Preoperative Assessment

Joint replacement & major surgical procedures

Dear Patient,

If you are scheduled for joint replacement or some other form of major surgery at our hospital (e.g. corrective osteotomy, hip fracture repair, fracture of the shin bone or upper arm).

During your preoperative assessment, it is necessary to perform the following laboratory examinations:
Complete Blood Count (RBC, WBC, Hb, Htc, PLT)
Erythrocyte Sedimentation Rate, C-reactive proteine
blood glucose, electrolytes (Na, K), Blood Urea Nitrogen, Creatinine
coagulation tests (PT, APTT, INR)
ECG
urine culture with antibiogram* (for joint replacement & pelvic surgery)
nasal and pharyngeal swab culture with antibiogram* (for joint replacement & pelvic surgery)
tranfusion tests (blood group, Rh factor, antibody identification tests)
chest X-ray* (if >60 years of age or history of smoking or pulmonary disease).

Please send us the results of your transfusion tests and the results of your urine and nasal/pharyngeal swab cultures AS SOON AS POSSIBLE via following fax number:

fax: + 385 49 587 476

or e-mail: akromion@akromion.hr

Please, bring with You to the hospital all medications you currently take, important hospital discharge letters, CT/MRI/x-Ray images/CDs and the original findings of all the exams mentioned before.

If You have any further questions, or there was a significant change in your health status in the meantime, please do contact us on + 385 49 587 487.

What to do with my medications prior to surgery?

If you are taking any medication against blood clotting (“blood thinners”, anticoagulants) such as – Martefarin, Marivarin, Marcumar, Clopidogrel / Pigrel / Zyllt / Plavix / Klopidex, Tagren, Aggrenox, Xarelto, Pradaxa… please let us know right away since some of them may need to be discontinued temporarily 5-7 days prior to some surgical procedures and may not allow some regional anesthesia procedures to be performed.

Low dose antiplatelet therapy with acetylsalicylic acid (Aspirin) usually can be continued until the day of surgery.

If you have diabetes and take insulin or peroral medications to control your blood sugar levels, they need to be omitted on the morning of surgery.

Any medication prescribed to you for thyroid disease (hypofunction or hyperfunction of the thyroid gland) usually can and should be continued also on the day of surgery.

Medication for blood pressure control (hypertension) should also be continued as usual, except if you received specific instructions from our anesthesiologist to do otherwise.

If you are routinely taking drugs to control pain (“painkillers”) you should try and omit those belonging to the so called nonsteroidal anti-inflammatory drugs (NSAIDs) – e.g. diklofenak, ibuprofen, ketoprophene etc. since they might increase surgical bleeding. If needed replace them with acetaminophene / paracetamole and tramadol during the week preceding your surgery.

If necessary you will receive further information regarding preparation for surgery and handling the medications you take from our anesthesiologist, who will contact you during the week prior to your scheduled hospital admission.

For any further information please contact us on + 385 49 587 487 or by e-mail: akromion@akromion.hr

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