Advice after your nerve block for surgery
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What is Enhanced Recovery?
Enhanced recovery is the name given to a programme that aims to get you back to your normal health as quickly as possible after a major operation. Hospital staff look at all the evidence of what you and they can do before, during and after your surgery to help give you the best chances for a quick and full recovery. This should get you home sooner.
It aims to ensure that patients:
- are as healthy as possible before receiving treatment
- receive the best possible care during their operation
- receive the best possible care while recovering
Having an operation can be both physically and emotionally stressful. Our Enhanced Recovery Programme will support you and the people looking after you to try to get you back to full health as quickly as possible.
By following an enhanced recovery programme, there are usually fewer complications after surgery. There is also less chance of you needing to go back into hospital again.
What does it involve?
A multidisciplinary team approach to work with you and the ones that care for you to achieve a set of goals for your recovery, by enabling you to independently perform routine activities like eating, dressing and walking as early as possible.
Where does it begin?
It begins with you at home, from the moment you are listed for your operation. To enhance your recovery from surgery, it is important that you play an active role in your own care. Fitter patients who are able to improve their health and activity levels recover from surgery more quickly and with fewer complications. What you do in the time leading up to surgery can have a really big impact on your recovery and long term health.
Important points to consider before your operation include:
- eating well – your body will need energy for repair
- exercise – being physically active before your operation will help you recover quicker
- relaxation – try to relax and not worry about your operation
- smoking and alcohol – giving up or cutting down will help speed up your recovery and reduce your risk of developing complications
Your GP will give you advice about getting into the best possible shape before having surgery. They'll also identify and try to stabilise any health conditions you have that may affect the operation.
Consultant appointment
After being referred from your GP, the first step will be a new consultation with the surgeon in clinic. The Consultant will discuss with you possible treatment options as well as possible complications from those treatment. This is a shared decision making and we aim to give you all the necessary information for the most appropriate decision. The most likely outcome of this consultation is surgery and this is where the process starts.
If you decide to go ahead with a surgical procedure, an Information Pack will be given to you at this point so you can start your Enhanced Recovery. All information regarding your procedure should be kept in this pack and you should bring it to every appointment that you attend, including the day of the surgery.
Included on your pack will be the following information:
- Pre-rehabilitation exercises
- Surgical Site Infection (SSI) leaflet
- Anaesthetic options for hip and knee replacement leaflet
- Fitter Better Sooner leaflet
Once your operation date has been set, you will receive a letter at home with Admission Day Instructions, such as date, time, location, fasting instructions and/or other essential information. If there is a short notice cancellation, you might receive a phone call with the new instructions.
The team will also call you 72h-48h before your surgery to confirm that everything is in place and ready for your procedure. This will minimise the risk of unwanted cancellations and will give the opportunity to raise any questions or concerns from your part.
Pre-Assessment Clinic
Our pre-assessment team will meet with you before your operation and ensure that you will have all the information and advice you need to make decisions regarding your care, ensure you are ready for your operation and fully understand all the steps for your recovery.
In this visit, you will be given the following written information:
- Things you will need for your hospital admission
- Instructions regarding pre procedure medication and carbohydrate drinks
- Blood clot prevention leaflet
- Other instruction specific for health conditions (e.g. diabetes)
- After Visit Summary with pre-procedure medication instructions
On this visit you might also be asked to provide blood tests and a tracing of your heart (ECG – Electrocardiogram), to make sure that you are ready and safe to proceed with surgery. A swab for MRSA screening and prevention, which is a germ commonly found living on your skin and rarely causes problems for healthy people, may also be necessary. Occasionally, in very vulnerable and/or unwell patients, infection and post op problems may occur, requiring specific treatment.
At this visit you might also be referred to the High-Risk Anaesthetic assessment and/or other health specialists, if you have significant medical problems that need to be addressed before your operation, to ensure the best and safest care possible.
You will also have contact with our rehabilitation team where they will assess your social history and living circumstances. This will help speed up your recovery and enable you to be discharged from hospital as safe and soon as possible.
Depending on your operation, you may be able to go home sooner than usually expected. It is therefore important to plan and prepare for your return home before going into hospital.
They will discuss with you and/or the people looking after you, length of stay, pain levels and goals expectations after surgery. They will also provide you information on the following:
- Furniture height form to complete and return on day of surgery
- Other care advice according to your specific needs
If you need transport and special equipment before and/or after the operation to empower your recovery, or another assessment from a specific team before your admission and/or while an inpatient, they will also organise for this to happen.
If you are planned for a joint replacement, you might be asked at this point to read about and sign a form for the National Joint Registry (NJR). The NJR records, monitors, analyses and reports on performance outcomes in joint replacement surgery in a continuous drive to improve service quality and enable research analysis, to ultimately improve patient outcomes.
There is a significant increase risk of venous thromboembolism (VTE) after a surgery, due to the procedure itself and the reduce mobility after your operation. VTE is the term used for blood clots that can occur in a deep vain, most commonly in the lower leg. You will have a risk assessment carried out to decide the most appropriate treatment to reduce this risk.
The prevention treatment can be:
- Flowtrons©: electronic automatic inflatable calf pumps/sleeves that will be applied on your lower legs after surgery to provide pressure at regular intervals.
- Anti-embolism stockings: if suitable, these stockings are made from elastic and they reduce the risk of blood clots by gently compressing your legs continuisly.
- Anticoagulant medication: commonly known as blood thinners, are chemical substances that prevent or reduce coagulation of blood, prolonging the clotting time.
Any further questions, please contact:
Pre-Assessment Clinic - 0300 614 7778 / 0300 6147147
Day of the surgery
Please attend the ward location specified on your Admission Day Instructions letter exactly at the time stated. You must attend on time, as this can influence the theatre list. Otherwise, there is the possibility that your surgery can be delayed and/or postpone. Last minute changes are possible, such as location or time of attendance. If that occurs, you will be contacted as soon as possible with a phone call.
When you report at reception, you will be asked by our administrative staff if you are feeling well and they will take your temperature to ensure that is safe to proceed with your admission. Visiting times and contact numbers will be explained and provided at this point and this might differ according to ward needs, in line with current Trust and National guidelines.
Once you have been allocated a space, you will be approached by different healthcare professionals before your operation to make sure that you are safe and everything is in place. Not in a specific order, you will see the following:
- Nurse and/or healthcare assistant: They will help and support you and/or the person looking after you with changing of clothes, storage your belongings, check your vital signs and ask you a few questions to know you better.
- Therapy team: They will come to assess your mobility and/or joint range of movements, talk you through the most suitable walking aids and show you the post operation exercises that they will be working with you after your surgery.
- Ward doctor: They will come to update your health records, check if you have any significant allergies and confirm the current medication that you take, to see if there are any contraindications, necessary modifications and/or variations.
- Consultant and/or Assistant: They will ask you to sign a consent form, which is a written record that you have agreed to the planned operation. Before you can give your consent, they will discuss with you what the operation is likely to involve, the benefits and risks and any alternative treatments.
- Anaesthetist: They will come to explain the safest anaesthetic plan for you and your operation. Once the plan is agreed, they will ask you to sign a consent form, which is a written record that you have agreed to. Before you can give your consent, they will discuss with you what the type of anaesthesia is likely to involve, the benefits and risks and any alternative treatments. They might also confirm your fasting status and what medications you have taken before you arrived to the ward.
Depending on the type of operation and/or your health condition, extra blood tests might be required on the morning of your operation. Further investigations, such as x-ray or a tracing of your heart, may also be necessary before your surgery.
Once you are ready to proceed, a porter will come and collect you from the ward to be transported to theatre, accompanied by a nurse or healthcare assistant on your bed or trolley. After most anaesthetics, you will be cared for in a recovery room close to the operating theatre. Surgeons and anaesthetists are close by if there is any change in your condition. You will be taken back to the ward when the recovery room staff are satisfied that you are safely recovering normally.
Delays and/or cancellations of operations on day are possible, but rare. Unfortunately, this can happen by reasons that are generally out of our control. Staff sickness, lack of resources and/or health problems that can compromise your safety and wellbeing, are the most common causes.
After your operation
We will aim to get you Drinking, Eating and Mobilising within 24 hours of surgery, known as DrEaMing initiative. Patients who do so have shorter hospital stays and reduced complications.
Depending on the type of operation and/or your health condition, you might require further investigations to make sure that you can go home safely, such as blood tests and x-ray. These can be done immediately before or after you return to the ward, to avoid any delays in treatment.
Your progress will be monitored by the multidisciplinary team. We will ensure that your pain is managed effectively and that any other possible symptoms, such as nausea and dizziness, are under control. This will allow you to progress with your rehabilitation, have a quicker recovery from the surgery and a more promising outcome.
We encourage patients to bring in your own clothes to wear after surgery, as thi supports early recovery and helps protect your privacy and dignity.
Going home
We will aim to discharge you within 24 hours, unless there is a clinical indication that will prolong your stay. Please ensure that you have enough support for a safe discharge, such as transport to go back home. The Trust does not provide non-emergency patient transport service, except in special circumstances.
As soon as you have been declared medically fit and the inpatient therapy team deems you safe for you to go home and continue you rehabilitation programme, the team will start initiating the discharge process.
As there is quite a significant amount of information that is crucial for a successful recovery, we will give different written information that you must read and keep in your Information Pack.
On discharge, you will be provided with the following information:
- Pain management after surgery and pharmacy information about medicines management
- Surgical dressing/swelling/bruising care instructions (if required)
- Rehabilitation/exercises advice and plan
- After Visit Summary/Discharge Letter
- Other information that might be significant for you and/or your procedure (if required)
- Contact numbers in case of any questions or concerns
- Feedback forms
After your surgery, you will be followed up in clinic by your Consultant, the therapy team or both, but this will depend on the surgical procedure that you require. Not all procedures require a set follow-up, some might only require a visit to clinic if your have concerns – this is called a Patient Initiated Follow-Up (PIFU). Your appointments details can be given to you upon discharge or you can receive a letter by post.
Review of surgical wounds and removal of skin primary closure, such as clips or stitches, will take place at the GP surgery and we will give you a referral with instructions for you to arrange for that appointment accordingly.
We aim to provide the best experience possible during your journey. In order for us to improve our service, we would like for you to provide us with honest and constructive feedback.
Any further questions, please contact:
Treetops Ward - 0300 614 4175 / 0300 6144160
Parkside Suite - 0300 614 4185 / 0300 6144181
Day Surgery Unit - 0300 614 4130 / 0300 6144131
Booking Centre (appointments) – 0300 614 7919
Physiotherapy follow-up
The therapy team will talk to you about your Physiotherapy follow up before you leave hospital. If a follow up appointment is needed, this will be arrange for you and you will be contacted once you are at home.
Any further questions, please contact:
Inpatient Rehab Team – 0300 614 4178
Post Discharge Welfare Check
During your stay with us, there is several members of the team that will give you advice and instructions on how successfully recover from your surgery. Sometimes it can be overwhelming the amount of information that you will need to remember for a rapid and safe recovery.
If you had a shoulder replacement, a total hip replacement or a partial/total knee replacement, you will received a phone call from the team 24h-72h after you have gone home. This is to ensure that there are no immediate issues, you are following all your post op instructions accordingly, refresh the most important information that has been communicated to you on discharge and reassure you.
If you haven’t receive this phone call, you are welcome to contact us at any time. We also advise you that, if you have any questions or concerns regarding your procedure and recovery, to contact us primarly.
Any further questions regarding your joint replacement, please contact:
Joint Replacement Practitioner: 07789 927 177 (Mon-Fri 7am-3pm)
Nurse Led Clinic (NLC)
You may need to be seen in our nurse led specislist clinic if your surgeon predicts that it will more difficult for your surgical wound to heal due to a specific health or skin condition, or if you develop post op wound complication, as a routine check. This appointment will be arranged for you and the details given after your discharge.
Any further questions, please contact:
Nurse Led Clinic: 07342 065057 / 0300 614 7207
Mobile App for Patients
We enourage patients to download and use the MyFrimleyHealth Record App. This electronic application allows you to:
- Communicate with your doctor - Get answers to your medical questions from the comfort of your own home.
- Access your test results - No more waiting for a phone call or letter, view your results and your doctor's comments within days.
- Request prescription refills - Send a refill request for any of your refillable medication.
- Manage your appointments - Book your next appointment, or view details of your past and upcoming appointments.
Our mobile applications for patients, including MyFrimleyHealth Record for iOS and Android, connect to servers and systems operated and maintained by healthcare organisations that use Epic – to provide patients with secure, mobile access to health information in those servers and systems.
To access MyFrimleyHealth Record, you must have electronic record with the Trust, and your use of MyFrimleyHealth Record is subject to the Trust’s privacy and other related policies, to obtain a copy of the privacy policy, please contact us via the Trust website.
Contact us
If you have any queries relating to this information, please contact the Orthopaedics service.
About this information
Service:
Orthopaedics
Reference:
DD/010
Approval date:
3 February 2025
Review date:
1 May 2026
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.