Op preparation

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The term surgical preparation is understood to mean various measures that must be observed before a surgical procedure. This includes, for example, stopping or taking certain medications or diet rules before the operation. Read here what is involved in surgical preparation and why it is so important.

What is meant by surgical preparation?

The preparation for the operation comprises various measures that the doctor and patient must take before a surgical procedure. Above all, this includes an informative talk about the procedure as well as rules on nutrition and medication use. Depending on the type of operation, additional steps may also be necessary, for example:

Colon cleansing by drinking special fluids
Depilation of the surgical area
Marking the surgical area on the body (for example, for breast enlargements)
Stabilization of the patient's condition, for example by giving infusions (usually in the case of emergency interventions)

The doctor and nursing staff carefully document the individual steps in preparation for the operation in the medical file. This is to ensure that no important point has been forgotten.

Op preparation: What happens during the clarification interview?

During the informative discussion about preparation for the operation, the patient learns about the procedure and the risks of an operation. This information is intended to enable the patient to make an informed decision for or against the operation. So that he as a layperson is not put under pressure with this decision at short notice, the information must not first take place “on the operating table”. In the case of inpatient treatment, for example, the clarification talk must take place at least the day before.

In the case of interventions that are carried out in outpatient departments or doctor's offices, the doctor may not hold the informational discussion until the same day. However, he must give the patient a considerable amount of time before the intervention begins.

In the ideal case, especially in the case of difficult interventions, the clarification discussion takes place as soon as the appointment is made. The patient often receives an information sheet from the doctor on which the individual points are recorded again in writing.

The anesthesiological briefing

In addition to the surgeon's explanation, the patient also receives a visit from the anesthetist before the operation. This explains the process and type of anesthetic procedure to the patient and explains alternatives. He also informs him about the typical risks associated with anesthesia and asks the patient again about previous illnesses and medication. This enables him to assess possible individual risk factors and plan the anesthesia accordingly.

Operation preparation: what do I have to inform my doctor about?

Various diseases or conditions can increase the risk of complications from surgery - sometimes so much that the procedure has to be canceled. Therefore, inform your doctor about any concomitant diseases such as:

Fever (current or recent)
Asthma or chronic bronchitis
Tendency to breathlessness (dyspnoea)
increased blood pressure
Heart cramps or palpitations
irregular pulse
Blood clots or known narrowing of blood vessels
Allergies to materials or drugs (for example latex or penicillin)
bad experiences with anesthetic drugs, for example severe nausea after previous interventions
previous complications from previous interventions

A sudden mild cold, on the other hand, is not a problem, especially in otherwise healthy patients. If the cold is more severe or suddenly worsens before the operation, the operation can be postponed. In most cases nowadays, an operation is possible despite a cold.

Op preparation: what is examined in advance?

Comprehensive diagnostics are part of the preparation for surgery, especially in the case of more difficult interventions. What exactly needs to be clarified in advance depends on the type of procedure and the individual risk of the patient:

physical exam (for each patient)
EKG (for patients at high risk of heart problems or existing heart conditions)
Chest x-ray
Lung function test (for previous diseases of the respiratory tract and lungs)

In addition, as part of the preparation for the operation, important blood values are determined before operations. These include blood count, electrolytes, blood sugar as well as kidney and liver values. In the case of major interventions, the blood group is also determined so that the patient can receive appropriate blood reserves if necessary.

Surgical preparation: medication

In the informative talk about preparation for the operation, you should inform your doctor about whether and which medication you are taking. Blood-thinning medication, for example, must be stopped several days before the procedure to prevent dangerous bleeding. However, taking ASA (aspirin) before an operation is no longer considered to be so risky that many interventions can be carried out despite ASA therapy.

Oral diabetes medication, such as metformin, must not be taken on the day of the operation! Instead, diabetics can inject themselves with insulin, depending on the blood sugar level measured.

However, there are also medications that can be taken without any problems on the day of the operation before the procedure. Your doctor will tell you exactly which these are in your case (e.g. beta-blockers) and the doses to be taken. It is very important that you carefully follow the doctor's instructions! This will help reduce the risk of complications during the operation.

Antibiotics before surgery

In some cases, to reduce the risk of wound infection, the doctor will give antibiotics through a venous line immediately before the operation. This is called antibiotic prophylaxis. When it is necessary depends on the type of surgery, the wound conditions and the individual risk factors of the patient. For example, an antibiotic is often given in advance for the following operations:

orthopedic or trauma surgery (broken bones, joint replacements, etc.)
"Unclean" interventions (opening of abscesses, interventions after wall injuries of the intestine, removal of foreign bodies, etc.)
Operations after trauma
Interventions in which foreign material is used (e.g. vascular prostheses)

If the operation takes several hours or if the patient loses a lot of blood during the procedure, they may receive a second dose of the antibiotic during the operation.

Premedication: what is it actually?

Premedication is the administration of calming medication before the procedure. For example, the patient is given a sedative 30 to 60 minutes before the operation to relieve the excitement. If you are very afraid of operations, the doctor can administer a sedative the evening before, so that the patient can sleep better and is more relaxed before the operation. In the case of an outpatient operation, keep in mind that tranquilizers before an operation can limit your ability to drive! So organize someone in advance to pick you up afterwards.

Op preparation: what do I have to bring with me?

You should bring the following with you to your surgery appointment:

Briefing slip
personal medication
Aids (e.g. glasses or hearing aids)
Findings from preliminary examinations and doctor's letters
Contact details of relatives (name, address, telephone number)

Op preparation: What does “sober” mean?

When the doctor tells you to stay sober, he's not just saying that you shouldn't drink alcohol before the operation. Rather, it is about important dietary rules. You should not eat any more food for at least six hours before the operation. Milk and other cloudy liquids are also considered food and must therefore not be drunk.

As a rule, however, you can still drink some clear liquids such as water or tea up to two hours before the procedure. Then you can rinse your mouth out with water if you have a dry mouth or ask for an infusion if you feel very thirsty.

Chewing gum and sucking candy are also not allowed. If you are unsure what to eat before the operation, always ask your doctor or nurse beforehand. Otherwise the operation may have to be postponed.

Emergency patients are of course not necessarily sober before the operation. Of course, this does not mean that a life-saving procedure is not carried out. But it harbors a greater risk for the patient: the anesthetic drugs used in general anesthesia switch off not only the sensation of pain but also the protective reflexes, for example the cough reflex. This can cause stomach contents to get back into the throat and then be inhaled - doctors call this aspiration.

For you as a patient during planned operations, the following applies: If you accidentally eat before the operation, inform the nursing staff or the doctor!

Smoking before surgery?

Smokers are at higher risk of complications than non-smokers. This particularly affects wound healing disorders, problems with the oxygen supply and infections. Therefore, your doctor will recommend that you quit smoking. In particular, you shouldn't smoke in the days before and after an operation. If this is particularly difficult for you, your doctor can advise you on possible smoking cessation measures.

The more conscientiously you follow the rules for preparing for surgery, the easier and less risky it will be for you and the doctor.

Tags: therapies palliative medicine alcohol