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Getting ready for surgery

It is important to think about how you can be as healthy and fit as possible before surgery. Perioperative care aims to optimise patients journey from  the moment surgery is contemplated until recovery. 45% of operations requiring an anaesthetist are in people aged 65 and over. 14.8% of patients decide against surgery after discussions with a geriatrician-led service. 

Smoking

Smoking reduces the amount of oxygen in your blood and increases the risk of breathing and heart problems during and after your surgery. There is a 50% reduction in complications with smoking cessation. Smoking also interferes with wound healing and on average smokers stay longer in hospital.  If you smoke you should give up before your surgery.

If you need help to stop smoking, please visit our help me quit pages. 

Your weight

Being very overweight increases the risks of your operation and is associated with chest infections, breathing difficulties, blood clots, wound infections and poor wound healing. there at least four times more complications if you are physically inactive or frail. By exercising and keeping fit there's up to 50% reduction in complications with pre-op preparation. 

Being underweight can also cause problems in the perioperative period.  If you have been unwell you may have lost your appetite and your body may not be getting the nourishment it needs.  If this is the case you may be seen by a dietician.  If they advised you to follow a special diet please check with them before following the advice here.  They may supply you with nutritional supplements to take prior to surgery.

The following websites have more information and resources on managing your weight: 

https://www.nhs.uk/better-health/lose-weight/

https://www.rcoa.ac.uk/sites/default/files/documents/2022-06/13-YourWeight2020web.pdf 

Alcohol

The NHS recommends that men and women should not drink more than 14 units a week on a regular basis.  If you regularly drink 14 units a week you should spread your drinking our over three or more days.  Cutting down alcohol intake prior to surgery is advisable. Information and advice on reducing your alcohol levels can be found here

Medical problems

If you have a long-term condition, such as diabetes, asthma or bronchitis, heart problems, are overweight or have high blood pressure, you should make sure you are as well as possible before your operation. If you think you could make some improvements, you can ask your GP for an extra check-up. You should do this as soon as you know that you are having an operation.

Diabetes management | taking care of your diabetes | Diabetes UK

High blood pressure (hypertension) - NHS (www.nhs.uk)

Anaemia

Anaemia is a condition where there are low levels of red blood cells in the blood.  Having a good level of red blood cells and iron in the blood is important for healing and recovery after surgery.

The most common symptoms of anaemia are tiredness and lack of energy, shortness of breath, noticeable heartbeats (heart palpitations), pale skin.

Blood tests to check for anaemia can be arranged by your GP if you think you might be anaemic you can request a health review at your surgery and this can also be checked at the preoperative assessment clinic

Keeping active

Research has shown that the fitter you are prior to surgery the quicker your recovery and the more likely you are to survive.  This means that being active in the lead up to surgery can have long lasting positive effects.  Activity can be anything that raises your heart rate and gets you a little out of puff.  The World Health Organisation recommends thirty minutes of exercise five times a week for all adults.  This may well not be possible but anything that you can do to increase your activity levels in the run up to surgery would be beneficial.  If there is any reason not to exercise prior to surgery your surgeon will advise on this, however this is rarely the case.

Types of activity include but are not limited to:

  • Going for a walk
  • Carrying your shopping home
  • Gardening
  • Climbing stairs instead of taking the lift
  • Swimming
  • Cycling
  • Yoga

Whatever your normal activity level is, try to double it in the weeks preceding your surgery. 

For more information on getting active, check out Fitter Better Sooner on the Royal College of Anaesthetists here:  https://www.rcoa.ac.uk/patient-information/preparing-surgery-fitter-better-sooner/fitter-better-sooner-general-information