Preparations for General Anesthesia
An eye procedure under general anesthesia is relatively safe. However, medical clearance (from a pediatrician or an internist) is still necessary. Once the patient is medically cleared, the patient should be assessed by the outpatient anesthesiologist-on-duty via a short interview. The anesthesiologist shall instruct the patient regarding fasting and what not to take prior to surgery. Last solid and liquid intake should be 6 hours prior to the scheduled time of surgery. An empty stomach ensures that anesthesia-related problems, such as regurgitation of gastric contents into the lungs, are prevented. A scheduled procedure may be canceled or rescheduled when proper fasting was not followed.
It is important to place all these documents in one clear plastic envelope for easy access:
- admitting orders from the surgeon
- medical clearance (from pediatrician or internist)
- anesthesia evaluation papers
- HMO LOA (letter of authorization)
- Philheath MDR (member’s data record)
- any prescribed medication that should be brought to the operating room
The above documents should be brought by the patient (and parent for pediatric patients) to the hospital’s admitting section. The patient shall be given a patient identifier and shall be subsequently transferred to the operating room complex. Only the patient is allowed into the operating room. Pediatric patients are allowed to be accompanied by one parent only.
The eyes are usually not covered but will be protected by plastic goggles after a procedure. This is to allow for fusion of the images from both eyes.
Adult patients may expect shivering, dizziness, and nausea after general anesthesia, but these should wear off within an hour. The throat and the IV drip may also be a bit sore in some cases.
Pediatric patients are usually crying, not because of pain but because they still feel sleepy or groggy, but they usually calm down after an hour. They may also feel a bit of nausea and could vomit, particularly if fasting regimen was not followed.
The recovery room is a safe place in the operating room complex where patients are allowed to experience the effects of the GA wearing off.
It is best to eat soft solids after exposure to general anesthesia to avoid distending the stomach too soon, and cause vomiting. Those who underwent surgery should avoid scratching the eyes and avoid swimming for 2 weeks. Resuming of daily personal care or hygiene on the day after surgery is encouraged.
Are there signs to watch out for that might require a visit to the emergency room after general anesthesia?
It is very rare to need an ER visit after an eye procedure under general anesthesia. However, it should be considered when the patient is experiencing one of the following symptoms:
- intractable eye pain
- profuse eye bleeding
- proptosis or bulging of the eye
- recent onset blurring of vision or loss of vision
- intractable vomiting
The eye doctor will place the date and time of the next clinic visit on the discharge papers. It is best to bring all discharge papers and all eye medications on the next clinic visit.