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PREPARING FOR ANESTHESIA The normal instructions with preparing for anesthesia are to let the patients know not to eat or drink anything after midnight before surgery. If you have surgery first thing in the morning, then these guidelines are not hard to comply with. But for surgeries later in the day for diabetic patients – then dangerous dehydration from lack of drinking water or low blood sugar from not eating can result.
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There are now new guidelines by the American Society of Anesthesiologists:
Exceptions with taking medications include the following:
Insulin and the diabetic patient increases the incidence of peri-operative complication. The risks are infection, metabolic derangements, renal and cardiac complications. The major peri-operative complications in diabetic patients are infection and impaired wound healing. Infection contributes up to 2/3 of post-operative complications. Hyperglycemia affects greatly to wound healing and susceptibility of infection.
Diuretics, commonly known as "water pills" are used to treat not only high blood pressure but are also given to patients with heart failure, or to treat swelling of the legs (edema). Theses medications when taken the day of a surgical procedure can cause two problems for the patient. Diuretic cause the patient to lose any retained fluid, so going long distances without a restroom nearby can sometimes be problematic.
Diuretics cause a decrease in blood volume called "hypovolemia", which can be detrimental during and after a surgical procedure. Many anesthesiologists will tell their patients not to take the diuretic the morning of surgery, however; every patient is different in their needs and will be consulted on what is right for them.
There are many people who actively use Herbal Medications. Many patients can be reluctant to admit they take these herbal supplements however; it is very important to make sure you tell your plastic surgeon and anesthesiologist before your surgery. Acute and chronic hepatic or renal toxicity is possible with these agents.
Other adverse effects that may complicate the surgical and anesthetic include excessive bleeding, heart and blood pressure effects and sedation. Most surgeons and anesthesiologist recommend discontinuing use of herbal medications for at least one to two weeks before surgery.
Some of the most common herbal products are the following:
Vitamin E should be discontinued completely for at least two weeks before your surgical procedure. Vitamin E can cause prolonged bleeding. Its antioxidant effect reduces thrombin formation and thus helps decrease blood clotting, and it also appears to minimize platelet (blood-clotting component) aggregation and stickiness. Blood clotting time is important when you are expecting to have a surgical procedure.
Discontinue all diet pills, prescription and over the counter; as they can cause cardiovascular problems with anesthesia. Flenfluamine and Phetermine (are two diet aids) should not be stopped abruptly. These two drugs need to be stopped slowly and titrated down in dosage. Mazindol (Mazanor and Sanarex), Dexfenfluramine (Redux), Dextroamphetamine (Dexadrine) and all over the counter diet aids need to be stopped two weeks before surgery.
Medications that contain aspirin or ibuprofen can cause bleeding problems during and after surgery. These medications can interfere with normal blood clotting. Most surgeons and anesthesiologists suggest stopping all medications that contain aspirin or ibuprofen at least two weeks prior to your surgery. Tylenol should be used instead.
Medications that contain Aspirin or Ibuprofen that should be avoided:
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DRUG INTERACTIONS WITH ANESTHESIA There are many drugs that interact with anesthesia and include toxic levels, increased bleeding and other dangerous interactions. ALWAYS tell your surgeon and anesthesiologist everything you are taking, prescription and over the counter, so he or she can adjust your anesthesia with the levels of medication you might have in your bloodstream. Do not ever stop taking a prescription medication without first discussing this with your surgeon, anesthesiologist, or internist (at your pre operative check-up).
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The following is a list of symptoms you might have that you are taking medication for that could cause potential complications with anesthesia:
Anesthesia can be hard on the human body. It is even harder on patients who smoke. Because of the fact that smokers have a tendency to develop coughs and an elevated heart rate, makes the odds higher for problems with anesthesia.
Smoking causes the following symptoms:
Read more about smoking and cosmetic surgery
If you have received minimal sedation only, you may be able to go home once the procedure is finished. If you have received moderate or deep sedation, you will probably require more time to recover. Often this may be within an hour. In the recovery room, you will be monitored until the effects of the medication wear off.
Any after-effects of the medication must be minimal or gone before you will be discharged from the facility to go home. You will not be allowed to drive yourself, so arrangements should be made for a responsible adult to provide you with transportation. If you think you may need some assistance, you might consider having someone stay with you on the day of surgery.
If you have had anesthesia combined in any kind of form of sedation (oral or intravenous), you will need someone responsible to drive you home after surgery.
Standard post anesthesia instructions for 24 hours after leaving the hospital or surgery center include:
Your own Plastic Surgeon will have his or her own specific post operative instructions that you need to make sure you adhere to.
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