Pre-operative Care

Question 1

What are the time frames of food and drink fasting before an operation?

Answer 1

6 hours of no food before op

2 hours of no clear fluids before op

Question 2

How long does a patient need to stop taking a DOAC for before surgery in hours?

Answer 2

24-72 hours

Question 3

A patient needs emergency surgery and is on warfarin, what can be given to reverse the effects of warfarin quickly?

Answer 3

Vitamin K

Question 4

How long before surgery in weeks does oestrogen containing medications and hormone replacement therapy need to be stopped before surgery in weeks?

Answer 4

4 weeks

Question 5

What diabetes medications need to be adjusted or omitted around surgery? (3)

Answer 5

Sulfonureas e.g glicazide (causes hypoglycaemia)

Metformin (causes lactic acidosis)

SGLT2 inhibitors e.g dapagliflozin (risk of diabetic ketoacidosis)

Question 6

What type of insulin should be given during surgery for diabetics?

Answer 6

Sliding scale

Question 7

What type of insulin should be stopped in surgery until the patient can eat and drink again?

Answer 7

Short-acting

Question 8

At what percentage of their normal long acting dose of insulin should be continued while fasting before surgery in diabetics?

Answer 8

80%