Patient Information

Before your admission

Your anaesthetist will usually meet you on the day of your surgery. If your surgeon or the nursing team identify a reason to refer you to us before this, or if you particularly wish to meet us, we will invite you to an outpatient clinic.

If you have long-term medical problems, such as asthma, high blood pressure or diabetes, these should be as stable as possible before your operation. You may want to see your GP if you know that your health problems could be better controlled.

Please try to stop smoking, or reduce your intake before surgery; this increases the oxygen in your blood and improves wound healing.

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Stopping food and drink before surgery

It is important that you stop eating and drinking for a short period before your operation. Otherwise it is possible that stomach contents could flow back up into the back of your throat while you are anaesthetised. If these stomach contents entered your lungs serious damage could result.

The time you should stop eating and drinking depends on the time your surgery is planned:

Morning lists start at 8:30 – 9 am
You may eat until midnight
You may drink clear fluids until 6:30 am

Afternoon lists start at 1:30 – 2 pm
You may have a light breakfast such as tea and cereal or two slices of toast before 7:30 am
You may drink clear fluids until 11:30 am

Evening lists may start after 4.30 pm
You may eat till 10.30 am
You may drink clear fluids until 2.30 pm

Please note:

  • ‘Clear fluids’ means only water, squash and tea or coffee without milk.
  • Please don’t eat sweets or chew gum after the cut-off time for food. Don’t drink alcohol, fruit juice or anything with milk in it.
  • Do brush your teeth on the day of surgery (having a bath or shower is also helpful as it may reduce the chances of wound infection).

For procedures using only a local anaesthetic – where an anaesthetist is not involved – you may be able to eat and drink normally before your operation.

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Are you taking any medicines?

With the few exceptions listed below you should continue taking your regular medicines right up until surgery, despite the guidelines on food and drink intake above. In particular if you are in pain before your operation please take any painkillers you require. You can safely take medicines labelled 'take with food' on an empty stomach during this brief period. You can drink a small volume of water to help you swallow tablets.

Drugs which should be stopped before surgery:

Clopidogrel (Plavix) and warfarin

You should normally stop these long-acting drugs some days before surgery, but not for longer than necessary. It is essential to seek advice from your surgeon or the pre-admission assessment nurses as there are some instances when these drugs should not be stopped.

Diabetic drugs

You shouldn’t take tablets to control blood sugar on the day of your operation. If you take insulin you will probably need to omit your injection before surgery - your surgeon or the pre-assessment nurses will advise you.

Herbal and alternative medicines

These should be stopped for a week before surgery because some ingredients can interact with anaesthetic drugs.

A few blood pressure drugs

Most blood pressure drugs should be continued before surgery. However if you take drugs with names that end in ‘...pril’ (e.g. ramipril, perindopril, lisinopril) or ‘...sartan’ (e.g. candesartan, losartan, valsartan) you should omit them on the day of your operation.

Water tablets (diuretics)

Drugs such as bendroflumethiazide and furosemide increase the amount of urine you pass during the day. You may be more comfortable if you omit them on the morning of your surgery.

Note: medicines have two names – a brand name which may be prominently displayed on the packet and a ‘generic’ name in smaller type. For example Nurofen is one of a number of brand names for ibuprofen, just as Nescafé is a brand name for instant coffee. We have quoted the generic names of drugs.

We need to know exactly what drugs you are taking. It may be easier to bring the medicines themselves rather than try to remember all the names and doses.

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Planning your anaesthetic: visiting you on the ward

Your anaesthetist will visit you on the ward to find out about you, and to talk through any anxieties you have. They will describe what will happen during your visit to the operating theatre.

They will discuss your anaesthetic options with you, suggest the type of anaesthetic they think best, and agree this with you before surgery. When making their recommendations your anaesthetist will consider your preferences, any medical conditions you have and the planned operation.

The anaesthetic makes surgery possible. There are several types of anaesthetic:

  • A ‘general anaesthetic’ makes you completely unaware of your surroundings and what is happening. Although most operations are possible under a general anaesthetic sometimes a ‘regional anaesthetic’ (see next paragraph) provides a more comfortable and pleasant experience. Common side effects after a general anaesthetic include drowsiness, dizziness, nausea, sore throat and shivering. These usually wear off quickly.
  • A ‘regional anaesthetic’ numbs part of you, so that you don’t feel pain where the surgeon is working. The blocked part often remains numb for some hours after surgery, which can be helpful for pain relief. You may be unable to move this part for a while after your operation. Regional anaesthetics don’t make you sleepy when used alone, but we often combine them with sedation (see next paragraph). Spinal and epidural anaesthetics are regional anaesthetics where the drugs are put close to your spinal nerves. They are suitable for many operations on the lower part of the body, especially hip and knee replacements. Other types of regional anaesthetics, called ‘nerve blocks’ have many uses, but are particularly useful for limb surgery.
  • Sedation is drug treatment to make you sleepy. We can use it to produce a state of calm tranquillity, or to make you slumber deeply through your time in theatre.
  • A local anaesthetic numbs only the area of the wound. It is used on its own during relatively minor procedures. You will probably not need an anaesthetist to help with your care if this is the only sort of anaesthetic you have. Your surgeon will discuss this possibility with you if it is a suitable choice for your surgery.

Your anaesthetist may suggest that a combination of these sorts of anaesthetic is the best choice for you.

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During your operation

Your anaesthetist will watch you and monitor your vital signs throughout your operation to ensure that you are safe, and that you feel as well as possible after surgery. They will administer drugs to ensure that you are anaesthetised throughout the procedure, and help to keep your circulation and breathing stable.

After surgery

Your anaesthetist will prescribe drugs to prevent or treat pain, nausea and other unpleasant symptoms you might experience later.

We use a variety of techniques to control pain after surgery. As well as medicines by mouth this may include injections, and for larger operations painkilling pumps. Because everybody feels pain slightly differently, we will tailor our treatment to your particular needs. We hope to keep you comfortable as you recover from your operation. Please make sure the nurses know if you are in pain.

We know many people dread feeling sick. Most people don’t feel sick after surgery; some unfortunate people do. We will do our best to prevent this happening to you. If you do feel sick afterwards please make sure the nurses are aware of this, so that you can be given treatment without delay.

After some surgery, including most day stay procedures, you may be able to eat and drink straight away. If you feel sick please tell the nurses; wait till the feeling settles before you eat anything.

Your anaesthetist will call to see you after your operation. However in some circumstances you may be ready to go home before the remainder of the day’s operating is complete. Unless you want to speak to your anaesthetist you need not wait for them to be finished. If you are required to stay in hospital after your operation your anaesthetist may visit the day after surgery to check that you are recovering well.

In the unlikely event of a problem arising after your surgery, one of our team of consultants will attend to you. This may not be the same person who administered your anaesthetic as they may be committed to operations elsewhere, but the two doctors will be in communication to ensure the relevant information regarding your case is known.

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Are you going home on the day of your surgery?

Anaesthetics may affect you more than you realise for 24 hours or so. Your judgement may be impaired, so:

  • A responsible adult must be with you. You should behave much as though you were still in hospital.
  • Don’t take any important decisions
  • Don’t drink any alcohol
  • Don’t operate any machinery
  • You must not drive for at least 24 hours, and not until you are certain you can do so safely. Until then it will be dangerous (and illegal) to drive. Your insurance company may refuse to cover the costs of any accident.
  • If you have any worries after you leave the hospital, including pain that stops you sleeping despite painkillers, please contact the ward to discuss what to do. The nurses will give you the telephone number before you leave.

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Are you staying in hospital for a longer period?

Although your surgeon will be in charge of your post-operative recovery, we will be available to offer advice to the ward team throughout your stay if you suffer pain, nausea or other problems.

If you are unhappy with our service

We hope you will be pleased with the care we give you. If you are dissatisfied please tell your anaesthetist, contact us directly or if necessary take the matter up through the hospital complaints system. We undertake to respond as quickly as possible.

Further reading

The Royal College of Anaesthetists have produced a number of excellent booklets and articles about anaesthetics. You can read them online at Titles include:

  • You and your anaesthetic
  • Anaesthesia explained (a more detailed booklet)
  • Anaesthetic choices for hip and knee replacement
  • Local anaesthesia for your eye operation
  • Your spinal anaesthetic
  • Your child’s general anaesthetic
  • Your tonsillectomy as day surgery

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