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Before Surgery

Before Surgery

Preparing for an upcoming surgery is challenging and stressful. Here are some frequently asked questions about planning for surgery and anesthesia.



What is an anesthesiologist?

An anesthesiologist is a physician that has undergone specialized training in the field of anesthesiology.  The administration of anesthesia is complex and technically demanding.  Like all physicians, an anesthesiologist graduated from medical school, where he or she studied all aspects of medicine. After choosing to specialize in anesthesiology, he or she then proceeds to a four-year residency-training program. 
Some anesthesiologists choose to obtain subspecialized fellowship training, such as pediatric, obstetric, or cardiothoracic anesthesia. This amounts to an extensive medical education (around 12-14 years) and clinical training (around 12,000 to 16,000 hours).

Other types of anesthesia providers exist such as nurse anesthetists and anesthesia assistants. However, Matrix Anesthesia almost exclusively uses physician anesthesiologists as the sole providers at the facilities they staff. If a nurse anesthetist is involved in your care, be assured that a board certified anesthesiologist is overseeing all aspects of your anesthetic care.  For further information, refer to the link below.

Physician Anesthesiologists: The Anesthesia, Pain, and Critical Care Specialists

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Will I always be given anesthesia care by an anesthesiologist?

Within Matrix Anesthesia, a board certified or board eligible physician anesthesiologist will direct, and in the vast majority of cases, personally provide your anesthetic. An anesthesiologist will be monitoring you from start to finish for the entire duration of your surgery.  Only after you are medically stable will your care be transferred over to our recovery room nursing staff.

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Will I meet my anesthesiologist prior to surgery?

Yes, you will meet your anesthesiologist prior to surgery.
Your anesthesiologist will come to the preoperative admission area to meet you. After a thorough medical history is taken and a physical exam is performed, your anesthesiologist will discuss with you appropriate anesthetic options for your surgery. This is the best time to ask any remaining questions about your anesthetic and voice any concerns you may have. It is always helpful to learn of your prior anesthetic experiences so we can more personally tailor your anesthetic to your specific needs.


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May I request a particular anesthesiologist?

If your requested anesthesiologist is available on the day of your surgery, we will do our best to honor your request. However, due to scheduling conflicts, vacations or other request by patients or surgeons, your request may not always be available. Occasionally a particular anesthesiologist may also be requested by your surgeon because of his or her special skill in a particular type of anesthesia care. 

If you would like to request a particular anesthesiologist, please call 425-688-5229 for Overlake Hospital or call 425-899-3455 for Evergreen Hospital. 

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What should I bring with me to the hospital?

1. A detailed list of the physician prescribed and self-prescribed medications you currently take. Please include the exact dosages, how often you take the medication, and the date of your last dosage.
2. Medical insurance information. 
3. All paperwork from the surgeon’s office or preoperative consultations. This may include lab work, EKG’s or x-ray reports.


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Should I bring my medications and/or herbal supplements from home?

For accurate documentation of your medications, it is always helpful to bring your medications and supplements with you to the hospital. It is particularly important to bring any inhaler medications.  Bringing your medications and supplements allows the medical staff to see exactly the medications you take and dosages you require.  We ask that you bring your herbal supplements due to the fact that some supplements can increase the risk of surgery or procedure. For further information on herbal supplements, refer to the link below.

Herbal and Dietary Supplements and Anesthesia


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Should I take my prescription medications on the day of surgery?

Most medications can be taken the day of surgery. However, exceptions to this rule include some diabetic medications, high blood pressure medications, vitamins/herbal supplements, hormone replacements or anti-coagulants (blood thinners). Insulin is usually given in a reduced dose the day of surgery. All questions pertaining to this issue should be discussed with your surgeon at the time of your pre-operative visit or an anesthesiologist via our pre-operative clinics. For Overlake Hospital please call 425-646-5825. For Evergreen Hospital, please call 425-899-2706.


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What may I eat prior to surgery?

It is very important to have an empty stomach prior to surgery or a procedure requiring anesthesia.  When anesthesia is given, it is common for all the normal protective reflexes to relax.  This condition increases the risk of aspiration as it easily allows stomach contents to come up the esophagus and regurgitate into the lungs and airways.  Since the stomach contains acid, any acid that ends up in the lungs may cause a pneumonia called aspiration pneumonitis. Therefore, all anesthesia providers nationwide have strict criteria regarding eating and drinking prior to surgery. Matrix Anesthesia have the following requirements for your safety:

Adult patients: We require all patients to have no food or liquids after midnight the night before surgery. For surgeries scheduled later in the day, you may be allowed to drink clear liquids up to 8 hours in advance of the surgery. However, this should be done only with the permission of the nurse via your preoperative phone call or an anesthesiologist at the facility where you are having your procedure.  Clear liquids are defined as liquids you can see through.  A good rule of thumb is if you can read printed text through the liquid, then it is considered clear (except alcoholic beverages).  These include water, apple juice and black coffee. Orange juice, milk, coffee with cream, or any alcoholic beverages are NOT clear liquids. Please refrain from drinking these items on the day of surgery. If a patient has been found to consume non-clear liquids within 8 hours of surgery, the surgery may be delayed or canceled for safety reasons.

For Children: For children age 5 and under, please have them refrain from eating all solids 6 hours prior to surgery. Children may have clear liquids (see above) up until 4 hours prior to the scheduled surgical time. Breast milk is not considered a clear liquid. Clear apple juice or pedialyte is a good alternative. If you feel your child may have difficulty the morning of surgery without their normal feeding, please consider waking the child during the night to give the child clear liquids up until 4 hours prior to surgery.

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May I chew gum, eat hard candy or brush my teeth on the day of surgery?

Although not swallowed, chewing gum and candy still increase the amount of acid your stomach produces. This in turn will increase the risk of pulmonary aspiration (see “What may I eat prior to my surgery?” above).  Therefore, we advise that patients do not chew gum or eat hard candy prior to surgery for their safety. Brushing your teeth is allowed if the water is not swallowed.

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May I smoke prior to the surgery?

Studies have shown that a patient will do better in the postoperative period if they can refrain from smoking for 24 hours or longer prior to the surgery. If this is not possible, the longer you can refrain, the better your recovery will be.  For further information regarding the risk of smoking associated with surgery, refer to the link below.

Stop Smoking for Surgery


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Who should come with me to the hospital?

Outpatient/Ambulatory surgery: If you are scheduled as an outpatient, you need to have an adult with you that will be responsible for your care at home for the first 24 hours after surgery. Your companion will need to be able to drive you home. You are not allowed to leave alone, nor take a taxi home.  For further information regarding outpatient surgery, refer to the link below.

Outpatient Surgery and Anesthesia

Inpatient surgery: If you are scheduled to stay in the hospital overnight, you may come alone to the hospital. However, arrange transportation in advance. You will need an adult to drive you home and take care of you for at least 24 hours after you are discharged.

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May I bring my friends?

Yes, you may. However, you may be anxious before surgery and tired after surgery. As much as your loved ones care about you, you may want to limit the number of visitors you have. Please note that visitors are not allowed in the recovery room.

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Where will they wait?

There are surgical waiting rooms available in all of our surgical facilities. Your friends and loved ones will be shown to these areas.

After surgery, your surgeon will discuss the findings and results of the surgery with your family if that is your wish.  Confidentiality and privacy is always important, and therefore, if you only want certain aspects of your care discussed with your family, please let your surgical team know in advance.

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When should I come to the hospital for the planned surgery?

We normally require patients to arrive two to three hours prior to scheduled surgical time. Your surgeon may request an even earlier arrival time if you need additional testing. This may include an x-ray, echocardiogram or a consultation with a pulmonary or cardiac physician. Your surgeon’s office will inform you of this in advance. Your surgical time will be communicated to you, usually the day before your surgery. Please note however, that surgical times can change due to cancellations, unexpected delays, or emergency surgery additions. We will do our best to keep your surgery time, but delays or even an early surgical time are possible. Please be available by phone the day before and the day of surgery so we can reach you to communicate any time changes.


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What should I NOT do after an anesthetic?

Modern anesthetics generally leave your body quickly. However, some people, in rare circumstances, may not have a totally clear mental status for up to 24 hours. Therefore, it is for this reason that you should refrain from making any legal decisions or use any mechanical device (including driving a car) for at least 24 hours after your surgery. 


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What about glasses, contact lens, and hearing aids?

These items can be brought with you to the hospital. They all need to be removed just prior to surgery, so please remember to bring a storage case for them.

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May I wear makeup and jewelry?

It is always safer not to wear makeup into the operating room. Makeup in general can be a source of skin and eye irritation during surgery. Eye makeup particularly can be hazardous. Since people don’t blink their eyes under general anesthesia, flecks of eye makeup can cause eye (corneal) irritation and scratches.
Jewelry also will need to be removed during surgery for access to IV sites and placement of surgical gowns. Therefore, to prevent these items from getting lost or damaged, it would be preferable if you leave your jewelry at home. Wedding rings are the exception if you are not having surgery on that arm. These can be taped to your finger for its security.


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If I am anxious prior to surgery, can I receive medication for this?

Yes, in most situations you can receive medications prior to surgery to help relieve anxiety. However, in some rare circumstances, this medication may interfere with your anesthesia or surgery and thus cannot be given.  This will be discussed with your anesthesiologist prior to your surgery.


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Do I need to remove my dentures?

During most surgical procedures, your dentures will need to be removed in order to prevent damage. However, they can be left in place up until the last moment prior to entering the operating room. They can be reapplied immediately after awakening from a general anesthetic.

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