You have been advised surgery and the entire family is in
panic. Surgery has been advised to correct a health problem that cannot be cured by
medicines alone. Surgery is generally a one time affair and unlike medicines cannot be
reconsidered and another option given. Before you are put on the operating table, your
surgeon has to be very sure that you are FIT for surgery, that both during and after
surgery you will not have a problem that either endangers your life or retards recovery.
His ensuring all this is "Pre-operative Fitness".
Who will ensure my Pre-operative Fitness?
Your Family Physician in consultation with your surgeon. Once in the hospital your
Anesthetist will look at all the reports and may suggest an additional test as the
Anesthetist is solely responsible for your health during surgery.
But I am healthy except my problem requiring
That is what you feel and even if that is true we must have a documentary proof of your
fitness. Most of the times patients are surprised by the result thrown up.
What are the tests done and why?
The following tests are done ONLY to declare you FIT. Other tests pertaining to the
problem and the surgery may also be carried out.
- Complete Blood Test - to check for Anaemia. If the surgeon is expecting
blood loss during surgery, your Haemoglobin has to be normal.
- Blood Group & Rh - every good surgeon will keep a bottle or two of
blood ready for emergency. Better than running around last minute
- Bleeding time, Clotting time & Prothrombin time - indices of blood
clotting. Altered values may prolong bleeding leading to more blood loss thus delaying
- Blood sugar - both Fasting & Post Lunch - raised blood sugar
greatly affects healing. Unless an emergency no surgery is undertaken till blood sugar is
normal. Many Diabetics are switched over to Insulin for better control during and
immediately after surgery
- HIV & Hepatitis B - These test have become mandatory last few
years. This is for protection of the operating team, who have to take extra precautions
- BUN & Creatinine - tests for kidney function. Certain anaesthetic
agents cannot be used if kidney function is compromised.
- Urinalysis - also to indicate kidney function by presence of proteins
and signs of infection
- X-ray chest PA view - to rule out presence of Tuberculosis, which may
disseminate under general anaesthesia and also to see heart size.
- ECG - to know any latent cardiac problem
- Clinical examination especially for Blood pressure and lungs.
These tests are done in most surgeries being planned
under general anaesthesia. In special circumstances a surgeon may want Lung function tests
(in a known asthmatic or a heavy smoker) or Cardiac Stress test (patient with history of
Heart attack or other major cardiac problem)