Preparing for Surgery

Anesthesia

All surgeries require some form of anesthesia. Since anesthesia affects different people in different ways, it is important that our surgery care team choose the best anesthesia method for you and your type of surgery. Our surgical care team including doctors specializing in the administration of anesthesia, called Anesthesiologists, will spend time with you prior to your surgery to review your medical record and any lab data previously collected. The care team will talk to you about any concerns or any preferences you may have.

Before Surgery

• Write down the name and dosage of the medications (including non-prescription medications, vitamins, and supplements) you are currently taking and or have taken in the past year. Bring this list with you
• Appoint someone to stay at the hospital during your surgery. This person can phone family and friends and watch your belongings. Refrain from eating or drinking after midnight the night before your surgery.
• Discontinue prescription and over-the-counter medications, especially blood-thinning medications such as aspirin the morning of the surgery unless instructed otherwise by your physician. Taking or discontinuing a medication depends on your medical condition, the type of drug(s), and the type of scheduled surgery. Discuss this with your doctor before the day of the surgery. If you must take medications, do so with small sips of water.
• Do your very best not to smoke at least three weeks prior to surgery.
• If you develop any signs of illness (a cold, the flu, bronchitis, respiratory infection, fever), notify your surgeon.

After Surgery

After surgery, you will be brought to the recovery room where your vital signs - blood pressure, respiration, temperature, and oxygen levels - will be monitored closely. Most people spend between one and two hours in recovery before being discharged home in the case of Ambulatory Surgery or moved to a patient room. After some surgeries, you may be placed in the Intensive Care Unit to be more closely monitored.

Most people feel groggy when waking up after having received anesthesia. You may also experience nausea or feel cold.

Pain is expected following surgery. Medications may be given intravenously, through an injection, orally, or through a patch placed on the skin to help control the pain.

Helpful Hints

• If your surgery is scheduled before noon, do not eat or drink anything the night before after midnight. If your surgery is scheduled after noon, do not eat any solid foods after midnight. You may have clear liquids such as coffee or tea with no milk, clear juice, broth or gelatin until 8:00 a.m.
• Bring a list of the prescription and over-the-counter medications you take along with the dose you take.
• If you wear glasses, bring them.
• If you take blood pressure medications, ask your surgeon if you can take them on the day of your surgery.
• Do not bring valuables or money with you.
• Bring a family member or friend to drive you home after you are discharged.

Reporting for Surgery

Arrive 60 minutes to 90 minutes prior to your scheduled surgery.

If your surgery is scheduled at St. Elizabeth Hospital, report to the registration desk at Entrance 2. If your surgery is scheduled at the St. Elizabeth Hospital Ambulatory Surgery Center located in Medical Plaza II on the campus of the St. Elizabeth Hospital, check in at the surgery center desk on the second floor.

Pain Control

The staff at St. Elizabeth Hospital is very concerned about keeping your post-surgical pain to a minimum. Once you have awakened from anesthesia, your care team will ask you to rate your pain on a scale from 1 to 10, ten being the worst. You may be shown the following chart and asked to identify your level of pain using it. View Pain Intensity Chart.

Pain Control Methods

Depending on your surgery, your physical condition, and various other factors, one or more of the following methods of pain control will be used after your surgery:

• Medications given by mouth
• Medications given by Injection into muscle
• Medications given by Injection into the spine
• Medications given through the veins
• Non-medication pain control

Tips for Pain Management After Surgery

Your doctor will prescribe pain medications to help control your pain. Be sure to take them as directed before pain becomes severe.

Types of pain medications include:

For mild to moderate pain:

• Acetaminophen (Tylenol)
• Non-steroidal Anti-inflammatory Medications (NSAIDS) such as ibuprofen (Advil, Motrin) and naproxen (Alleve). These can come in both prescription and over-the-counter forms.

For moderate to severe pain:

• Opiates such morphine and levorphanol

Before you are discharged, your care team will periodically ask you to evaluate your level of pain on a 10 point scale (10 being the worst). Let a member of the care team know if your medication needs to be adjusted.

Before discharge let a member of the care team, or after discharge, your surgeon, know if you have any of the following symptoms:

• Fever above 100°F
• Nausea or vomiting
• Constipation or diarrhea
• Shortness of breath
• Redness, pus, or discharge from the surgical site

Common side effects of pain medications are stomach upset, nausea, vomiting, and constipation. If you are able, eat a little before taking pain medications to help with stomach upset. Eating fruits and vegetables and drinking lots of water can help to prevent or reduce constipation.

After surgery, some patients experience throat discomfort which can lead to coughing that can make pain at the surgical site worse. Placing a pillow or more than one pillow over the surgical site can help to ease pain when coughing.

Ask your surgeon or a member of the care team about alternate methods of managing pain such as heat or cold compresses, or relaxation techniques such as deep breathing.

Before discharge, be sure to ask your surgeon the following questions:

• When to take pain medications
• When and if to change bandages
• When to eat
• What activities you can do
• When it is safe to take a bath
• When to call him or her
• When to return for a checkup