Pre-Anesthesia Patient Information

Please note that the following does not constitute an actual consult by an anesthesiologist.

Unlike in years past, most patients who undergo surgery today arrive at the hospital on the same day as their surgery. As a result they do not meet their anesthesiologist until just before surgery. With this in mind, we would like to offer a brief explanation of what to expect and how to prepare yourself for your procedure.

What to do before coming to the hospital

We ask that you follow a few guidelines the night before and day of your procedure. These guidelines are for your safety, and not following them could result in your surgery being cancelled or postponed.

1. Eating: You may not eat or drink anything after midnight before your procedure except for a small amount of water to take certain medications. The reason for this is that you may be at increased risk for developing pneumonia if your stomach is not empty. This also means no gum, candy, or oral tobacco.

2. Medication: Remember to bring a list of all your allergies and medications (with the doses you take) with you whenever you come to the hospital. Most medications that you would normally take each morning should still be taken as scheduled the morning of your procedure. This is especially important with cardiac/blood pressure medications, except as noted below.

You should NOT take the following medications the morning of your procedure unless you are specifically told to do so:

	Any diuretics (fluid pills) this includes, but is not limited to: furosemide (Lasix), HCTZ (HydroDIURIL), triamterene (Dyrenium), torsemide (Demadex), spironolactone (Aldactone), acetazolamide (Diamoz)
	Any Angiotensin Converting Enzyme Inhibitors (ACEIs) or Angiotensin Receptor Blockers (ARBs). Examples of these include, but are not limited to: ACEIs such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril (Monopril), lisinopril (Prinivil, Zestril), moexipril, perindopril (Aceon), quinapril (Accupril), ramipril (Altace), trandopril (Mavik); and ARBs such as candesartan (Atacand), eprosartan (Teveten), irbesartan (Avapro), losartan (Cozaar), olmesartan (Benicar), telmisartan (Micardis)
	Any oral diabetic medication this includes, but is not limited to: pioglitazone (Actos), glimepiride (Amaryl), rosiglitazone (Avandia), chlorpropamide (Diabinese), glyburide (DiaBeta), meformin (Glucophage), glipizide (Glucotrol), miglitol (Glyset), tolbutamide (Orinase), repaglinide (Prandin), acarbose (Precose), nateglinide (Starlix), tolazamide (Tolinase)
	Any medication that has to be taken with food or milk

Options for Anesthesia

You and your anesthesiologist will discuss your options for anesthesia. Simply stated, there are two choices: general anesthesia (completely asleep), and varying degrees of awareness with the operative site numb. Obviously, there are some procedures that require a specific type of anesthesia, but there are some situations where you may be able to choose. Your anesthesiologist may feel strongly about one option over another, and this will be based on your safety and comfort as well as other circumstances unique to your situation.

General anesthesia means that you will be given medication to make you completely unconscious (asleep) and to keep you that way until your procedure is over. This usually requires that a breathing tube be placed. If so, this is usually done after you are unconscious, and is usually removed prior to you regaining awareness. Since nothing can be guaranteed in medicine, there are situations where this plan may need to be altered, and your anesthesiologist will discuss this possibility with you.

The other option is to make the surgical site numb, and then you and your anesthesia team can discuss how aware or unaware you would like to be. Keep in mind however, that the plan may be altered as the procedure goes along, and that it is still possible that you may require general anesthesia. Again, this decision would be based on your safety and comfort. There are different ways of making the surgical site numb, and once again, some procedures require a specific plan. Your anesthesiologist will discuss the risks and benefits of the available options with you. At the end of your procedure, you will be taken to the Post-Anesthesia Care Unit (recovery room), where you will be monitored until it is safe to allow you to leave.