four doctors in the OR

Having surgery at UCSF

UCSF is a pioneering institution, continually advancing the understanding of medicine and the human body through research and collaboration. We aim to make your surgery as easy and stress-free as possible. Use the links below to find answers to common questions about surgery and access further information.

Preparing for surgery

Follow medication instructions: You will receive specific instructions about taking your regular medications on the day of surgery. Failure to follow these instructions can lead to your surgery being cancelled.

Stabilize medical conditions: Ensure that any long-standing medical conditions are stable.

Stop using recreational drugs: Refrain from using recreational drugs for as long as possible before your surgery.

Quit smoking: Try to stop smoking at least 6 weeks before your operation, if not permanently. This will help your blood transport more oxygen, aiding in the healing process.

Remove nail polish: Take off any nail polish from your fingers and toes.

Reduce alcohol consumption: Avoid alcohol for 24 hours before and after surgery.

Manage your weight: If you are overweight, losing weight can improve your overall physical condition prior to surgery.

Remove jewelry: For your safety, remove all jewelry before admission. Jewelry in the mouth or nose may become dislodged and end up in your stomach or lungs. Rings can restrict blood circulation to fingers or toes. The hospital is not responsible for lost jewelry.

This can all seem overwhelming, which is why you will be scheduled an appointment at our Prepare Clinic to ensure you are safe and optimized for your surgery. Information for pediatric patients is here.

During your Prepare Clinic appointment, you will receive instructions on fasting times for food, liquids, and medications. It is crucial to adhere to these guidelines, as not doing so can result in the cancellation of your surgery. If you are not properly fasted, there is a risk of vomiting or regurgitating stomach contents into your lungs under anesthesia, which can cause severe lung damage or even death. The American Society of Anesthesiology recommends fasting for 6-8 hours for solids and 2-6 hours for clear fluids.

Yes, depending on the type of surgery you are undergoing and your co-morbidities, the Prepare Clinic may ask you to bring recent test results on the day of your surgery or arrange for repeat tests. Occasionally, these test results may necessitate further medical optimization before your surgery. Your surgeon and anesthesiologist will determine if you need any tests prior to your procedure.

ERAS stands for Enhanced Recovery After Surgery and if this program applies to your surgery the ERAS program commences before you even have surgery. ERAS aims to improve surgical outcomes and enhance the patient experience throughout the surgical journey. This multidisciplinary team of surgeons, anesthesiologists, nurses, and other healthcare professionals works collaboratively to implement evidence-based interventions and protocols that accelerate recovery before, during, and after surgery.

 

Day of surgery

If you had investigations at an outside hospital, bring copies of recent test results. Medical equipment, such as CPAP machines, and medication lists or your Webster-Pack should also accompany you to the hospital on the day of your surgery.

Most healthy patients will meet their anesthesiologist on the day of their surgery. However, patients with medical conditions such as heart disease, diabetes, or asthma often consult with their anesthesiologist in the pre-admission clinic before the day of their surgery.

Your anesthesiologist will review your medical history, allergies, confirm your fasting status, and discuss the type of anesthesia you will receive. There will be time to discuss the risks and benefits of the proposed anesthesia plan. You will often be cared for by a trainee anesthesiologist or CRNA (nurse anesthetist) as well as your anesthetist and you will meet all practitioners before going to sleep. Your anesthesiologist will also conduct a physical exam, focusing on your airway and discuss your post-operative disposition, which could be going home the same day or staying in the hospital. 

Some patients will need blood products before surgery for certain conditions like anemia, and this will have been arranged by the Prepare Clinic. If your surgery carries a risk of blood loss your anesthetist will consent you for blood products. Some patients refuse some or all blood products and this will be documented by your anesthetist on your anesthesia record. 

Each anesthesia technique carries its own unique set of risks, which your anesthesiologist will discuss with you when informing you of the anesthesia technique being used.

After surgery

Immediately after you leave the operating room you will be transported to the Post-Anesthesia Care Unit (PACU) where your anesthesiologist and PACU nurses ensure you are comfortable, without nausea or vomiting and awake enough to be discharged from the PACU to either home or another ward within the hospital. In a select few cases, you may be admitted directly to higher levels of care called the Intensive Care Unit. 

Your post-operative disposition is typically planned before your surgery, and you will be informed of your discharge location in advance. However, in rare cases, an intraoperative event such as unexpected bleeding may result in a change to your post-operative disposition.

Some patients are discharged home on the same day as their surgery. In these cases, it is crucial to arrange for a responsible adult to take you home and stay with you overnight in case you experience a complication from either your surgery or anesthesia.

If you are staying in the hospital after your surgery, there are different types of wards to which you could be discharged, depending on your co-morbidities and the type of surgery. Most patients are discharged to a regular surgical ward, but others are sent to wards with higher levels of care, such as the Intensive Care Unit.

For day surgery, you will remain in the Post-Anesthesia Care Unit for a few hours until you are comfortable, able to tolerate food, and awake enough to be safely discharged. If you stay in the hospital after your surgery, your surgeon and team will inform of your likely duration of hospital stay. 

Some medications, like blood pressure treatments, can be restarted the day of your surgery. Other medications, like blood thinners, may continue to be withheld for a few days after your surgery. Your anaesthesiologist and surgeon will educate you on when to recommence your usual medications. 

Depending upon the type of surgery you have had, you may be discharged with a script for pain medication, antibiotics, and/or medications for nausea and vomiting. Your surgical team will arrange a prescription prior to your discharge.