Patient Notes Before Anesthesia
Anesthesiologists aim to protect their patients during surgery. Certain health factors can increase the risks
associated with surgery and anesthesia. We can help lower these risks by examining your medical history andassessing your health before surgery. Although your medical care team will provide specific instructions
before your surgery, please review the following information to prepare for your upcoming procedure.

Once the surgery has been scheduled
Stop smoking
We strongly encourage patients to stop smoking once surgery is scheduled. Smokers may experience excessive
coughing and phlegm production after surgery, which can lead to pneumonia or worsen wound pain. Inaddition, smokers typically have a higher rate of infection after surgery and a longer healing time.

Treating high blood pressure levels
An anesthetic will typically reduce your blood pressure. If you have untreated hypertension or high bloodpressure, you may experience a larger drop in blood pressure than an individual with normal blood pressurelevels. This may cause ischemia or reduced blood flow to major organs, such as the brain, heart, or kidneys.
After surgery, your blood pressure can increase significantly due to bleeding from the open scar, and you may
have an increased risk of stroke or heart attack. Please consult with your medical provider to properly treat
elevated blood pressure levels before surgery.

Treating abnormal blood sugar levels
High blood sugar levels or hyperglycemia are risk factors for postoperative infection, cerebral ischemia(impaired blood flow in the brain), heart attack, and impaired wound healing. If you have poorly controlled
hyperglycemia, you may be hospitalized for a few days before surgery to implement a low-carbohydrate dietand intensive insulin therapy to normalize your blood sugar levels.

Maintain a proper body weight
Being considerably overweight can lead to challenges during anesthesia, such as difficulty ensuring adequate
oxygen and airflow for your body and locating veins to intravenously deliver anesthesia medications. It may
also complicate breathing tube placement due to airway narrowing. Being overweight can increase the time
taken to regain consciousness after surgery.
Maintaining a healthy body weight before surgery can decrease complications and recovery time. If you are
extremely overweight (body mass index [BMI] of 30 or greater) and your surgery can be postponed, we may
instruct you to lose some weight.
For safety reasons, we do not allow anesthesia management for patients with a BMI of 44 at our hospital.
BMI = weight (kg) / height (m2)After being hospitalized for surgery
Refrain from eating and drinking before surgery
While under anesthesia, you could inhale any food or liquid remaining in your stomach into your airway,
leading to life-threatening choking or severe pneumonia. You must NOT eat or drink before your surgery.

Remove everything from your body that can be removed
Please remove nail polish and makeup from your face. A machine will be placed at your fingertips to measure
your body’s oxygenation, which requires that you keep your fingernails free of any embellishments. We will
also observe your complexion during anesthesia administration. Cosmetics that contain metallic components
can cause burns on your face during surgery. The same risk is present with contact lenses and rings; therefore,
they must also be removed.
Dentures and orthodontic appliances can cause oral injury during airway management. They are also very
dangerous if they fall into the esophagus or trachea while you are unconscious under anesthesia. All these
items should be removed from your mouth before entering the operating room.

Shave your beard around your mouth
Beards may interfere with airway management during anesthesia. Please make sure to keep your beard neatly
trimmed on the day of your surgery.