The pre-operative assessment is where your surgery is made as safe as possible, often weeks before the operation itself. Coming prepared, and being honest about your health, can prevent last-minute cancellations.
Imagine arriving for your hip operation after weeks of waiting, only to be told it is cancelled because your blood pressure is too high and nobody knew you were on a blood thinner. A good pre-op assessment is designed to stop this happening.
What a pre-op assessment is
A pre-operative assessment is an appointment, usually with a specialist nurse, that checks you are fit for your operation and anaesthetic. It may happen in person, by phone or through an online questionnaire, depending on the operation and your health.,The aim is to spot health problems early, plan your care around them, give you information and reduce the risk of complications or cancellations.
What to bring
- A list of all your medicines, including doses, inhalers, creams, supplements and herbal remedies, or the boxes themselves
- Details of any allergies and reactions
- Information about previous operations and anaesthetics, and any problems you or your family have had with anaesthetics
- Your glasses or hearing aids
- Questions you want to ask
What usually happens
- Questions about your health, lifestyle, home situation and support after surgery
- Measurement of height, weight, blood pressure, pulse and oxygen levels
- Blood tests, depending on your health and the operation
- An ECG for some people
- MRSA or other swabs before some operations
- Pregnancy tests where relevant
- Sometimes a breathing test or a referral to an anaesthetist
Medicines before surgery
You will be told which medicines to continue, adjust or stop before your operation. Commonly reviewed medicines include blood thinners such as warfarin, apixaban and clopidogrel, diabetes medicines including insulin and SGLT2 inhibitors, some blood pressure medicines, hormone treatments such as the combined contraceptive pill or HRT, and some herbal remedies.,Never stop a medicine before surgery unless you have been told to, and write down the instructions you are given, including dates.
Fasting before surgery
Fasting reduces the risk of stomach contents entering the lungs during anaesthesia. Common guidance is no food for about six hours before an anaesthetic, while clear fluids such as water are often allowed until one or two hours before, but local rules vary.,Many hospitals now encourage you to keep drinking clear fluids until a set time, because being dehydrated can make you feel worse. Follow your hospital’s instructions exactly; if you eat or drink when told not to, your operation may be delayed.
Getting fitter for surgery
- Stop smoking, ideally at least several weeks before, to reduce breathing and wound complications
- Cut down on alcohol
- Stay active and walk daily, as fitter people recover faster
- Eat well, including enough protein
- Manage blood sugar if you have diabetes
- Plan help at home for after the operation
Why honesty matters
It is important to be open about smoking, alcohol, recreational drug use, sleep apnoea, loose teeth and any symptoms such as chest pain or breathlessness. These details help the team plan a safe anaesthetic. The information is confidential and used only to keep you safe.
Planning for going home
- Arrange someone to take you home and stay with you if you are having a general anaesthetic
- Prepare your home, with frequently used items within reach
- Organise help with shopping, pets or childcare
- Ask how long you are likely to stay in hospital and when you can return to work or driving
- Ask what pain relief you will need at home
Frequently asked questions
Can my surgery be cancelled after the assessment?
Sometimes, if new health problems are found. Usually the team will try to treat them first so surgery can go ahead safely.
Can I wear nail varnish or make-up?
You may be asked to remove nail varnish, gel nails and make-up, as they can affect oxygen monitoring and checking your skin colour.
What if I get a cold before surgery?
Contact the hospital for advice. A minor cold may not delay surgery, but a chest infection or fever might.
But my operation is only minor
Even minor operations involve some risk, especially with anaesthesia. The assessment helps keep it as safe as possible.
Your next step: Write a complete list of your medicines and allergies today, so it is ready for your pre-op assessment.
Related: Recovering after surgery at home
Sources: Royal College of Anaesthetists, Centre for Perioperative Care, National Institute for Health and Care Excellence (NG45), American Society of Anesthesiologists.
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