What is surgery preparation?
Preparation for surgery includes various measures that the doctor and patient must take before a surgical procedure. Above all, this includes an informative discussion about the procedure as well as rules on diet and medication. Depending on the type of operation, further steps may also be necessary, for example
- Bowel cleansing by drinking special fluids
- Depilation of the surgical area
- Marking the surgical area on the body (e.g. for breast augmentation)
- Stabilization of the patient’s condition, for example by administering infusions (usually in emergency procedures)
The doctor and nursing staff carefully document the individual steps in preparation for the operation in the patient’s medical records. This is to ensure that no important points are forgotten.
Surgery preparation: What happens during the pre-op consultation?
During the pre-op consultation, the patient learns about the procedure and the risks of an operation. This information should enable the patient to make an informed decision for or against the operation. To ensure that the layperson is not put under pressure to make this decision in the short term, the information must not be provided “on the operating table”. In the case of inpatient treatment, for example, the informed consent discussion must take place at least the day before.
Ideally, especially in the case of difficult procedures, the patient information discussion should already take place when the operation is scheduled. The patient often receives an information sheet from the doctor on which the individual points are recorded in writing.
The anesthesiology consultation
In addition to the surgeon’s consultation, the patient will also be visited by the anesthetist before the operation. The anesthetist will explain the procedure and the type of anesthesia to the patient and explain alternatives. He also informs the patient about the typical risks associated with anesthesia and asks the patient again about previous illnesses and medication. This enables him to assess possible individual risk factors and plan the anesthesia accordingly.
Preparing for the operation: what do I need to inform my doctor about?
Various illnesses or conditions can increase the risk of complications during an operation – sometimes to such an extent that the procedure has to be canceled. You should therefore inform your doctor about any concomitant illnesses such as
- Fever (current or recent)
- Asthma or chronic bronchitis
- Tendency to shortness of breath (dyspnea)
- High blood pressure
- Heart cramps or palpitations
- irregular pulse
- Blood clots or known vascular constrictions
- Allergies to materials or medication (e.g. latex or penicillin)
- Previous complications with earlier interventions
A sudden mild cold, on the other hand, is not a problem, especially in otherwise healthy patients. If the cold is more severe or suddenly worsens before the operation, the operation can be postponed. In most cases, however, surgery is now possible despite a cold.
Surgery preparation: What is examined in advance?
Preparation for surgery includes comprehensive diagnostics, especially for more difficult procedures. What exactly needs to be clarified in advance depends on the type of procedure and the patient’s individual risk:
- Physical examination (for every patient)
- ECG (for patients with a high risk of heart problems or existing heart disease)
- X-ray of the chest
- Pulmonary function test (for patients with pre-existing respiratory and lung conditions)
Important blood values are also determined as part of the pre-operative preparation. These include blood count, electrolytes, blood sugar, kidney and liver values. For major operations, the blood group is also determined so that the patient can receive suitable blood reserves if necessary.
Preparation for surgery: medication
Oral diabetes medication, for example metformin, must not be taken on the day of the operation! Diabetics can inject themselves with insulin instead, depending on the blood sugar level measured.
However, there are also medications that can be taken on the day before the operation without any problems. Your doctor will tell you exactly what these are in your case (e.g. beta-blockers) and in what dosage you should take them. It is very important that you follow the doctor’s instructions conscientiously! This will help to reduce the risk of complications during the operation.
Antibiotics before surgery
To reduce the risk of wound infection, in some cases the doctor administers antibiotics immediately before the operation via a venous access. This is known as antibiotic prophylaxis. When it is necessary depends on the type of operation, the wound conditions and the patient’s individual risk factors. For example, an antibiotic is often given in advance for the following operations:
- orthopaedic or trauma surgery (bone fractures, joint replacement, etc.)
- “unclean” operations (opening of abscesses, operations after wall injuries to the intestine, removal of foreign bodies, etc.)
- Operations following trauma
- Operations in which foreign material is used (e.g. vascular prostheses)
Premedication: what is it actually?
Premedication is the administration of sedative medication before the operation. For example, the patient is given a sedative tablet 30 to 60 minutes before the operation in order to relieve anxiety. If the patient is very anxious about surgery, the doctor can administer a sedative the evening before so that the patient can sleep better and is more relaxed before the procedure. In the case of an outpatient operation, remember that sedatives before an operation can impair your ability to drive! So organize someone in advance to pick you up afterwards.
Surgery preparation: What do I need to bring with me?
You should bring the following to your surgery appointment:
- referral form
- Personal medication
- Aids (e.g. glasses or hearing aids)
- Findings from preliminary examinations and doctor’s letters
- Contact details of relatives (name, address, telephone number)
Preparation for surgery: What does “fasting” mean?
When the doctor tells you to stay sober, he doesn’t just mean that you shouldn’t drink alcohol before the operation. Rather, it is about important rules regarding nutrition. You should not eat anything for at least six hours before the operation. Milk and other cloudy liquids are also considered food and should therefore not be consumed.
Chewing gum and sucking sweets are also not permitted. If you are unsure about what you are allowed to eat before the operation, always ask the doctor or nursing staff in advance. Otherwise, the operation may have to be postponed.
Emergency patients are of course not necessarily sober before the operation. Of course, this does not mean that a life-saving operation will not be performed. But it does carry a greater risk for the patient: The anesthetic medication used during general anesthesia not only shuts down the sensation of pain but also the protective reflexes, for example the cough reflex. This can cause stomach contents to return to the throat and then be inhaled – doctors refer to this as aspiration.
The following therefore applies to you as a patient during planned operations: If you have accidentally eaten before the operation, inform the nursing staff or doctor!
Smoking before surgery?
The more conscientiously you follow the rules for preparing for the operation, the easier and less risky it will be for you and the doctor.
