PREOPERATIVE PHYSICAL EXAMINATION
You will attend a scheduled surgical examination as agreed. Following the examination, consultation and the decision on surgical treatment, physical examination by an anaesthesiologist will be performed.
The anaesthesiological examination requires the below mentioned:
1. Previous medical documentation (discharge letter, medical records, diagnostic test results)
2. Medications that you take, including inhalations, drops and all products purchased without a prescription (vitamins, food supplements, herbal products)
3. Medical test results of complete blood count, electrolytes (sodium, potassium), glucose, urea, creatinine, coagulation profile (PT, APTT, fibrinogen), liver enzymes (AST, ALT, GGT) – the tests must not be older than one month
4. Test result of thyroid hormones (in case you suffer from a thyroid disease) – the test must not be older than 6 months
5. ECG test result – the test must not be older than 3 months
6. Heart and lung X-ray examination (It is not required if a patient is under 40 years of age, does not smoke or has had no serious lung disease) – test must not be older than 6 months
7. Blood typing test result (ABO group and Rh type)
8. Test results of urine and urine sediment – the test results must not be older than one month
9. If you undergo regular follow ups by other medical specialist for chronic diseases (heart, lungs, kidneys, liver, thyroid gland, diabetes mellitus and other) you MUST bring the most recent specialist examination result and related laboratory results (the results must not be older than one year)
10. If you have a pacemaker, ICD or CRT device you shall undergo a preoperative examination by a cardiologist.
11. for children at the age of 6/7 years, a complete blood count and coagulation profile results as well as a pediatric physical examination result are required.
12. for children at the age of 7, a complete blood count and coagulation profile results as well as a physical examination result performed by a family medicine specialist are required.
13. for minor outpatient procedures (gastroscopy, colonoscopy, fractional curettage and other) a complete blood count, electrolytes (sodium, potassium), glucose, urea, creatinine, coagulation profile and ECG test results are required.
The most recent specialist examination result is also required in case you undergo regular follow-ups for a chronic disease
An anaesthesiologist will check your medical record and laboratory results and ask you about your weight, height, unhealthy habits (alcohol, smoking, stimulative or narcotic drugs), medications, allergies (to medications, food, pollen and other) and previous anesthesia. It is very important to give true information about yourself.
An anaesthesiologist will perform a physical examination by applying auscultation and palpation.
At the end of the examination you will be informed about the risks and advantages of the anaesthesia. The choice of a certain type of anaesthesia depends on your general health condition and a type of surgical procedure or diagnostic-therapeutic intervention. Additional laboratory tests, specialist consultations and change in the therapy may be required, so you could undergo a procedure in the best possible health condition in order to minimize surgical and anesthetic risks. Allergy to anesthetics is possible, mostly mild, but rarely occurs in an extremely severe form which can even cause death, despite the adequate treatment. In case you have information on the allergy reaction to anesthesia and you have not been tested so far, an allergy test will be necessary in order to avoid any risks in the future. Any medical procedure or intervention carries a risk, but life-threatening complications are extremely rare. Complications can occur during a surgical procedure or intervention or after the procedure. Preparation and accompanied procedures may also carry risks (anesthetics, infusions, transfusions etc.).
You can read Explanation and written consent for anesthesia and postoperative treatment for more details.
Anaesthesiological examination is documented and constitutes a part of your medical record.
PREPARATION FOR SURGICAL PROCEDURE
The preparation for a surgical procedure includes several steps.
1. Smoking cessation is recommended 6 weeks before the surgery, and should not smoke at least 8 hours before a surgical procedure.
2. Alcohol consumption is forbidden before a surgical procedure.
3. In the evening before anaesthesia you should eat light, mushy and/or liquid dinner without fruit, salads or carbonated beverages. Do not eat sweets, bonbons or chewing gums, do not drink black tea, coffee, alcoholic drinks and do not smoke. Do not eat or drink after midnight, in order to avoid vomiting during the anesthetic induction and the risk of the gastric content returning from the stomach to the lungs (aspiration) which can cause severe and serious pneumonia.
4. A written anaesthesiological examination result will include the medications which should be skipped as well as the medication which you should take in the evening before and on the day of a procedure with a sip of water. Bring in your medications in original packaging to the Hospital.
You should stop taking anticoagulant medications ( Marivarin/Martefarin, Klopidex/Pigrel/Plavix, Zyllt, Aggrenox, Tagren, Xalerto, Pradaxa and other) 3 to 7 days prior to surgery. You can keep taking acetylsalicylic acid (Andol, Aspirin, Cardiopirin), unless it is necessary to stop taking it 7 days before a surgical procedure. Since they affect blood coagulation, you should stop taking NSAID drug class pain medications 5 days before a procedure (Brufen/Ibuprofen, Ketonal, Knavon, Naklofen, Voltaren, DicloDuo etc) and you should take Paracetamol or Tramadol instead ( Plicet, Panadol, Lupocet, Tramal, Zaldiar, Zaracet and other).
You should keep taking antihypertensive drugs regularly, unless you are otherwise instructed by an anaesthesiologist.
In case you suffer from diabetes mellitus, insulin or oral anti-diabetic drug should be skipped in the morning on the day of a surgical procedure.
Medication used for thyroid diseases should be continued on the day of a surgical procedure.
You will receive application instructions from an anaesthesiologist for other medications (antidepressants, anticonvulsants and other) as well as herbal food supplements.
5. Take care of regular personal hygiene (bathing, shaving).
6. Remove all jewellery, makeup, nail varnish, dental prostheses, contact lenses etc.
7. A half an hour to an hour before a surgical procedure, you will receive a sedative drug or injection, which will prepare you for anesthesia / surgery so that you would feel relaxed, please keep lying on the bed after.
PREPARATION FOR MINOR OUTPATIENT PROCEDURE / INTERVENTION
Minor outpatient procedures and / or interventions are usually performed under short-lasting intravenous anaesthesia. A plastic cannula is inserted into a vein of the arm and infusion is connected. You will receive an intravenous anaesthetic shortly before a procedure. You will breathe on your own with oxygen transferred via nasal cannula or mask. All your vital body functions are monitored (blood pressure, heart rate, oxygen saturation level).
You have to be on an empty stomach for at least 6 hours before procedure/intervention. After you will be under supervision for 2 hours. Eating and drinking is allowed after discharge (unless a physician gives some different instructions). Neither driving motor vehicles and/or engines nor taking on full personal and /or business responsibilities is allowed for at least 24 hours after the anesthesia.
EXPLANATION AND WRITTEN CONSENT FOR ANESTHESIA AND POSTOPERATIVE TREATMENT
Explanation and written consent for anesthesia and postoperative treatment can be downloaded here: