Other medications should be continued including those usually taken on the morning of surgery. These medications should be taken with a sip of water even though the patients may be nil by mouth otherwise. If you are in any doubt, then please contact Prof Owler’s rooms or the hospital.
Patients with a history of diabetes will need to have their medications managed depending on the nature of their condition and fasting times. Some diabetic medications will need to be ceased prior to surgery but this will be planned prior to surgery with Prof Owler and his anaesthetist.
All patients undergoing a general anaesthetic will need to fast. That is, they should have nothing to eat or drink for around 8 hours prior to surgery. Failure to comply with this may necessitate cancellation of the procedure as it may expose the patient to significant risk. As most patients are admitted on the day of the surgery, the hospital will contact them to inform them of the time for admission, likely time of surgery and the required fasting times on the day before the surgery.
Most patients are admitted to hospital on the day of the surgery. Patients need to ensure that their latest X-rays, CT scans and MRI scans are with them when they come to hospital. These scans are the surgeon’s road map and without them the operation cannot proceed. Except in rare circumstances, patients are responsible for these films, and are normally given back to them at the time of consultation.
At the end of the operation, most patients are recovered, that is woken-up and the breathing tube removed just like any other general anaesthetic. The patient is then assessed in terms of their neurological function and transferred to the intensive care unit or high dependency area where they closely observed. After a few hours the patient can normally start to eat and drink.
Either on the same day or the next day the patient will undergo a CT scan of the brain to check the position of the ventricular catheter and ensure there are no other issues. If they are well then, they are transferred to a normal ward bed. Observations are still performed but less frequently. Depending on the patient’s condition and their clinical progress most patients are discharged home. Some patients, especially older patients with iNPH may undergo a period of rehabilitation. The average length of stay in hospital is 4- 7 days.
The scalp and abdomen are normally closed using skin clips. In children a dissolving suture us usually used. Skin clips need to be removed 7-10 days after the surgery and patients are asked to return to their GP for removal of the clips. This also provides an opportunity for the wound to be reviewed by their doctor
Patients are encouraged to return to see Prof Owler around 4-6 weeks after the surgery to ensure that the recovery is proceeding as planned and discuss any concerns. An appointment will be made for you shortly after the procedure has been performed.
