Know the Recent Advances in PAC (Pre-Anesthesia Checkup) Test

A visit to a hospital is often viewed with great anxiety. Most of the patients worry about what to expect if the doctor advises surgery or an interventional procedure as a treatment option. In the present scenario availability of safe and quality anesthesia services makes the experience of surgery a pleasant one for any patient. Anesthesia services are an integral part of any super speciality hospital.

Anesthesia services are provided to you in case you have to undergo surgery and an interventional procedure. Any patient undergoing surgery can be given Anesthesia in any one of the following ways:

1. General Anaesthesia (patient is asleep during the procedure and does not respond to any stimuli, including pain)
2. Regional Anaesthesia (a part of the body where the surgery is to be performed is made numb, especially useful in limb surgeries and cesarean sections)
3. Monitored Anaesthesia Care/ Procedural Sedation (this is used for procedures like Endoscopy Surgery, ERCP, Colonoscopy, etc. where general anesthesia is not required or may not be possible and an anesthetist is present to monitor and ensure the maximum comfort possible)

Planning for Surgery

Once your surgeon advises surgery, you will be asked to undergo a pre-anesthetic evaluation.The PAC test in full form in medical terminology is called the Pre-anaesthesia check-up.

How is the PAC (Pre-Anesthesia Checkup) Test Done?

1. You will be directed to the pre-anesthesia checkup (PAC), which may be done in OPD.
2. An anesthetist specialist is available in the PAC room. He/ She will enquire about your past and existing medical conditions if any and perform a general physical examination. He/ She will check your vital signs and document your medical problems, the treatment which you are currently on, and enquire about allergies. It is important to share your past and present medical history, and medication if any with your anesthetist.
3. If any of the medical problems require evaluation or optimization of the treatment you will be advised to go to the concerned specialist in the hospital.
4. You will be advised of basic laboratory and radiological investigations if they have not been done already. These will be relevant to the kind of surgery you are being planned for.
5. The plan for anesthesia will be discussed with you and the surgery scheduled along with the coexisting medical conditions. The sole aim is your safety and comfort during the surgery. This plan will also take care of your postoperative pain management options. You will also be informed about any postoperative requirement for a stay in an Intensive Care Unit or a High Dependency Unit.
6. You will be advised about the risk stratification for the surgery you are being planned for and about the informed consent form.

Do’s And Don'ts Before PAC (Pre-Anesthesia Checkup) Test And Surgery

1. Eating and Drinking

   The basic requirement before undergoing any kind of anesthesia is to be empty stomach for six to eight hours before having solids and two hours before taking a small amount of water intake.  Babies can be given breast milk up to four hours prior to surgery and top feed till six hours prior to surgery. The doctor usually provides diet instructions for endoscopy, colonoscopy, and some intestinal surgeries. It is suggested to follow the doctor’s instructions related to measures required for the PAC test and surgery.

2. Bath and Shave

   You must take a shower or bath both the night before and the next morning i.e. the day of the surgery. Do not shave the area you will be operated on. The doctors or nurses will do that at the hospital if needed. Scrub your fingernails with a brush. If you have a beard, moustache, or other facial hair, it is a good idea to trim or shave it prior to surgery. A beard or other facial hair interferes with the fitting of your oxygen mask. Do not forget to brush your teeth too.

3. Smoking

   It is strongly encouraged that you stop smoking and the use of tobacco once you have decided to undergo surgery. This will reduce your risk of respiratory and cardiac complications after your operation. Cessation of smoking goes a long way towards a faster and uneventful recovery.

4. Blood Thinners

   If you are on any kind of blood thinning medication like aspirin, clopidogrel, etc. kindly inform the anesthetist involved in your PAC, as these medications may have to be stopped or their schedule may require adjustment.

5. Nail Polish

   A nail polish should be removed before your arrival for surgery. Even though tips, wraps, gels, etc., are expensive; however, these products must be removed from at least one finger on each hand (preferably the index or middle finger). This will be used to accurately monitor your oxygen level during the surgery.

6. Hearing Aids And Contact Lenses

   Patients who rely on hearing aids should wear them to the hospital on the day of surgery so that you can hear and understand everything. Hospital personnel needs to communicate with you. Wear glasses when possible. If contact lenses must be worn, bring your lens case and solution. If glasses are worn, bring a case for them.

7. Dentures

   You will be asked to remove all non-permanent dental work before your surgery.

Preparing Your Child For A PAC Test and Surgery

1. You must follow the instructions given by your anesthetist regarding fasting for your child completely as it is very important for your child’s safety.
2. Your child may be given some medicine to keep him calm or make him sleep before the surgery.
3. If the child is old enough, he may be explained in simple terms about the PAC test.
4. You may ask your doctor if the child can be sent home the same day. Many times the same can be done.