Preoperative preparation

Preoperative tests:
Your doctor will insist on to do some tests before hospitalizing for the planned surgery. The tests are relevant to your health condition. The list of tests below is provisional because every patient gets a private prescription. If the patient has any allergies, testing by an allergy specialist is also required.

What are the necessary preoperative tests?
•    Blood group and Rh (Rhesus factor)
•    Valid until 7 days before the surgery - Erythrocyte Sedimentation Rate, Full blood counts test, Glucose, Total Protein, Creatinine, Urea,  GOT, GPT, Potassium (K), Sodium (Na), Prothrombin Time (PT), /% / INR, Fibrinogen, APTT (KKV), Urine – OCHI
•    Valid until six months before the surgery - Syphilis (Wass), AIDS (HIV), Hepatitis B (HBsAg), Hepatitis C (HCV)
•    ECG (electrocardiogram)

Preoperative documentation:
Necessary documents for surgery:

•    A questionnaire according to the medical standard “Anesthesia and intensive treatment”

•    Declaration for informed consent statement – any medical procedure related to your treatment is provided with a signed document for informed consent statement in appropriate form and volume, which allows you to choose the treatment. Understandably, informed consent offers information about your upcoming operation, its benefits, and risks, as well as any complications that might arise for existing alternatives. Informed consent also includes consent for additional medical activities, including non-planned operations, resulting from emergencies and urgency, occurring after local or general anesthesia or in the course of surgical intervention

•    Declaration for informed consent statement for blood transfusion and blood components transfusion

Preoperative consultation
Before any surgery, the preoperative consultation with an anesthesiologist and internist is mandatory along with the laboratory test results. If necessary and by indications, consultations with specialists from various medical specialties and additional clinical studies can be arranged to state your health condition.

The date of the preoperative consultation will be determined by your doctor or a midwife in the ward. Pre-operational consultation includes:

•    Consultation with an anesthesiologist – The anesthesiologist is the doctor who will introduce you to the essence of anesthesia. It will assess the ASA (American Society of Anesthesiologists) risk based on the answers to the questionnaire you have completed, the results of the preoperative studies and the clinical examination. The specialist will figure out an opinion on the safety, indications, and contraindications of the upcoming anesthesia, plan the possible anesthetic techniques and how they should be done.

•    Consultation with an internist – the internist is a doctor who will read the result of the electrocardiogram (ECG), and the results of the preoperative examinations and will perform a clinical examination.

In the day of the preoperational consultation you have to bring with you:
•    ID Card
•    Preoperational preparation tests results;
•    Medical documentation that has not been provided so far (epicrisis, results of reviews, consultations and/or studies)
•    A list of currently administered medicines
•    A list of medications to which you have an allergy

Preoperational information

Diet Information
When the hospitalization is planned it is mandatory before the surgery to follow the instructions for the diet you have received during the preoperational consultations. You should not take food after 8:00 p.m. and water after 10:00 p.m., the day before the surgery. These terms are provisional as each patient receives individual instructions. Failure to follow the instructions may result in delay or cancellation of the surgical intervention.

Medicines information
When the hospitalization is planned it is mandatory to follow the instructions you got during the preoperational consultations for the regime of taking medicines. This regimen includes both medications you are currently taking and specific ones that are related to the surgical intervention. For some drugs, it may be necessary to discontinue or reduce the dose for several days before the surgery. Medications that affect blood coagulation (anticoagulants, aspirin) must be stopped. Failure to follow the instructions may result in delay or cancellation of the surgical intervention.

Anesthesia information

What is anesthesia?
Anesthesia is used for analgesia in surgical interventions. Anesthesia (Latin: anaesthesia) is a word of Greek origin and means insensitivity (to touch, pressure, temperature, including pain). Today, this term refers to a set of pain-relieving actions in medical practice for performing painful surgical, therapeutic and diagnostic procedures.

What are the types of anesthesia?
There are two types of anesthesia is two types - general and local. In general anesthesia, medications (anesthetics) are used to suppress the central nervous system (CNS) function, and the patient reversibly loses consciousness (falls asleep). The general anesthesia is divided into the following types applied in operative gynecology:

• General venous anesthesia - anesthesia is achieved by intravenous injection of an anesthetic. Venous anesthesia delivers rapid and pleasant sleep without irritation of the respiratory tract, such as inhalation anesthetics

• Balanced anesthesia - anesthesia is achieved through different combinations of venous analgesics, oxygen, nitrous oxide, and halogenated hydrocarbon and muscle relaxants. These combinations allow avoiding the side effects of each drug by using several medications in smaller doses

• Endotracheal anesthesia - anesthesia is achieved by feeding a gas mixture containing oxygen and anesthetic. A tube for supplying the gas mixture and for connecting the patient to the anesthesia apparatus is placed in the trachea of the patient

Local anesthesia uses medications (local anesthetics) that are injected into different parts of the body thus temporarily interrupting the transmission of nerve impulses from the operative zone to the brain. Local anesthesia is divided into the following sub-types applied in operative gynecology:

• Spinal anesthesia - anesthesia is achieved by injecting a local anesthetic into the spinal space. Gradually blocking nerve impulses on spinal cord brains in a different sequence. A sensory and motor block is attained

• Epidural anesthesia - anesthesia is achieved by injecting a local anesthetic - the amount needed to sniff the affected nerves. The injection is through a catheter, a thin, flexible plastic tube placed near the nerves in the spine at the level of the waist. Only a sensory block is achieved

• Combined spinal/epidural anesthesia - anesthesia is completed by a combination of both local anesthesia, thus combines the benefits of both methods

How is the anesthesiology method determined?
During the preoperative consultation with an anesthesiologist, you will determine the most appropriate anesthesia for you. When choosing anesthesia for surgical intervention, the anesthesia team, headed by a specialist anesthesiologist, takes into consideration your general condition, age, gender, primary and accompanying illness; type, volume, and duration of the operation; para-clinical deviations, if any; past diseases.