Before Surgery

Preparing for surgery: what you need to know for a safe start

Preparing for surgery is not only a physical process. It is a medical assessment in which the patient's current state of health is analysed comprehensively by the anesthesiologist. Every detail attended to at this stage prevents problems on the day of the operation.

Why you have to fast

Fasting before surgery is the most basic safety rule in anesthesia practice. Under general anesthesia, protective reflexes such as swallowing and coughing are temporarily suspended. If there is food or fluid in the stomach, the contents can pass back towards the oesophagus during the operation (aspiration).

This can allow foreign material into the lungs and cause serious respiratory complications. To eliminate that risk, it is vital to follow the stated times strictly: generally six to eight hours for solid food, and the specified periods for water and clear fluids.

Why surgery is postponed when there is an infection

A mild flu, a cold or another upper respiratory infection can create unexpected risks during surgery and anesthesia. During an infection:

• Airway sensitivity: infection makes the airways more reactive, which can increase the risk of spasm (bronchospasm) during anesthesia.
• Immune burden: adding surgical trauma while the body is fighting an infection can slow recovery and worsen the infection. For elective (non-urgent) operations, the aim is therefore for the patient to go into surgery at full capacity and in the best possible health.

Drug interactions: the risks you cannot see

Anesthetic drugs act simultaneously on many systems in the body. Any medication you take can therefore affect the anesthesia plan directly:

• Blood thinners: because they can increase bleeding risk, they must be stopped or adjusted for a defined period before surgery.
• Chronic medication: some blood pressure, diabetes or cardiac drugs need to be taken up to the morning of the operation; others can interact with anesthesia.
• Herbal supplements: herbal teas and supplements can change the effect of anesthetic agents, increase the tendency to bleed or affect liver enzymes.

Sharing a list of every drug and supplement you take, with the dose and how often you take it, is essential to a safe process.

How the process is managed: the preoperative visit

All of this preparation is coordinated through the anesthesia visit held before the day of surgery. During that consultation, the following are reviewed in detail:

• The patient's existing conditions
• Previous experiences with anesthesia
• History of allergy
• The list of medication

The result of that assessment is an anesthesia strategy tailored to the patient. It covers every detail, from which drugs will be given at what dose to which monitoring methods will be used.