If the surgery is scheduled for the morning, be ready after brushing your teeth. You will be taken to the operation theatre at the time, which will be informed the previous night.
If your surgery is scheduled for afternoon, you may be allowed tea/coffee and light breakfast early morning of the operation day.

Some medicines may be required to be taken by mouth on the morning of surgery with few sips of water and some injections may be administered prior to being taken to the operation theatre.

At the appointed time you will be taken to the operation theatre.

Please remember:

• To remove your denture.
• To remove contact lenses.
• To remove spectacles.
• To remove jewellery.
• Not to carry cash or valuables.

In the operation theatre the anesthetist would connect you to various monitors and check-up your heart, oxygen saturation and blood pressure.

Before starting the anesthesia, an intravenous line in the forearm will be taken to administer various medications.

As discussed previously you will be administered the anesthesia most suitable for you. If it is going to be Epidural anesthesia, you will be made to sit and your lower back will the cleansed with an antiseptic solution. Then after numbing your skin, a thin tube will be inserted in your back with the help of a special needle.

Once you are anaesthetised, a catheter may be put to ease passing urine.

The actual preparation for the operation consists of thorough cleansing of the area to be operated and covering it with sterile drapes.

Most of us are afraid of surgery, because we associate surgery with intense pain. Hence it is natural for the patient to know the intensity of pain after the surgery.

Generally, for surgery, Epidural anesthesia is preferred. This is continued for pain relief in the days following surgery.

Due to this advanced technique, the pain after the surgery is much reduced. Hence the patient does not require to take strong pain relieving medication.

Epidural anesthesia is a technique in which a very thin plastic tube is inserted in patient's back. Through this tube the anaesthetic agents are injected during Surgery. After the surgery, this tube is connected to a computerized infusion pump, which controls the dose of medication given to the patient for relief of pain. The concerned anesthetist will take the care of this equipment.

Thin Plastic Tube inserted in the Back	Computerised Infusion Pump

The advantages of Epidural anesthesia are :

• It is safe for the elderly and those who have diabetes, high blood pressure, heart and lung ailment.
• The patient is awake during surgery if he/she so desires or can be sedated if required.
• Oral feeds can be started within 3 hours of surgery.
• This anesthesia is converted to mild dose to control pain after surgery. This is continued for 3 days after the surgery, thus avoiding strong pain relieving medicines which usually cause indigestion, acidity and drowsiness.
• Since the pain relief is adequate by this technique patient can be put to early exercise program.

Hip Surgery
For the surgery you are put on the side, with the normal side down.
The actual surgery consists of entering the hip joint through an incision on the side of the hip.
The irregular cartilage of the hip socket (the acetabulum or the cup) is shaved off by power graters. The ball of the hip (the head of the femur) with some of the neck is removed using a power saw.
The artificial parts are either press fitted to the prepared bones as in the non-cemented design. In the cemented design they are fixed with the help of a substance called bone cement.
The tension in the hip muscles is adjusted so that the hip is stable.
At the end of the surgery, the wound is thoroughly washed with antiseptic solution.
A thin plastic tube is inserted in the joint to drain out the blood.
After meticulously stitching up of the wound, a dressing is applied.
You are turned to lie flat on the back. A pillow is placed in between the legs to keep the legs separated.
Please do not remove this pillow and do not bring the legs together. This precaution is necessary for few days.

Both Knee Joints in One Sitting - Our centre has performed the largest number of successful two knee surgeries in one sitting in India

Some patients may prefer to get operated on both knee joints in one sitting. The fitness for the same has to be decided by joint consultation between the operating surgeon, the consultant physician and the anaesthetist.

The following will be the differences in their post operative management:

• Antibiotics may be continued for total five days, as compared to three days.
• The same post operative routine will be followed for the first 3 days.
• The exercise programme will alter in such a way that sitting at the edge of the bed, standing and walking may be delayed by two or three days.
• The hospital stay will be for 7 to 10 days, instead of five.
• Rest of the care and protocol will remain the same.

• On the day of the surgery you will lie flat on your back with the legs separated apart by a pillow.
• You are not allowed to turn on side.
• After some period of observation in the theatre complex, you will be shifted either back to your room, or to intensive care unit for observation for 24 hours.
• If the surgery is carried out under Epidural anesthesia, you will be allowed to take oral fluids within 2-4 hours after being brought to the room.
• On the day of surgery, you will continue to receive IV fluids.
• For pain relief, the Epidural tube will be connected to a computerized infusion pump, through which you will receive continuous dose of pain relieving medications.
• From time-to-time you will be administered injections and oral medications as per the doctors' instructions.
• Some patient may require administration of oxygen for first 24 hours.
• If you have difficulty of any kind, please do not hesitate to call a nurse or a doctor. They will be always available to help you.

You will be discharged when :

• You are are able to do exercises which are taught for the first few days after surgery.
• You are able to get out of bed unaided.
• You are able to walk to the toilet.
• You are able to sit and getup comfortably on you own.
• You do not have any other complication.
• The discharge is usually between five to seven days after the surgery.