On the day of your operation

Please read the useful information and guidance provided below about the day of your operation.

At home

Have a bath or shower: This will clean your skin and reduce the risk of infection.
Wash your hair: If you are having an operation on your head or neck.
Do not shave anywhere near the site of surgery.
No make-up or body lotions: This will ensure heart monitor pads and dressings can stick to your body.
Remove nail varnish.
Do not smoke: This will help avoid breathing problems during your anaesthetic.
Remove jewellery: If you cannot remove your jewellery, it will be covered with tape to prevent damage to it or to your skin.
Wear warm clothing.
Take your medications: Unless you have been advised otherwise, and bring your medicines with you in their original labelled containers.
Leave plenty of time to get to your appointment.

Food and drink - fasting

These fasting instructions for adults undergoing elective procedures under sedation or regional/general anaesthesia.

Please ensure you follow these fasting instructions or your procedure might not go ahead. Fasting is important before having sedation/regional or general anaesthetic to reduce the risk of food coming up and entering your lungs.

If you smoke, please do not smoke on the day you come into hospital. Smoking reduces the amount of oxygen in your lungs and may lead to breathing difficulties during or after your anaesthetic.

Do not drink alcohol or use recreational drugs 24 hours before your procedure as those can interfere with your anaesthetic.

Please do not chew gum or suck sweets for 2 hours before admission time.

Admission time and guidance

Morning list - 7am, and all day list - 11am (where the order is decided on the day)

Last meal/snack/sweets - midnight of the operating day
Last drink containing milk or pulp - midnight of the operating day
Last drink of clear fluids - keep well hydrated the day prior to the operation and have last drink of clear fluid at home at 6am
Medication - take only prescribed medication as advised by pre-assessment up until 6am with enough water to swallow it safely

Afternoon list - 12.30pm

Last meal/snack/sweets - before 7am on the day of the operation
Last drink containing milk or pulp - before 7am on the day of the operation
Last drink of clear fluids - keep well hydrated with clear fluid the morning of the operation, with the last drink no later than 11am at home
Medication - take only prescribed medication as advised by pre-assessment up until 11am with enough water to swallow it safely

On arrival

On arrival at hospital you will be admitted to a ward/unit. Please be aware that you may have to wait sometime before you go to theatre for your procedure.

At the appropriate time you will be taken into a anaesthetic room to prepare for your operation in the following way:

You will be asked to wear a hospital gown (and your own dressing gown) and a pair of elastic stockings (TEDS).
You will be asked to remove contact lenses.
You can keep your pants on as long as they won’t get in the way of the operation.
Anaesthetists are doctors with specialist training who assess your health and are responsible for giving your anaesthetic and maintaining your safety throughout your surgery.
You may be visited by the anaesthetist and surgeon to confirm your plan for operation. Nothing will happen to you until you understand and agree.
Please ask any questions you have.
Premedication (‘premed’) are drugs which are given before some anaesthetics to help with relaxation or pain relief. They may make you drowsy after the operation. A needle may be used to start your anaesthetic. If this worries you, please let us know.

When you are called for your operation

When it is time for your operation, a member of staff will go with you to the theatre.
You may be asked to walk to the operating theatre but this will depend on your general health and whether you have had a premedication. If you are walking, you will need your dressing gown and slippers.
Theatre staff will check your identification bracelet, your name and date of birth and will ask you about other details in your medical records as a final check that you are having the right operation.
The theatre may look and feel quite different from other hospital departments – more cold and clinical and will be brightly lit. The theatre staff normally wear coloured ‘pyjamas’ and hats (scrubs).
You will be asked to remove your glasses and dentures. These will be returned to you immediately after your operation.
The anaesthetist or anaesthetic assistant will then attach machines which measure your heart rate, blood pressure and oxygen levels.

General anaesthetics

There are two ways of starting a general anaesthetic:

Anaesthetic drugs are usually injected into a vein through the cannula (tube in your hand).
Occasionally you can breathe anaesthetic gases and oxygen through a mask, which you may hold if you prefer.

Once you are unconscious, an anaesthetist stays with you at all times and continues to give you drugs to keep you anaesthetised. As soon as the operation is finished, the drugs will be stopped or reversed so that you regain consciousness.

Regional (spinal, epidural or nerve blocks) and local anaesthetics

A regional anaesthetic or ‘block’ is an injection of local anaesthetic to make part of your body numb. They are a type anaesthesia and pain relief that can be used with, or sometimes instead of, a general anaesthetic. They are used to enhance your recovery by reducing pain and some side effects that can occur with general anaesthesia and other types of pain relief.

The local anaesthetic is injected very carefully and may be guided by an ultrasound machine or sometimes a nerve stimulator, which you may feel as gentle twitching. Blocks are usually performed with you awake or sedated if you prefer. If you are having a general anaesthetic they may sometimes be performed after you are asleep. The ‘blocked’ area of your body will become warm, heavy and numb and may last several hours – so after surgery you’ll be advised how to protect yourself until normal sensation returns. You’ll also be reminded to take regular painkillers around this time to ensure you remain comfortable when the numbness wears off.

Regional and local anaesthetic techniques are generally safe and effective although risks may occasionally include an incomplete block, bruising around the injection site or damage to veins, arteries or nerves. Other serious complications such as seizures or heart problems are rare and your anaesthetic team are trained to deal with these.

Your anaesthetist will explain everything that is involved in having a regional anaesthetic, including how any benefits and risks relate to you and your operation.

More information can be found in the video below: Nerve Blocks: An Information Video for Patients.

Blood transfusion

Blood is essential for carrying oxygen around the body and a lack of red blood cells is called anaemia. In some cases anaemia can be treated with medicines; in others, a blood transfusion may be the best treatment. You can reduce the need for a blood transfusion by eating foods containing iron before your operation.

You may have a blood sample taken in pre-op assessment before your operation to see if you are anaemic. A second sample of blood is required within five days of the operation and is often taken on admission.

If you have previously been given a card which states that you need to have blood of a specific type, please show it as soon as possible to your doctor, nurse or midwife and ask them to tell the hospital transfusion laboratory.

Blood transfusion is only needed for a small number of patients during or after surgery. Sometimes it is possible to recycle your own blood during the operation.

A blood transfusion is usually given through a tiny tube directly into a vein, and you will be observed before, during and after.

You do have the right to refuse a blood transfusion but you need to fully understand the consequences of this. If you have any concerns you should discuss these with your doctor, nurse or midwife.