Brain Surgery Information:

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CHAPTER 11: PREPARING FOR OPEN SURGERY

The perioperative period is a time involving the few days before and after open surgery. The preoperative period is before surgery, while the postoperative period is after. In the preoperative period, a patient should have met the microneurosurgeon who will carry out the surgery. The discussions should have involved some of the topics covered in the preceding chapters. The patient may also have met a member of the anesthesia team involved in administering a general anesthetic to the patient and looking after the patient during the operation itself. The surgeon should have discussed the benefits, risks, alternatives and team approach for surgery (Chapter 12), reviewed the basics of the surgery and recovery period, and addressed any questions or concerns that the patient may have. The anesthesiologist will want to know the patient’s basic medical history, medications, allergies, any previous anesthetics, and so forth. For elective brain surgery, that is, surgery planned in advance by the surgeon and patient to be carried out on a certain date, a patient may have to undergo routine blood tests, chest x-ray and electrocardiogram (ECG) testing to be formally cleared for surgery. Any further testing and consultation depends on the medical condition of the patient, but for most patients, the process of preoperative workup is fairly straightforward and brief. A patient should tell his or her doctor if taking medications that can thin the blood such as Coumadin/Warfarin, Plavix, Ticlid, and Aspirin.

The evening before surgery, a patient should have a good meal and get some rest. Usually from midnight onwards on that night before surgery, the patient should not eat or drink anything, however one should check with the doctor regarding taking any regular medications. On the morning of surgery, or at the time prearranged by the doctor’s Office staff with the patient, the patient should make his or her way to the admitting area of the hospital. The admitting staff will assist patients and their families. They will generally confirm a patient’s identity, the side on which the operation is to be carried out, that is, left versus right, and answer any questions or concerns before surgery. They may confirm if the patient has an "advance directive" with them, such as a Living Will or another equivalent document.