Before Your Procedure

If you are ill with fever, chest cold, vomiting or diarrhea just before the day of your surgery, please contact your surgeon’s office; he or she may contact us to discuss the possibility of postponing your procedure.

You will need to remove contact lenses before your procedure – as well as all jewelry and dental appliances. It’s also best to avoid wearing lipstick and eye makeup on the day of your procedure.

Avoid smoking for 24-48 hours prior to your procedure. There are many reasons to quit smoking as soon as possible and prior to your surgery. Your primary care doctor can help with this process and may suggest prescription or over-the-counter therapies.

Patients who use a CPAP or BiPAP device at home should bring the device to the hospital for use after surgery. It’s best to bring the device with you, even if you plan on returning home on the day of your procedure.

Medications should be taken with a small amount of water on the day of your surgery. These may include:

  • Cardiac/heart medications
  • Most blood pressure medications (exceptions)
  • Cholesterol medications
  • Bronchodilators (inhaled medications for the lungs)
  • Acid reflux/heart burn medications
  • Anticonvulsants (anti-seizure medications)
  • Thyroid replacement medications
  • Steroids (Prednisone and others)
  • Parkinson’s Disease medications
  • Oral contraceptive pills
  • Opioids and narcotic medications (only if they do not contain aspirin or ibuprofen)

Medications and supplements to be avoided on the day of surgery:

  • Diuretics (fluid pills such as Lasix or hydrochlorothiazide)
  • Insulin
  • Oral diabetic medications (Metformin)
  • Aspirin
  • Non-steroidal anti-inflammatory drugs (Motrin, Advil, ibuprofen, Mobic, Orudis, and others)
  • Weight reduction medications
  • Vitamins
  • Herbal medications or supplements

It is recommended to avoid the following for at least one week prior to surgery:

  • Garlic
  • Gingko
  • Ginseng
  • Vitamin E
  • Fish oil
  • Alfalfa
  • Chamomile
  • Kava
  • Licorice

The risks and benefits of taking aspirin, coumadin, Plavix, Eliquis and other blood thinners should be discussed with your prescribing physician (typically your primary care physician or cardiologist), your surgeon and your anesthesiologist well in advance of the date of your procedure. A decision on whether or not to continue these medications is best made jointly by the patient and all of the physicians involved.

It is generally accepted that patients should have nothing to eat or drink (referred to as “NPO”) after midnight on the evening prior to surgery. Exceptions to this rule are rare and should be discussed with your anesthesiologist. Infants who are breast feeding may have breast milk until four hours prior to surgery or infant formula until six hours before surgery. Although clear liquids may be allowed closer to the time of surgery, in the even that your surgeon is ahead of schedule, drinking could unnecessarily delay your procedure. It is often a good idea to stay well hydrated on the day prior to your surgery and avoid alcoholic beverages.

For most elective procedures at Saint Mary’s Regional Medical Center, your surgeon may arrange for a preoperative evaluation at the STAR Clinic. Regardless of the location of your procedure, the anesthesiologist responsible for your care will contact you the night before surgery and will discuss what you can expect the day of your surgery. They will also go over any anesthesia-related instructions related to your procedure. You will meet with your anesthesiologist and others from the surgical team on the day of your procedure. Your medical history and the anesthetic plan will be discussed, and you will have the opportunity to ask questions at that time.

During Your Procedure

Throughout your procedure, you will be monitored by your anesthesiologist. Your vital signs are monitored and analyzed until you are fully recovered and leaving the post-anesthesia care unit. Those monitored parameters include heart rate and rhythm, blood pressure, oxygen saturation, breathing patterns, temperature and often brain wave activity.

Being aware or conscious under the effects of anesthesia is one risk of general anesthesia, but with the use of modern pharmacology and monitoring, it is extremely rare. Having some recall of events or circumstances under regional anesthesia or heavy sedation (otherwise known as MAC or monitored anesthesia care) is always possible and should not be considered a failure of these techniques. It is not uncommon for patients to remember “waking up” during previous procedures (such as colonoscopy and wisdom tooth extraction) done under sedation and for a small number of patients, this can be terrifying. Your anesthesiologist will be happy to address any of these concerns and discuss the risks of awareness for your specific anesthetic and surgical procedure.

After Your Procedure

Common complaints after anesthesia include generalized muscle aches, soreness where needles or catheters were inserted, sore throat and drowsiness. Also, there is the risk of an allergic reaction to one of several medications used before surgery, but most reactions are very mild and are diagnosed and treated very quickly. Serious complications, including death, are exceedingly rare.

If you plan on going home following your procedure, you must have a responsible adult drive you and stay with you for the entire evening. You must not drive or operate heavy machinery for 24 hours following anesthesia.

Postoperative cognitive dysfunction (POCD) is primarily a concern for elderly patients. POCD most often involves a subtle decline in memory and the ability to focus. The length of time POCD lasts varies with each individual. Symptoms usually improve over several months without ongoing illness. The actual cause of POCD is still not clearly understood. There may be some benefit in choosing regional anesthesia over general anesthesia for certain operations.

Postoperative nausea and vomiting (PONV) is a common concern for surgical patients. There are many risk factors for PONV that unfortunately cannot be completely avoided, but several modifications in the anesthetic plan can decrease this risk. The use of one or more anti-nausea medications is part of most anesthetic plans, and the careful use of these medications is guided by a range of considerations, including effectiveness, cost and the risk of side effects.