Preoperative Care
Most patients who undergo a fistulotomy can go home frome the hospital the same day. If a patient must remain in the hospital, he or she is usually discharged the following day.
As with any surgical procedure, certain preoperative tests are ordered. Blood and urine tests, a chest x-ray, and an EKG may be required. The need for additional tests depends on the patient's health and if general anesthesia is going to be utilized. These tests are normally done a few days prior to the surgery.
Medications that "thin" the blood, including aspirin, are usually discontinued several days before scheduled surgery. On the day of surgery, other prescription drugs may also be held. The need for discontinuing medications must be discussed with the physician before the operation.
If general anesthesia is going to be used, nothing can be eaten from midnight on the evening before surgery until after the procedure. This includes all food, water, chewing gum, and candy. This precaution decreases the possibility of vomiting during and after surgery.
For local and spinal anesthesia, dietary restrictions vary. Some doctors require their patients to follow the guidelines for general anesthesia in case it becomes necessary to switch to general anesthesia during the procedure. Dietary restrictions should be discussed with the physician in advance.
Check-in is usually the same day as the surgery. An informed consent form must be signed acknowledging that the patient understands the procedure, the potential risks, and that they will receive certain medications.
The anesthesiologist (doctor who administers the anesthesia) performs a brief physical examination and takes a patient history. It is important that the anesthesiologist is aware of all medications that the patient is taking, any allergies, and if there has been a prior adverse reaction to anesthesia. This information helps the anesthesiologist select the most suitable anesthetic agents and dosages and avoid possible complications.
Hospitals usually have an area reserved for same day or ambulatory surgical patients. Instead of checking into a room, same day patients go to this unit before and after the procedure. In preparation for surgery, patients have an intravenous line put in to receive fluids and medication during and after surgery. They may be given a sedative by injection or through the intravenous line to help them relax.
Same day surgical patients may go from this area to the operating room or may be taken to the preoperative or holding area, for a short time. Sometimes the intravenous is started here, depending on hospital protocol. The anesthesia is administered in the operating room.
Postoperative Care After surgery, the patient is taken to the recovery room or post anesthesia recovery unit (PACU) and is closely monitored by the nursing staff until they are stable. The amount of time spent in the PACU depends on the patient's progress and the type of an...
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