PRE OPERATIVE INSTRUCTIONS FOR GENERAL ANESTHESIA & SEDATIONThe anesthesia/sedation will be administered by a combination of breathing mask and intravenous medications. You will also receive a local anesthetic (numbing) after you are sedated to keep you comfortable immediately after your procedure. Preparations: A. No food or drink should be taken within six hours of the appointment time. This includes water. REASON: Your stomach should be empty of food and liquid to minimize the possibility of vomiting. EXCEPTION: Persons taking medications may do so, as directed, with a small sip of water. Please discuss medications with us to avoid any confusion. B. Loose clothing should be worn with short sleeves. Contact lenses and jewelry must not be worn during the procedure. Also, makeup and false eyelashes should be removed. REASON: A blood pressure cuff will be placed on your arm, and we must also listen to your heart and lung sounds. We also wish to avoid the inconvenience of misplaced or lost personal items. Morning procedure - Nothing to eat or drink after midnight. You may brush your teeth and rinse. Afternoon procedure (1:00 p.m. or later) - nothing to eat or drink after 7:00 a.m., however you may have a clear liquid breakfast before 7:00 a.m. Consume no alcoholic beverages the night before or the day of the procedure. After the Procedure any patient accepting anesthesia/sedation, must agree :
THE PATIENT MUST BE DRIVEN HOME BY A RESPONSIBLE ADULT!! **AT THE TIME YOUR APPOINTMENT IS MADE, YOU WILL BE ASKED TO PAY A DEPOSIT TO RESERVE YOUR APPOINTMENT TIME. THE BALANCE OF THE TREATMENT FEE IS TO BE PAID ON THE DAY OF THE ANESTHESIA APPOINTMENT, UNLESS OTHER ARRANGEMENTS HAVE BEEN AGREED TO. 72 HOURS NOTICE IS REQUIRED TO CHANGE OR CANCEL YOUR APPOINTMENT. IF THIS NOTICE IS NOT GIVEN, YOUR DEPOSIT WILL BE FORFEITED. __________________________________________ _____________________ Signature: Patient, Parent, Guardian Date |