Ask Anesthesia

Quick Answer

Preparing for surgery isn’t just about showing up- what you do beforehand plays a major role in your safety and recovery.

If you’ve been given a list of pre-op instructions, make sure to follow them exactly.

They exist to keep you safe.

Why pre-surgery instructions matter

Before anesthesia, your body needs to be in the safest possible condition.

Following instructions helps:

• Prevent complications during anesthesia
• Reduce the risk of nausea and vomiting
• Improve recovery time

Skipping steps – even small ones – can delay or cancel your surgery. Or, you might be putting yourself at serious risk of harm.

1. Do NOT eat or drink (NPO guidelines)

This is the most important rule.

Typical guidelines:

• No liquids or solid foods for 8 hours before surgery or past midnight

These guidelines are given because they are easy to follow and are designed to keep you safe. However, the official guidelines are:

• No heavy or fatty meals or foods for 8 hours before surgery
  • This includes a splash of milk in coffee or tea
  • No meat, butter, oils, or dairy
• No light foods for 6 hours before surgery
  • An example would be a piece of toast WITHOUT butter
• No breastmilk for 4 hours before surgery
  • For babies who are going to receive anesthesia
• No clear liquids for 2 hours before surgery
  • You can have small amounts of:
    • black coffee or tea with no milk, cream or sugar
    • water
    • sports drinks

Why this matters

During anesthesia, including twilight/moderate/conscious sedation, your body loses protective reflexes. If your stomach isn’t empty, contents can come up and enter your lungs.

This is called aspiration, and it can be deadly.

2. Take medications as instructed

Some medications should be taken, others should be stopped. You should receive a list of medications to stop, as well as be given specific instructions for your personal medications.

Usually CONTINUE up to day of surgery:

• Blood pressure medications
• Heart medications
• Anxiety or pain medications
• Cholesterol medications
• Thyroid medications

Usually STOP:

• Blood thinners
• Certain diabetes medications, such as metformin or GLP-1 like Ozempic
• Some blood pressure medications, like lisinopril or losartan
• Supplements, especially ginkgo biloba, garlic, and ginseng (they can increase bleeding risk)

Always ask for specific guidance and follow your surgeon or anesthesia provider’s instructions exactly– they’re tailored to you.

3. Shower before surgery

Many hospitals or surgeons recommend:

• Showering the night before and morning of surgery
• Using antibacterial soap like Hibiclens (if instructed)

This reduces your risk of infection and keeps the surgical area clean.

4. Avoid alcohol and smoking/vaping

Alcohol: avoid at least 24 hours before surgery

• Alcohol can interact with anesthesia medications

Smoking/vaping: ideally stop as early as possible before surgery (4-6 weeks is ideal)

• However, even stopping 1-2 days before surgery improves oxygen circulation and reduces the risk of lung or breathing complications
• This includes marijuana

5. Do NOT wear certain items

On the day of surgery, avoid:

• Jewelry
• Makeup
• Nail polish
• Contact lenses

Why this matters:

Monitoring devices rely on accurate readings, and these items can interfere. Also:

• Nail polish can make it difficult to see your oxygen levels
• Makeup can make it difficult to secure breathing tubes, which can become dislodged
• Eye makeup can make it difficult to gently tape your eyes shut for general anesthesia, which increases dryness and scratch risk
• Eye contacts increase scratch risk
• Jewelry can cause burns, or cut off circulation if swelling occurs. They also increase the risk of catching on bed rails or other items and becoming damaged or harming you

6. Arrange a ride home

If you’re receiving anesthesia or sedation, you cannot drive yourself home. Your procedure may be canceled if you do not have transportation.

Plan ahead:

• Have a responsible adult pick you up
• Ideally have someone stay with you for the first 24 hours

7. Get a good night’ sleep

Your body handles anesthesia and recovery better when well-rested.

If you’re feeling anxious:

That’s completely normal. Understanding how safe anesthesia is can help ease your concerns.

8. Bring the right information

Provide your anesthesia provider with:

• Medication list
• Allergies
• Medical history

This helps them avoid complications and make the safest decisions for you.

What happens if you don’t follow instructions?

Your surgery may be:

• Delayed
• Rescheduled
• Canceled

You risk serious harm, complications, or even death.

Bottom Line

Pre-surgery instructions are not random – they are designed to keep you safe under anesthesia and improve your recovery.

• Stop eating on time
• Take only approved medications
• Shower
• Avoid alcohol/illegal drugs/smoking/vaping
• Remove jewelry/makeup
• Arrange a ride
• Bring medical info

Following these rules carefully is one of the most important things you can do for a smooth, safe surgical experience. Help us keep you safe.