The PAS nurse will ask you about your health history and related issues. They may ask questions about the following:
They will also give you specific instructions about your particular surgery or procedure. These instructions include specific restrictions on what and when you are allowed to eat or drink before surgery. This is because time is needed for food to move out of your stomach and into your small intestine so that there is much smaller chance of aspiration while you are anesthetized or sedated. Aspiration occurs when food and/or liquids come up from the stomach and go down into the lungs. This can cause serious illness and even death.
There is no single or right amount of anesthesia for all patients. Every anesthetic must be tailored to the individual and to the operation or procedure that the person is having. Individuals have different responses to anesthesia. Some of these differences are genetic and some differences are due to changes in health or illness. The amount of anesthesia needed can differ according to such things as age, weight, gender, medications being taken, use of drugs or alcohol or specific illnesses (such as heart or brain conditions). Among the things the anesthesia provider measures or observes, and uses to guide the type and amount of anesthetic are: heart rate and rhythm, blood pressure, breathing rate or pattern, oxygen and carbon dioxide levels and exhaled anesthetic concentration. Because every patient is unique, the anesthesia provider must carefully adjust anesthetic levels for each individual patient.
It is very important that patients have an empty stomach before any surgery or procedure that needs anesthesia. When anesthesia is given, it is common for all the normal reflexes to relax. This condition makes it easy for stomach contents to go backwards into the esophagus (food tube) and mouth, and possibly into the windpipe and lungs. Because the stomach contains acid, if any stomach contents do get into the lungs they can cause a very serious pneumonia, called aspiration pneumonitis.
Your surgeon’s office will give you specific instructions for this. It is very important that you comply with these instructions. Failure to follow them could result in postponement or cancellation of your surgery or procedure.
The last food you eat before your fasting time should be a light meal with low amounts of fat. This is because fatty foods and large volumes of food take longer to digest and pass out of the stomach. Fasting from food also means:
Clear Liquids – Special Instructions
If you are given instructions about consuming clear liquids up to a certain time before your surgery, it is important to be exact about this. You may be told to consume a specific type of clear liquid (possibly Gatorade, ClearFast or similar). If that is not specified, then clear liquids are things like:
Alcohol should not be consumed 24 hours before surgery/procedures.
We want your surgery to go well without complications, and one way to accomplish that is by having you in optimal health prior to surgery. If you are not feeling well in the week leading up to your procedure, please notify your surgeon’s office.
Reasons to call include:
Additionally, please notify your surgeon’s office if you have any questions or concerns regarding your medicines before surgery.
It is very important to closely follow instructions regarding medicine use, especially anticoagulants (blood thinners). Failure to do so may result in cancellation of your surgery due to the increased risk of bleeding.
Your procedure and history will determine the appropriate type of sedation. See our full listing of types of sedation here.
Patients with sleep apnea often have CPAP (Continuous Positive Airway Pressure) breathing devices for when they are sleeping. We recommend that you bring your CPAP machine with you. Even if you are scheduled for outpatient surgery, you may be sleepy in the recovery room, and could possibly benefit from your CPAP machine. If you do not bring your CPAP machine, and are in need of one at the hospital, one can be provided for you. However, most people find their own mask and machine more comfortable, in addition to the cost saving aspect of bringing your own.
Cigarette smoking can cause postoperative problems. Smoking may slow down the healing of surgical wounds and bones. While it can take a long time to achieve all the benefits from not smoking, even brief periods of quitting can help you.
Visit www.smokefree.gov for more information.
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Monitored Anesthesia Care or MAC is not a level of sedation. It is a service in which an anesthesia provider monitors a patient during a diagnostic or therapeutic procedure. He or she may also administer medication (and often does) to a patient to provide sedation during the procedure. In some rare instances, however, no sedation medication is given while the anesthesia provider monitors the patient.
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