Microsoft word - tprs preop instructions 10 07.docx

The Pain Relief SurgiCenter
Specialists in the Treatment of Pain
Your procedure will be done at our Ambulatory Surgery Center known as The Pain Relief SurgiCenter, Inc., located at 4100 Duval Rd., Bldg. 3, Ste. 100 1. TIME: Arrive at 4100 Duval Rd., Bldg 3, thirty (30) minutes before your procedure time. The staff will
inform you if any lab work is required. If so, please have lab work completed at least 24 hours prior to your procedure time, unless otherwise instructed. Plan to be at our facility approximately one (1) hour. 2. MEDICATONS: You may take your prescribed medications with sips of water on the day of your procedure,
unless other wise discussed with Dr. Mahendru.
Discontinue anti-inflammatories (Advil, Relafen, Celebrex, Naprosyn, Vioxx, Motrin, Aleve, etc…) for 2
days before the procedure.
Discontinue all aspirin products (Bayer, Excedrin, Anacin, BC Powder, etc…) 5 days before the
procedure. Also, discontinue the following HERBs: Feverfew and anything beginning with the letter G.
Discontinue Plavix, Ticlid and Aggrenox 7 days prior to the procedure with written clearance from the
Discontinue Coumadin(Warfarin) 5 days prior to the procedure with written clearance from the
Bring a printed list of all medications with you to your initial appointment. Thereafter, bring a list of any
newly prescribed medications to appointments. This includes any over the counter drugs, herbal medications and vitamins. 3. FLUIDS/LIQUIDS: Nothing to eat or drink within six (6) hours of the scheduled procedure time, with the
exception of small sips of water with required medications. 4. ACTIVITY: Plan to spend a quiet day and evening after the procedure. Do not try things that you have been
unable to do before because of your pain. No hot showers or tub baths until the following morning. 5. ILLNESS: If you have a sore throat, fever, chills, nausea, vomiting, urinary tract infection or any other sign of
illness, reschedule your appointment by calling (512)836-1200. No procedure will be done if you are ill, If you are started on any antibiotics, call and let us know. We may need to reschedule your appointment. 6. TRANSPORTATION: Bring a driver. You will not be allowed to drive yourself home after the procedure.
No exceptions will be made to this rule without the doctor’s express written order. DRIVER MUST
REMAIN ON PREMISES.

7. CANCELATIONS: If you are unable to make the appointment, please call The Pain Relief SurgiCenter, at
least 24 hours before your procedure at (512)836-1200 and reschedule your appointment. There will be a charge for no shows. *Please be informed that Dr. Mahendru has a financial interest in Austin Surgical Hospital and The Pain Relief SurgiCenter. You are free to choose any facility for obtaining services that are ordered for you. Our staff is happy to discuss alternatives with you. PROCEDURE DATE: _____________________ ARRIVAL TIME: _______________ APPT TIME: ____________
PATIENT SIGNATURE: ________________________________________ DATE: ______________________________

Source: http://psp121.sb.siliconmtn.com/binary/org/SJM_PSP_121/doc/PreOp_Instructions-English.pdf

Mashtishk 2010

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