6 May 2019 Author : César Resende For anyone about to have surgery, the preparations and the proximity of the operation are a milestone in their daily lives and those of their family and friends. Regardless of the degree of the complexity, it is up to the surgeon to inform the patient of all the details , goals and possible side effects of the procedure. This information is intended to answer queries and contribute to a decision and authorisation of the operation. However, as the date approaches, other issues are likely to arise , such as the following. What do I do until surgery? The bureaucratic formalities are handled by the hospital, which will also contact the patient closer to the procedure. If you have been asked for tests, be sure to have them done. Also schedule the anesthesiology appointment if requested. Have the test results with you and any other useful information (usual medication, prior clinical information). Can I continue to take my usual medication? Make careful note of the surgeon's indications for the preoperative period, which may include: Dietary recommendations A need to change or suspend medication. It is very important for the surgeon to know about your usual medication . For example antiplatelet agents and oral anticoagulation, among others. Only then can she or he make the right decision for each case. When will I have to go to hospital? The surgeon will tell you if you will be admitted on the day before or on the day of the operation and at what time. Try to be punctual. The surgeon is the visible face of a large team that works daily to provide surgical care. Excluding unexpected situations (e.g. emergency surgeries), the operating theatre’s schedule is organised in such a way as to provide the best patient care. Do I need to fast before the operation? Why? Yes. Surgeries performed under general or local anaesthetic involve fasting from solid and liquid foods . The aim is to reduce the possibility of complications when anaesthesia is induced. Failure to comply with the fasting period indicated by the surgeon or anaesthesiologist may make surgery impossible on the date. Will I feel any pain during surgery? Depending on the surgical procedure and the anaesthetic technique, more or less discomforting techniques may be necessary, such as: Channelling a vein for drug delivery Infiltration of a local anaesthetic Protocols are designed to minimise pain. Surgery only begins after the patient has been anaesthetised . This is confirmed with the anaesthetist in general anaesthetic or the patient in local anaesthetic. What happens in anaesthesia? Anaesthesia is safe . Anaesthetic drugs keep up with the enormous progress in medicine and are more effective, less toxic and have clearly determined mechanisms and times of action. In addition, monitoring technologies , which include many parameters other than vital signs, are also available and are monitored from the time the patient enters the theatre until discharge from the recovery room. Where will I wake up? Unless otherwise planned, patients are awakened immediately after the completion of the surgery, while still in theatre. However, due to the drugs used, a more or less prolonged perioperative period of amnesia (forgetfulness) may occur. It is not uncommon for the patient to only remember waking up in recovery or back in their room and ask when the operation is going to be! In some cases, the immediate postoperative period will be spent in the Intensive Care Unit or Intermediate Care Unit. In very particular circumstances, the patient will only be woken after a period of ventilation. In this case, the patient is connected to a ventilator that breathes for them and facilitates further recovery. How will I be able to care of myself after my operation? According to current knowledge, in most cases there is an obvious benefit of independence , including a rapid return to the patient’s daily routine. In hospital, the patient is encouraged to get up and walk as soon as possible. If the surgery does not allow this or there is a contraindication, the nursing team will take care of: Hygiene Meals The patient's comfort. Can I eat after the surgery? Depending on the surgery, postoperative diet may range from a nearly 'normal' meal to continued fasting. Above all, the patient should not eat or drink anything other than what is provided by the hospital staff . If in doubt, ask one of the nurses in the ward. And after discharge? Before surgery, the surgeon will inform the patient about the probable period of hospitalization and expected date of discharge. At that time, she or he will give the patient the appropriate recommendations for the convalescence period, which may include: Changes in diet Medication Dressings General measures A possible need to schedule a follow-up appointment. These aspects are set out in the discharge report. The content published in the Health Guide is intended for the general public and is provided for informational and educational purposes only. It does not replace individual medical assessment, diagnosis, or personalized clinical advice from a qualified healthcare professional. The content is produced or reviewed by physicians and other healthcare professionals at Hospital da Luz and is based on the knowledge available at the time of publication or the most recent update, as indicated at the beginning of each item.
