Pre Operative Instructions For Preparation For Interavenous anesthesia
Click to open the form, then enter your information. Once you are finished, you may print, sign and return at your appointment, or you may email your completed form to firstname.lastname@example.org (if you are using the Fond du Lac office) or email@example.com (if you are using the West Bend office).
You should have nothing to eat or drink for six hours prior to surgery unless otherwise instructed by your surgeon at the consultation. Your surgeon may want you to continue your daily medications on the day of your surgery. If he advises you to take then on the day of your surgery you may do so with a sip of water.
Alcohol or recreational drugs should not be consumed for 24 hours prior to any I.V. anesthesia. Drug use could result in very serious complications or death during anesthesia. Please advise your surgeon of any recreational drug use. Any patient who appears intoxicated will not be treated until sobriety is obtained.
Every patient undergoing intravenous anesthesia MUST have a responsible adult (over 18) to bring them to their appointment, wait in the waiting area during the procedure, and then drive them home. It is mandatory that the driver or another responsible adult stay with the patient at home for several hours after their procedure if they were sedated.
Please wear loose fitting short sleeve tops for placement of a blood pressure cuff on either arm and placement of the I.V. if you are going to be sedated.
Glasses and contact lenses should be removed prior to the surgical procedure. Piercings of the lips, tongue or nose must be removed prior to surgery.
Those female patients who are taking oral contraceptive medications and sexually active are at risk for pregnancy secondary to taking oral antibiotics after surgical procedures. It is important to discuss this with your surgeon prior to surgery.