Preparing for surgery

The following is an overview of preparing for all types of surgery, oncological or otherwise.

However, the procedures described may differ from one care setting to another. 

Types of anesthesia

Surgery can be performed in the doctor’s office, on an outpatient basis in the hospital or in an operating room. It is performed under the following types of anesthesia:

1- Local

A type of temporary anesthesia that numbs a specific area of the body to ensure that the surgery does not cause pain. The principle is to temporarily block nerve conduction in a specific area to prevent painful sensations. Several samples or biopsies can be taken in this way.

2- Locoregional

A type of anesthesia that consists in temporarily halting the transmission of nerve messages in a specific area of the body in order to permit surgery. It involves injecting local anesthetics in the vicinity of a nerve, a group of nerves or in the spine in order to numb a region of the body. The patient no longer feels anything in the targeted part of the body, yet remains conscious.

3- General

A type of anesthesia that brings about a state comparable to sleep. It is produced by injecting drugs into the bloodstream (intravenous infusion) or by inhalation of a gas. Under general anesthesia, the patient loses consciousness during surgery. He or she feels nothing and has no memory of the intervention. Awakening is gradual and usually peaceful.

The type of surgery performed, the type of anesthesia used and the overall health of the person determine the choice of same-day outpatient surgery or hospitalization. The latter may be very short, from 1 to 2 days, or longer, from 1 to 2 weeks or more.

The surgeon and the health care team provide information on the following topics:

• What happens before surgery and how to prepare for it;
• How the procedure is carried out and how long it is expected to take;
• The type of anesthesia that will be used;
• The possible after-effects of the intervention, the type of follow-up required, and the probable recovery time;
• The main risks associated with the procedure.

The surgeon frequently requests various tests and examinations before surgery. These tests depend on the surgery to be performed, the person’s state of health and their medical history. The anesthetist may also request tests.

WARNING!

Whether the surgery is performed as outpatient surgery or with hospitalization, in order to prevent complications it is recommended that patients:

• refrain from smoking (ideally 6 weeks before surgery): nicotine delays the healing process and increases the risk of lung infection;
• reduce or cease alcohol consumption: some medications cause side effects when taken with alcohol;
• stop using natural products 2 weeks before surgery. 

Hospitalization time

Same-day surgery

When outpatient surgery is to be performed, with the patient returning home the same evening, a telephone or face-to-face meeting is conducted with a nurse. The nurse gathers the relevant information from the file and gives the information and advice on the upcoming surgery and the postoperative period. She also ensures that everything is ready for the day the surgery is to take place. If examinations are required, they will be performed at this meeting or in the following days, depending on the date of surgery. Preoperative preparation instructions such as the required fasting period or taking medication will also be given. The patient may also be supplied with an educational guide on the surgery.

The day before the surgery (on Friday, if the surgery is scheduled for Monday), the person will be informed by telephone of the presumed time of surgery and the time at which he or she must report to the Day Surgery department. On the day of the surgery, the person will arrive at the appointed time and will generally have fasted (specific instructions to be followed). He or she must have followed the instructions for preparation such as showering or bathing, removing makeup and nail polish as well as taking medication, if prescribed. A nurse will ensure that the final preparations are complete before the surgery.

After surgery, the person will go back to the day surgery room for a day for a recovery period of variable length. A nurse will check vital signs on a regular basis in order to ensure good short-term recovery. The surgeon will often make a visit to give information about the surgery and will specify the instructions for convalescence and postoperative follow-up.

Upon returning home, the operated person must be accompanied and the accompanier or some other person must stay with the operated person until the next morning to ensure his or her safety.

Inpatient surgery

In general, the preoperative preparation for inpatient surgery is carried out in a preoperative care unit. A nurse will assemble the relevant information and provide information and advice on the upcoming surgery. Any necessary examinations and medical consultations with other specialists will also be performed during this preparatory day. Oral or written preoperative instructions and patient education guides on the surgery, if available, will be issued on this day. Sometimes the person may have to attend over a 2-day period if several examinations or consultations are required. The goal of this procedure is to have the ready person to undergo surgery in an optimal, safe manner.

The day before the surgery (on Friday, if the surgery is scheduled on Monday), the person will be informed by telephone of the presumed time of surgery and the time at which they have to report to the Ambulatory Preoperative Care Department.

On the morning of the surgery, the person must arrive at the scheduled time and will be taken care of by a nurse who will make the final preparations. They must have fasted (in accordance with specific instructions) and followed the instructions for preparation such as showering or bathing, removing makeup and nail polish, intestinal preparation if required, as well as taking any prescribed medication.

In preparation for hospitalization, the person must prepare a small suitcase, clearly identified with their name, for their personal belongings. The nursing staff will give instructions about the recommended items to bring.

The length of time spent in the operating facility before returning to the post-op room can vary greatly and is often far longer than the anticipated duration of the operation. In fact, to the time of the actual operation must be added the time needed to set up the anesthesia, the time spent in the recovery room and the time required to get a bed ready to receive the person operated on, which is difficult to control.

WARNING!

Whether the surgery is performed as same-day surgery or with hospitalization, it is essential to inform the nursing staff in the preoperative units of any change in health status and any change in medication that occurs between the preparation day and the day of the operation.

Meeting with the surgeon after the operation

For family and friends, the time of the operation is a source of concern and many will want to receive news as soon as possible. Surgeons often meet with family and friends after surgery. In order to obtain a meeting with the surgeon, if possible, it is recommended that a request be made directly to the surgeon, who will explain the procedure and set an approximate time for a meeting after the surgery.

Sources (in French only):

Guide d’accompagnement et d’enseignement conçu pour les patients devant subir une chirurgie, CHU de Québec

L’anesthésie locale

L’anesthésie loco-régionale

Information médicale sur l’anesthésie