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This is your time to meet with an anesthetist and ask all
the questions about your anesthesia. (See
Risks of Anesthesia)
This is our time to meet you and if needed take steps to make sure
you are in the best possible health. We also try to answer as many
questions as we can about your anesthetic. Research has shown that
this visit can go a far way to reduce your anxiety about your
surgery.
The outpatient clinic used for interviewing you before your surgery
is called the pre-assessment clinic (or PAC for short). This
encounter may also take place in the out-patient clinic sometime
prior to surgery; in the hospital if you are already admitted, or in
the operating area on the day of surgery prior to going into the
operating room. Sometimes, it may take place in a telephone
interview.
The visit to the pre-assessment clinic involves a few steps.
Nursing staff plays a very important role in gathering
information, answering your questions and giving you more
information about your surgery and recovery.
Firstly, the anesthetist gather all the relevant information - which
may include:
- Your previous operations and anesthetic experiences
- Any difficulties you have had with past anesthetics
- Any serious complications of anesthesia experienced by you
or your family members (such as malignant hyperthermia)
- Any allergies you have (or drug sensitivities)
- Whether you have any chronic medical conditions.
- What medications you are taking, including prescription
medications, over the counter medications, and herbal
preparations.
- If you are a woman, whether you are or could be pregnant, or
whether you are currently breast feeding
- If you are hearing, vision or mobility impaired, or require
any other special assistance
- If you are able to speak and understand English, or may
require a translator.
The anesthetist may ask for permission to obtain medical records
from your primary care physician or other healthcare givers as a
part of your preoperative evaluation. Whenever possible, you should
plan to bring any medical records you have with you to your
evaluation. In addition, bring a complete medication list with
dosages. Alternatively, you could bring all of your medications with
you on the day of your interview.
This is followed by a brief physical examination.
A decision is now made regarding the need for further tests - some
of these are always done if your are a certain age, gender or a
specific surgery (we call these routine tests). Your anesthetist
or surgeon may request additional tests depending on the information
gathered earlier.
After you have been deemed fit for OR (meaning the anesthetist is
happy to proceed without needing more information or testing) - we
talk to you about the what we plan for your upcoming surgery which
may include:
- when to stop eating or drinking before surgery
- which medications to take or not take prior to surgery
- the options for anesthesia (ie. general
anesthetic, regional anesthesia, sedation, or a combination of
these.)
- special measures that may be taken in your case (ie. extra
monitors, need for stay in intensive care after surgery, etc.)
- the risk of anesthesia in
your case given the type of surgery and any other medical
conditions you may have (such as heart or lung disease)
- the options for pain management after the surgery (ie.
patient controlled analgesia [IV pain pumps] or an epidural or
a nerve block
In most hospitals the anesthetist you talk to during the
preoperative encounter, is unlikely to be the anesthetist that will
be responsible for your care on the day of your surgery. On the day
of surgery, the anesthetist responsible for your care will finalize
the anesthetic plan. This is based on your health profile, the
surgery you are having.
While your clinic will try to accommodate your preference for a
specific anesthetic technique (for example a general anesthetic vs.
regional anesthetic) as far as possible, your doctor does have the
expertise to know what is the best option in your case. Discussing
the benefits and risks of certain anesthetic techniques is part of
the informed consent process.
Be sure to ask any questions you may have
Before Surgery.
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