How pre-op works in Colombia
Every Colombian surgical patient has a valoración preanestésica, an in-person evaluation by the anesthesiologist, before surgery. It cannot be done remotely. The anesthesiologist reviews your labs, examines you, assigns an ASA physical status class and either clears you, asks for more tests, or postpones. If you arrive with the standard tests already done and recent, the visit takes twenty minutes and surgery proceeds on schedule. If you arrive with nothing, you spend day one and two in labs and risk a result that pushes the date.
The standard pre-op panel
| Test | Who needs it | Valid for | Do it at home? |
|---|---|---|---|
| CBC (hemograma) | Everyone | 30 days | Yes, or on arrival |
| Basic metabolic panel, creatinine, glucose | Everyone | 30 days | Yes |
| PT / PTT / INR | Everyone having general or regional anesthesia | 30 days | Yes |
| HbA1c | Diabetics and anyone with BMI over 30 | 90 days | Yes; many surgeons want under 7.5 to 8 |
| ECG | Over 45 to 50, or any cardiac history, hypertension, diabetes | 6 months | Yes |
| Chest X-ray | Over 60, smokers, lung disease | 6 to 12 months | Yes |
| Pregnancy test | Anyone who could be pregnant | Day of surgery | On arrival |
| Type and screen | Larger surgeries with bleeding risk | 72 hours | On arrival |
| HIV, hepatitis B and C serology | Many clinics require | 6 to 12 months | Either |
| Cardiology clearance letter | Cardiac history, stents, arrhythmia, heart failure | Current | At home, from your cardiologist |
| Sleep apnea screening | Snoring, BMI over 35, daytime sleepiness | Current | At home if possible |
Bring printed and digital copies in English or Spanish. Colombian clinics accept US and Canadian lab results if they are recent and legible. Reference ranges differ by lab, so include the ranges on the printout.
Medications and supplements: the list that gets people postponed
- Blood thinners (warfarin, apixaban, rivaroxaban, clopidogrel): require a written plan from the prescriber on when to stop and restart. Never stop on your own.
- Aspirin, ibuprofen, naproxen, fish oil, vitamin E, ginkgo, garlic supplements: usually stopped 7 to 10 days before surgery.
- GLP-1 weekly injections: held about a week before anesthesia; tell the anesthesiologist the date of the last dose.
- Estrogen-containing contraceptives and HRT: some surgeons stop these before long procedures because of clot risk. Ask.
- Nicotine in any form: most plastic surgeons require 4 to 6 weeks abstinence and will test for it. Nicotine kills skin flaps.
- Alcohol: no binge drinking in the week before, and none the night before.
When your surgeon at home should be involved
If you have a stent, a pacemaker, a prior clot, uncontrolled blood pressure, poorly controlled diabetes, a BMI over 35, kidney disease, or take more than five daily medications, ask your primary care doctor or specialist for a pre-operative clearance letter before you fly. Colombian anesthesiologists take these letters seriously and it prevents a postponement. See our BMI limits guide and our guide to verifying your anesthesiologist.
Timeline
- 4 to 6 weeks out: get the labs and letters. Order the panel above through your doctor, a direct-to-consumer lab, or an urgent care. Request clearance letters for any chronic condition.
- 2 weeks out: stop what needs stopping. Supplements and NSAIDs per the surgeon's written list. Nicotine should already be gone.
- Arrival day 1 to 2: pre-anesthesia visit. Bring everything. Missing items are drawn on site; results are usually back in 24 hours.
- Day before surgery: fasting rules. Typically nothing solid for 8 hours and clear fluids until 2 hours before. Follow the clinic's written instructions.
Frequently asked questions
Can I just do all the labs in Colombia?
Yes, and they are inexpensive, but any abnormal result then delays surgery while it is sorted out. Doing them at home four weeks out gives you time to fix problems.
My HbA1c is 8.2. Will they operate?
Many surgeons want it under 7.5 to 8 for elective surgery. Talk to your doctor about tightening control and rebook when you are there.
How long are my labs valid?
Most routine labs for 30 days, ECG for 6 months. Confirm with the specific clinic.
Do they really test for nicotine?
Many plastic surgeons do a urine cotinine test. A positive result cancels the surgery.