Information for surgery patients

• On the morning of the operation, take your regular medication with minimal amount of water (except for blood thinners, which should be discussed with the doctor when planning the operation).
• Patients are asked to bring the medications they take on a daily basis (such as insulin for diabetics or an inhaler for patients with asthma) and a list of the medicines including their doses to the clinic.

In the case of surgery under general anaesthesia, do not eat for 6 hours before the surgery or drink, chew gum or smoke for 4 hours before the surgery. However, please note that excessive fasting (12 hours or more) before the surgery is also not recommended as it can cause nutrient deficiencies and dehydration.

Anaesthesia allows medical procedures and operations to be performed painlessly, and it ensures the safety and comfort of you or your child. Anaesthesia is performed by a specially trained doctor – an anaesthesiologist. There are several types of anaesthesia: local anaesthesia, regional anaesthesia affecting a specific area of the body, and general anaesthesia affecting the entire body.

GENERAL ANAESTHESIA

General anaesthesia is a carefully controlled state of unconsciousness achieved through a combination of medications.

Before the surgery, a cannula is inserted into the vein, through which medications can be administered. In addition, oral medications may be used, or you may be asked to inhale oxygen and anaesthetic gases through a mask covering your mouth and nose.

After the state of unconsciousness has been induced, a special laryngeal mask or intubation tube must be placed to keep the patient’s airway open and protected. There-fore, it is very important to inform the anaesthesiologist if you or your child have any loose teeth or dentures. If necessary, the anaesthesiologist will administer oral or nasal sedatives before the surgery.

Upon waking up from anaesthesia, you or your child may feel cold and have chills, drowsiness and short-term memory disturbances. Rarely, nausea and vomiting may occur, and the arm may be painful near the site of the cannula. In most cases, these complaints go away sponta-neously within a few hours, but if necessary, medications can be used to relieve these. Sometimes, you may have a sore throat after the use of an intubation tube, but this usually passes in a few days. You may experience muscle soreness, which also eases in a few days.

After the surgery or procedure, there may be pain in the wound area. Painkillers can be used to prevent and treat this.

After the surgery or procedure, you or your child will be taken to the recovery room or back to the ward.

At the surgery with your child

Parents are offered the opportunity to stay with their child in the operating room until the anaesthesia is administered and the child falls asleep. This reduces anxiety for both the child and the parent and creates the opportunity for better treatment outcomes.

After the surgery, the parent will be reunited with the child as soon as possible in the recovery room.

REGIONAL ANAESTHESIA

Spinal anaesthesia

The local anaesthetic is injected into the spinal fluid in the lumbar region (lower back) using a special needle. The medication will numb the lower body within 15 minutes. The mobility of the lower body is then limited for a few hours. It is restored when the medication wears off.

Epidural anaesthesia

The local anaesthetic is injected near the nerve roots exiting the spinal cord (in the epidural space in the lower back) using a special needle or an epidural catheter. The corre-sponding area becomes numb within 15–40 minutes, and leg mobility may also be disturbed. In the case of epidural anaesthesia, it is possible to administer additional doses of the medication through the catheter during the surgery or procedure and for the treatment of subsequent pain.

Plexus anaesthesia

This anaesthesia is used for hand surgery. The local anaes-thetic is injected in the armpit, in the collarbone or around the nerves in the neck area, as needed. Your hand will become numb within 15 minutes and you will not be able to move it for a few hours.

Intravenous regional anaesthesia

Suitable for minor hand or foot surgeries. A special tourni-quet is placed on the limb. The local anaesthetic is injected into a vein in the area to be operated on. The medication takes effect quickly and lasts until the tourniquet is released.

In rare cases, nausea may occur after all surgeries performed under regional anaesthesia.

POTENTIAL RISKS

All medical procedures involve certain risks. However, life-threatening complications (cardiac arrest, respiratory arrest, large vessel thrombi, brain damage) are extremely rare. Very rarely (1: 50,000), a malignant rise in body temperature (malignant hyperthermia) may occur.

Anaesthesia-related mortality is extremely low (1: 250,000). Most patients do not experience any complications related to anaesthesia.

Rarely, allergic reactions may occur with all types of anaesthesia.

Toxic reactions

Very rarely, systemic toxic reactions (visual disturbances, breathing difficulties, drop in blood pressure, cardiac arrhythmias, convulsions) may occur if the local anaesthetic enters the bloodstream.

Drop in blood pressure, dizziness, difficulty breathing

During all types of anaesthesia, a drop in blood pressure may occur, which is why the patient’s blood pressure and cardiac function are constantly monitored. Dizziness, nausea or breathing difficulties may occur. If such symptoms occur, they should immediately be reported to the anaes-thesiologist or anaesthesia nurse so that the necessary remedial actions can be applied.

Numbness in the legs or difficulty urinating

After a surgery or procedure performed under spinal or epidural anaesthesia, the legs may remain numb for a while and it may be difficult to empty the bladder. If necessary, a catheter is inserted into the bladder. After spinal or epidural anaesthesia, a headache (1: 250), nerve damage (1: 50,000) or paralysis of the legs (1: 150,000) may occur but in most cases this will pass.

Dental injuries

Under general anaesthesia, there is a possible risk of dental injuries when inserting the intubation tube or laryngeal mask.

Wakefulness during the procedure

Very rarely (at the beginning or end of anaesthesia), so-called wakefulness during anaesthesia may occur, where the patient can hear surrounding sounds but cannot move or feel pain.

Aspiration of stomach contents

In the case of unconsciousness (general anaesthesia), the body’s normal defensive functions do not work. Therefore, there is a possibility that the contents of the stomach may enter the respiratory tract and cause life-threatening complications.

That’s why it’s important to avoid eating for six hours and drinking for four hours before the surgery or procedure, even if regional anaesthesia is planned. However, please note that excessive fasting (12 hours or more) before surgery is also not recommended as it can cause nutrient deficiencies and dehydration.

If these rules are not followed, the surgery or procedure may be cancelled in the interests of your or your child’s safety. In emergency situations, the potential risks are considered and the necessary measures to protect the respiratory system are taken.

Local numbness

Muscle tone is absent during anaesthesia, so in rare cases, nerve compression caused by position may occur, causing numbness in certain body parts that can last for several weeks.

The risks associated with anaesthesia are higher if you or your child:

• have chronic illnesses (e.g. hypertension, coronary heart disease, asthma, diabetes);
• have allergies;
• smoke;
• use alcohol or drugs.

Recommendations for the safest anaesthesia possible

• Inform your doctor and anaesthesiologist about any chronic conditions you or your child are suffering from, any previous surgeries you or your child have had, and the medications you or your child are taking. Unless instructed otherwise by your doctor, take your prescribed medications regularly until the day of your surgery. Bring your medications with you to the hospital.
• Be sure to inform your doctor and nurse if you are taking any blood thinners (e.g. aspirin, Marevan, Eliquis, Xarelto, Pradaxa, Lixiana) or weight manage-ment medications (Ozempic, Mounjaro etc) so that you can plan to stop taking them in time before the surgery.
• Improve your physical fitness.
• Stop smoking at least six weeks before your surgery or procedure.
• Limit your alcohol intake.

For your information

• All needles, catheters and drips used for anaesthesia are disposable, which prevents the transmission of infection from one patient to another.
• Blood products will only be transferred to you if there is a specific indication, in which case the products will be individually matched. All products are pre-screened for infection, but all medical procedures always involve risks. If you or your child do not want a blood transfusion for religious or other reasons, inform your doctor. It is important to understand that in a life-threatening situation, a blood transfu-sion may be the only way to save your or your child’s life.
• If you or your child are discharged on the same day, it is recommended that you arrange someone to pick you up.
• For 24 hours after general anaesthesia, it is prohibited to drive motor vehicles, operate complex equipment, make important decisions, sign legal documents or consume alcohol.

Children’s last meal before surgery (over 1 year old):

• Clear liquid 2h
• Breast milk 4h
• Mixed feeding 6h
• Solid food 6h

• For pain relief (if there are no contraindications), take paracetamol 1 g three times a day and/or ibuprofen 400-800 mg three times a day for up to five days to reduce swelling and pain (including the evening of surgery; more detailed instructions will be provided by the attending physician).
• After orthopaedic surgeries, apply an ice pack to the operated area three to four times a day for 20-30 minutes over two to three days (including the evening of surgery). An ice pack can also be placed on the wound from time to time.
• If the operated limb is swollen, elevate it and perform the recommended exercises to improve blood circulation.
• If signs of infection appear (increased swelling and a different temperature in the operated area, fever over 38 °C), you should follow your doctor’s instructions or go to the nearest emergency department.
• After orthopaedic surgery, the load on the operated limb will be determined by your doctor and provided on the information sheet.
• Your family doctor will extend your sick leave, unless otherwise agreed.

Proper wound care promotes rapid and smooth wound healing. Always follow the wound care instructions and/or orders provided by your doctor or nurse. Use the recommended dressing materials and tools for proper wound care. 

Do not hesitate to ask for advice and if you have any questions or doubts, feel free to contact your doctor or nurse. 

The first 24 to 48 hours are critical for wound closure, after which the wound edges are considered closed to the external environment. Sutures, clips or wound glue hold the wound edges together. 

• Keep the wound clean and dry throughout the recovery period to promote healing and prevent infection. 
• Wash your hands before changing the wound dressings. The wound can be cleaned with wound care products you can find in the pharmacy (e.g. NaCl 0.9% saline solution, Prontosan solution or spray, wound or mucosal antiseptic), unless instructed otherwise.   
• Dry the wound with clean swab or towel and then cover the wound with a bandage or dressing. 
• The wound can be washed the day after surgery or as instructed by the doctor/nurse. 
• Before washing, remove the bandage or dressing and wash the wound under lukewarm running water, unless your doctor or nurse has told you otherwise. Let the wound air dry or gently pat it dry with a clean cotton swab. Do not rub the wound! If needed, apply a new dressing to the wound. If the wound is dry and shows no signs of infection, you can leave it uncovered. 
• The timing of the suture removal will be decided by your doctor. This usually takes place 10 to 14 days after surgery (later if necessary). 
• You can go to the sauna, take a bath or swim the day after the sutures are removed. 
• The dressing placed on the wound after suture removal can be removed the following day. 

 You can schedule an appointment with a surgical nurse or, if you prefer, your family doctor/nurse to remove the sutures. 

After surgery, the wound may become slightly red, there may be a tingling or itching sensation or bruising, and the wound may be tender. These are normal symptoms and will resolve on their own over time. 

However, complications may occur after any surgical intervention: wound infection (foul-smelling discharge from the wound, open wound edges), bruising, bleeding, swelling, damage to the skin nerves, etc., which may prolong the healing process. If problems arise, contact your family doctor or your treating physician. Outside working hours or in case of severe complications (high fever, intense pain in the operated area, breathing difficulties, etc.), please go to the nearest emergency department. 

The recovery process and speed depend on the diagnosis and the complexity of the surgery/procedure performed, the course of the surgery and the patient’s involvement in follow-up care. Recovery and sick leave duration vary for different surgeries. 

Your doctor will tell you the estimated length of the recovery period. However, every case is different and it is difficult to predict the exact course of recovery. 

If complications occur, the recovery period will be longer; therefore, it is necessary to follow the pre- and post-operative requirements and recommendations as much as possible (including avoiding smoking and alcohol consumption, diet, treatment of chronic diseases, movement, performing exercises recommended by the physiotherapist and doctor, and other rehabilitation). 

Patients arriving to the hospital for overnight treatment are offered dinner on the day of arrival and breakfast on the day of departure. 

• Perishable food is not allowed to be kept in the room.
• Please store labelled food items in the refrigerator for patients, which is located in the lounge area.
• It is also possible to use the microwave in the lounge area. Staff can assist you if needed.
• If you are staying for several days, meals are provided three times a day based on a set menu.

Approximate daily schedule 

06:00-07:30 – wake-up, nurse’s visit, procedures 

07:30-08:30 – dressing changes, medications 

08:30-09:00 – breakfast 

12:00-13:00 – lunch 

17:00-18:00 – dinner 

20:00-22:00 – evening procedures 

22:00-06:00 – quiet hours 

The staff is happy to assist you with any questions or concerns! 

Visiting hours are Monday to Friday from 16:00 to 18:30 and weekends from 10:00 to 14:30. At other times, visiting your close ones is possible by prior agreement with the doctor or nurse on duty. 

Visitors may bring you personal items and everyday necessities. 

For the health and safety of our patients, visitors with the following symptoms are not allowed: 

• signs of upper respiratory tract infection, including cough and runny nose
• diarrhoea
• persons who have been in contact with sick family members, relatives or colleagues.

Please note that parking at the hospital is subject to a fee.