Hemorrhoidectomy Preoperative Procedures
Preoperative tests may include blood and urine tests, a chest x-ray, and an EKG, depending on the patient's health. These tests are normally done a few days prior to surgery.
Medications that "thin" the blood, including aspirin, are usually discontinued before a scheduled surgery. Some drugs, such as the prescription medication warfarin (Coumadin, Jantoven, generics), usually must be withheld at least 3 or 4 days prior to a surgical procedure to avoid excessive bleeding during the surgery.
If general anesthesia is going to be used, nothing may be eaten from midnight on the evening before surgery until the procedure is completed. This includes food, water, chewing gum, and candy. This necessary precaution decreases the possibility of vomiting during and after surgery.
For local and spinal anesthesia, dietary restrictions vary. The surgeon may require patients to abstain from eating after midnight, and that should be clarified in advance.
Hemorrhoidectomies are performed in a hospital or outpatient surgery center. Some patients go home the same day and others remain in the hospital. Check-in is usually the same day as the surgery and at this time an informed consent form must be signed. This is a legal document acknowledging that the patient understands the procedure and its potential risks, and is aware of the medications they will receive.
The anesthesiologist (doctor who administers the anesthesia) performs a brief physical examination and obtains a patient history. It is important that the anesthesiologist is aware of all medications that the patient is taking, any allergies, and any prior adverse reaction to anesthesia. This information helps the anesthesiologist select the most suitable anesthetic agents and dosage and avoid possible complications.
Two to 4 hours before surgery, a mild laxative or enema may be ordered to clear out stool. A sedative also may be administered in the patient's room or in an area designed for patients who are about to undergo surgery. The sedative helps the patient relax and induces drowsiness. Sometimes it is given as an injection about an hour before the surgery, and sometimes it is given intravenously.
All patients have an intravenous line (IV) to administer fluid and medication before, during, and after surgery. The intravenous may be started in the hospital room or in the preoperative area. Anesthesia is given in the operating room.