Plan time off

Plan to take the recommended time off driving, work, sport and study to recover well.  You should not drive, work, operate dangerous machinery or make major decisions for at least 24 hours after a general anaesthetic. Do not drive on any day when you are taking strong pain reliever or if you don’t feel at your best, as there is an increased risk of having an accident. Your car insurance may not be valid if you are impaired when driving after surgery.

Stop smoking

Smokers are more likely to have side effects including heart and breathing complications, increased pain and bleeding and take longer to heal. The longer you have stopped smoking, the safer the surgery will be for you. If you smoke on the day of surgery, your surgery will be cancelled. Ask your surgeon for a Quit pack if needed. The nurses can help with nicotine patches while you are in hospital.

Eat vegetables, drink water and exercise regularly

The healthier you are on the day of surgery, the faster you’ll recover. The better you eat, the better you heal.

Continue these medications

If you take these medications for the following reasons continue to take them as usual before and after surgery:

  • contraceptive pill,
  • asthma,
  • reflux,
  • blood pressure,
  • depression,
  • cholesterol,
  • rhinitis (saline rinses, steroid nasal sprays, hayfever tablets and eye drops, desensitisation injections).

Stop these medications

For most operations you will need to stop medications and supplements that cause bleeding for one week before and two weeks after surgery. These include:

  • Non-steroidal anti-inflammatory drugs: there are lots of them, if in doubt ask your doctor or pharmacist. Some examples are Nurofen/ibuprofen, Voltaren, Ponstan, Indocid.
  • Echinacea, garlic, fish oil and many other supplements can cause bleeding. Ask your pharmacist, surgeon or other practitioner if needed.
  • If you take aspirin for pain relief and not to prevent clots, you should stop it one week before surgery. If your doctor has prescribed aspirin to prevent heart attack or stroke, see the information below.

Other health problems and medications

  • If you are diabetic, ask the surgeon for specific instructions about your diabetes medications and insulin
  • If you take medication to prevent blood clots, heart attack or stroke, your surgeon will weigh up the risk of bleeding with surgery and the risk of having a clot if you stop your medications for surgery. You will be given instructions specific to your health needs. These medications include
    • aspirin
    • Warfarin or Coumadin
    • Plavix or clopidogrel
    • Rivaroxaban
  • If you take medication for auto-immune disease or cancer you may need to adjust your dose. Your surgeon will discuss this with your physician and weigh up the risk of continuing the medication and the risk of stopping the medication. You will be given instructions specific to your health needs. These medications include
    • methotrexate
    • Imuran
    • chemotherapy
    • steroids
    • biologics, monoclonal antibodies

Obstructive sleep apnoea

Surgery is safer if you continue to use CPAP before and after surgery. Bring your CPAP machine to hospital and use it whenever you are sleeping.

Fasting before surgery

You must fast before an operation to reduce the risk of vomiting during the procedure. Vomiting or regurgitation of your stomach contents can cause you to stop breathing or to have severe pneumonia regarding treatment in the intensive care unit. Some people have an increased risk of this complication (if you are obese or have reflux). Keep taking your reflux medication and follow the fasting instructions given to you by the hospital. Don’t suck on lollies or use chewing gum.

The following information is from the Australian and New Zealand College of Anaesthetists guideline for fasting before surgery:

For adults having an elective procedure, limited non-fatty solid food may be taken up to six hours prior to anaesthesia. In most circumstances, patients are encouraged to drink clear fluids for up to two hours prior to anaesthesia.  Clear fluids are water, pulp free fruit juice, clear cordial, black tea and coffee. Cloudy or milk based drinks or alcohol are not to be taken.

For children over six months of age having an elective procedure, breast milk or formula and limited solid food may be given up to six hours and clear fluids are encouraged up to two hours prior to anaesthesia.

For infants under six months of age having an elective procedure, formula may be given up to four hours, breast milk up to three hours and clear fluids up to two hours prior to anaesthesia.

Prescribed medications may be taken with a sip of water less than two hours prior to anaesthesia unless otherwise directed.