without fruit. Fruit juices with pulp are not allowed.
2. BREAST MILK: Your child may be fed breast milk up until 4 hours prior to the time of surgery.
3. INFANT FORMULA: Your child may be fed formula up until 5 hours prior to the time of surgery.
4. NON-HUMAN MILK: Your child may be fed non-human milk up until 6 hours prior to surgery. Examples of non-human milk are whole, 2%, or skim cow’s milk, soy milk, and cream.
5. LIGHT MEAL: Your child may be fed a light meal up until 6 hours prior to surgery. Examples of a light meal are toast, cereal, or applesauce.

If you have any questions at all, please call our office at (804) 289-4937.

Can I chew gum prior to the surgery?
No. Chewing gum increases the amount of acid secreted in the stomach, and this may increase the risk of lung problems and pneumonia after anesthesia.

Can I take my medications before the surgery?

You should take most of your regularly scheduled medications with a sip of water before you come to the hospital. It is particularly important to take medications for heart disease or high blood pressure. Also, if you regularly take any medications for acid reflux (“heartburn”), asthma, bronchitis or emphysema, please take these as well. Patients taking blood-thinners or diabetes medications should discuss these medicines with your surgeon or anesthesiologist before surgery. If you have any questions, please call and we can review your medication list with you.

Can I smoke prior to the surgery?
It is always a great time to quit smoking. Stopping smoking increases the safety of your anesthetic and lets your recover more quickly! In particular, we ask that you avoid smoking for at least 24 hours prior to the surgery. This allows your blood to carry more oxygen during the surgery. In addition, your lungs and upper airways will be less irritated and will respond less to breathing tubes and anesthetic gases.

When should I come to the hospital for the planned surgery?

Your surgeon’s office will tell you when to be in the hospital. In general, you should arrive in the hospital about 2 to 3 hours prior to the planned surgery. If you need additional testing, you may be asked to arrive even earlier. The reason to be here so early is to allow time to complete the admission paperwork, pre-operative nurse's evaluation & medical history. Some patients requiring extra testing or preparation may be admitted to the hospital the night before the surgery.

Should I bring my medications from home?
It is often a good idea for you to bring your medications – or a complete list of names and doses - with you to the hospital. Then, we can see the medications and doses you require. If you bring the medicines, we will probably make a list and then return them to you. Our pharmacy will dispense the medications you need according to your physicians orders. There is no need to take any of your own medications while in the hospital. In fact, it may be dangerous to do so.

What else can I bring from home?
If you plan to be in the hospital for a few days, you may wish to bring a robe, slippers and reading materials. The hospital provides a gown, toothbrush, toothpaste, soap, comb, mouthwash, razor etc. For safety reasons, the hospital does not permit home blow dryers or electric razors that do not have 3 prong electrical plugs. Valuables are best left at home. It is not a good idea to bring money, credit cards, jewelry or expensive watches. If valuables are brought to the hospital, please check them in with the admitting clerk. They will be placed in the hospital safe until you are discharged.

Can I wear my contact lenses?
It is best that you leave your contact lenses at home where they will be safe. If you need to have your contacts or glasses to read consent forms or brochures, please bring them. At the time of surgery, you will be asked to remove them. If you choose to wear your contact lenses to the hospital, please bring your lens case for storage.

Can I wear makeup or jewelry?
Small amounts of makeup are acceptable, however eye makeup can smear and cause irritation to your eyes upon waking up from anesthesia. Please leave valuables and jewelry at home. If you have a piece of jewelry with particular sentimental value, for example a wedding band, then the ring will be taped during the procedure. Body piercing should also be removed prior to surgery, or replaced with a non-metallic version. Many anesthesiologists will not anesthetize a patient with a tongue piercing in place because the ring or stud may interfere with placing a breathing tube.

Should I bring my hearing aids?
Absolutely. If we need to remove them for your surgery, we will keep them in a safe place and return them to you as soon as possible after surgery, usually in the recovery room. We prefer that you wear your hearing aides for communication purposes.

Can I keep my dentures in?

You can keep your dentures in until the time of surgery. For your protection, when having a general anesthetic, we will ask you to remove your dentures for the surgery and return them to you as you wish after surgery. If you are having a local or regional anesthetic, you may be allowed to leave your dentures in place.

Will I have an IV before the surgery?
We know that getting an IV can be the hardest part of your anesthetic and surgery. An IV is necessary for several reasons. It allows us to give you fluids to make up for skipping breakfast. It also allows quick access for medication if any emergency should arise during surgery. Finally, an IV allows you to receive the pain medications, antibiotics, and fluids your body may require following surgery.
With the exception of some small children having a minor surgery like ear tube placement, almost all patients need an IV before surgery. For very young children who need an IV, we can often let them drift off to sleep with anesthesia gases and then start the IV For older children and adult patients, our nursing staff and Anesthesia team take great care to make the IV insertion as pleasant and painless as possible. Numbing medication to the skin before starting will often ease the process.

Can I bring my friends and relatives with me?
It can be a very anxious time for both you and your family, we recommend that patients bring only a few close family and friends to the hospital for emotional support. Also, with your permission, they can pass along information from your doctors and nurses to your other family and friends.
Although the Recovery Room does not typically allow visitors, the parents of young children may visit while their children recover from anesthesia.

Is there a waiting area for friends and relatives?
Yes. Your surgeon will usually suggest a particular place for you to stay so that he or she may contact you when the surgery is finished. On the Forest campus, there are waiting rooms on Level 1 for both Main Hospital and Women’s Pavilion OR suites. There is also a cafeteria and a Subway restaurant on this level. On Level 2, there is a large lobby with coffee bar and TV where friends and family members can wait. At the Parham campus, there is a waiting room on the first floor, near the Outpatient Surgery entrance and just down the hall from the cafeteria.

Will some one inform my family and friends of the progress or results?

With your permission, when your surgery is finished, your surgeon will go out to the waiting area to notify your family and friends. If the surgery takes longer than expected, your surgeon and nurses in the O.R. will keep your family and friends informed. For privacy reasons, your surgeon will only relate information about your surgery with your approval. Please discuss this with your surgeon prior to your surgery. When you leave the Recovery Room, the nurse will check for family and friends in the waiting room and notify them of your transport to a room.

I am very nervous and anxious. Will I get some medicine for that?

Many patients experience fear of the unknown. Knowing exactly what is going to happen to you and understanding how the system works in the hospital will help to decrease most patients’ anxiety.
If you are admitted to the hospital on the day prior to your surgery, your anesthesiologist will visit you and may prescribe medication to help you relax before surgery. If you are scheduled to arrive at the hospital the day of your surgery, then you may ask your surgeon for a sedative to be taken either the night before or the morning of surgery. In addition, your anesthesiologist will administer more medication through your IV to make you relaxed before surgery.

Will I meet my Anesthesiologist before the surgery?
Certainly. Your anesthesiologist will prescribe a combination of medicines specifically for your surgery and state of health. To design this plan, your anesthesiologist will interview you before your anesthesia to gather information and answer your questions. He or she will review results of lab tests, along with medical, surgical and anesthesia records and any history of allergic reactions. The risks and benefits of the prescribed anesthetic, along with any alternatives, will be discussed at this time.

Will I get the chance to talk to my surgeon if I have some questions?

If you wish to speak to your surgeon prior to surgery, please let your nurse know and he or she will make sure that you receive no sedative medication before your surgeon’s arrival. Your surgeon will always see you prior to the procedure. However, if sedative medications are administered through your IV before he arrives, you may not remember any conversations you have!

Besides an IV, what else might I need before surgery?
For major surgeries or very sick patients, it is often necessary to place other specialized monitors. Your anesthesiologist will discuss the need for these kinds of monitors during the preoperative assessment. These monitors may include an Arterial Line, a Central Venous Line, or a Pulmonary Artery Catheter. An arterial line is similar to an IV except that the catheter is placed in an artery instead of a vein, allowing us to monitor your blood pressure with every heartbeat during and after your surgery, while Central Venous Catheters or Pulmonary Artery Catheters are used to closely monitor heart function or give powerful medicines to help heart function and blood pressure. These special monitors are normally placed through tiny incisions in your wrist or neck while you are comfortably sedated.

Can I drive myself home after the same day surgery?
No. You MUST make arrangements to have a responsible adult to provide you with transportation. It is not advised to operate vehicles or machinery for 24 hours after surgery. It is strongly suggested that you have someone stay with you during the first 24 hours.

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