General Information for Surgical Procedures

Reviewed April 2020

It is important that you are fully informed on what your upcoming surgical procedure will entail.
To this end, I have prepared patient information documents covering the surgical procedures I
perform.
These will detail the potential risks and complications as well as the expected post-operative
course. They will answer many of the questions you may have about the surgery. They also detail
what is expected of you in order to ensure the best possible outcome.
However, they do not substitute for a discussion with Dr Butler. If you have any questions which
are not answered by the information document, please contact Dr Butler.
Please make sure that you have completed an informed consent form pertaining to the surgery.
Please ensure that you have received an anesthesiologist consent document as well.
Please make sure that you have received authorization from your medical scheme prior to the
day of surgery. This authorization must be forwarded to the office prior to the day of surgery as it
is required by the hospital in order to process your admission on the morning of surgery.

1. Fasting Pre-operatively
Please do not eat or drink anything other than water (or other clear fluids) for six hours before
surgery.
You may take any prescription medicines the morning of surgery with a sip of water.
For young children, breastmilk is allowed up to four hours before surgery, but formula feeds must
be stopped six hours before surgery.
Water or clear fluids (such as apple juice) may be drunk until two hours before surgery.
By law, you are not allowed to drive yourself home after having undergone a general anesthetic,
so please make arrangements for someone to fetch you from the hospital.
The Anesthesiologist will conduct an evaluation in the ward before the start of the day’s
procedures. He/She will discuss any potential risks related to the general anesthetic and question
you on medication, allergies, previous anesthesia etc. Should you/your child’s health worsen in
the week prior to surgery (for example, your child develops a productive cough and a fever), the
Anesthesiologist and Dr Butler may advise postponing the procedure. It is advised that you
contact the office before the day of the scheduled procedure should such an illness arise.
Blood thinners
Disprin (or Ecotrin) is used to reduce the risk of blood clots. It does this by impairing the function
of platelets in your blood. The effect only wears off if you stop the disprin for a period of 10 days.
If you have had cardiac or arterial stents inserted to keep blood vessels open, then you will need
to continue the disprin (Ecotrin).
If you have undergone a heart bypass operation to graft the coronary blood vessels, then usually
it is possible to stop the disprin (Ecotrin) for the 10 days prior to the surgery, and then re-start
taking the medication 2 days after the surgery.
If you have an irregular heartbeat (atrial fibrillation included), rheumatic heart valve disease or
have had a heart valve replacement then you are most likely using something like warfarin, Plavix,
Xeralto or clopidogrel. Depending on your risk profile, it may be possible to briefly stop this
medication 5 days prior to surgery and then re-start it 2 days after surgery. However, in most
cases it will be necessary stop this medication 5 days before surgery and give you a bridging
course of Clexane started 3 days prior to surgery, with the last dose 24 hours before surgery.
Your regular anti-coagulant can then be restarted the day after surgery.
If you are unsure about what to do, please consult Dr Butler through the office.
NB: PLEASE CONTACT THE ROOMS THE DAY AFTER YOUR PROCEDURE ON TEL: 041 4923185 IN ORDER
TO ARRANGE YOUR POST OP APPOINTMENT.