PREPARATION

Careful preparation before surgery helps improve safety, recovery and comfort during your hospital stay.

Please read the information below carefully and follow the instructions provided by your surgeon, hospital and anaesthetist.

Fasting Before Anaesthesia
When you are under anaesthesia or sedation, your normal protective reflexes are temporarily relaxed. If there is food or fluid in your stomach, it can come back up into the throat and enter the lungs. This is called aspiration and can cause serious complications.
To reduce this risk, fasting before surgery is essential.
Unless otherwise instructed:
  • No solid food, milk or chewing gum for 6 hours before your procedure
  • Clear fluids are usually allowed until 2 hours before arrival time
Clear fluids include:
  • Water
  • Black tea or black coffee (without milk)
  • Clear apple juice
  • Electrolyte drinks
Please avoid:
  • Milk or dairy products
  • Smoothies
  • Juice with pulp
  • Heavy meals late the night before surgery
If fasting instructions are not followed, your procedure may need to be delayed or postponed for safety reasons.

What to Bring
Please bring:
  • Medicare and health fund details
  • A current medication list
  • Relevant scans or medical information if requested
  • Comfortable clothing for discharge home
Please avoid wearing:
  • Jewellery
  • Nail polish
  • Contact lenses
  • Makeup

Medications
Most regular medications should be continued before surgery. However, some medications require specific instructions.

GLP-1 Medications
GLP-1 medications used for diabetes or weight loss can slow stomach emptying and may increase the risk of regurgitation during anaesthesia.
Examples include:
  • Semaglutide (Ozempic, Wegovy)
  • Tirzepatide (Mounjaro)
  • Liraglutide (Saxenda, Victoza)
Please inform your anaesthetist if you are taking any GLP-1 medication as you will need to undertake a 24 hr clear fluid fast prior to surgery. More information available here. 

Diabetes Medications
Fasting can affect blood sugar levels, and diabetes medications often need adjustment before surgery.
This may include:
  • Insulin
  • Metformin
  • SGLT2 inhibitors such as Jardiance or Forxiga (or similiar drugs with generic name ending in "-flozin")
SGLT2 inhibitors are commonly stopped 3 days before surgery.

Blood Thinners
Blood thinning medications may need to be stopped before surgery or certain regional anaesthesia procedures.
These include medications such as:
  • Warfarin
  • Apixaban (Eliquis)
  • Rivaroxaban (Xarelto)
  • Dabigatran (Pradaxa)
  • Clopidogrel (Plavix)
The timing of cessation depends on:
  • The medication
  • Kidney function
  • Type of surgery
  • Bleeding risk
Please only stop these medications after discussion with your surgeon, anaesthetist or prescribing doctor.

Supplements and Herbal Medications
Please also advise your medical team about:
  • Herbal supplements
  • Fish oil
  • Vitamins
  • Complementary medicines
Some supplements may affect bleeding, blood pressure or interactions with anaesthetic medications.

Illness Before Surgery
If you develop a cold or respiratory illness before surgery, please notify your surgeon, hospital or anaesthetist as early as possible.
A mild runny nose is often not a concern. However, symptoms such as:
  • Fever
  • Sore throat
  • Shortness of breath
  • Wheezing
  • Productive cough
may increase the risk of breathing complications during anaesthesia and sometimes require postponement of surgery until recovery.

Teeth, Airway and Breathing
Your anaesthetist may examine your mouth, jaw and neck before surgery.
This helps assess the safest way to manage your airway during anaesthesia. In many procedures, a breathing tube or airway device is used after you are asleep.
There is a small risk of dental damage during airway management, particularly if you have:
  • Loose teeth
  • Crowns or veneers
  • Fragile dental work
  • Limited mouth opening
  • Neck stiffness
Please let your anaesthetist know about any dental concerns or previous airway difficulties.

Anxiety, Needle Phobia and Difficult Veins
Feeling anxious before surgery is very common.
If you are particularly anxious, needle phobic, or have difficult veins, please let your anaesthetist know. There are a number of strategies available to make the experience more comfortable, including:
  • Topical numbing cream
  • Sedation before procedures where appropriate
  • Ultrasound guidance to help find the vein

Questions
If you have questions before your procedure, please discuss them with your surgeon, hospital or anaesthetist.
Understanding what to expect can often reduce anxiety and help ensure a smoother recovery.

If you have any concerns or questions about these instructions please contact me.